Bridging the Skills Gap: The Role of Near-Peer Teaching in Medical Student Suturing Training

This study evaluated a series of 4 weekly, two-hour suture clinics taught using near-peer instruction by trained second year medical students for peer participants at the University of Louisville School of Medicine using a repeated cross sectional mixed-methods study design.

Seven second year medical student instructors were trained and supervised in providing basic technical skills in suturing by a surgical faculty member (Dr Kasdan). Participants in the suture clinic consisted of 48 second year medical student peers who completed a pre- and post-clinic survey evaluating their interest in surgery, as well as their self-efficacy and confidence in performing basic suture skills. Paired-sample t-tests examined self-perceived changes in participants' skills, confidence, and interest from pre- to post-clinic sessions.

Quantitatively, student participants showed strong improvement in their knowledge of using the needle driver and suture correctly as well as an understanding of when to use a hand tie versus an instrument tie. In addition, confidence in surgical handwashing, gowning, and gloving improved significantly. Knot tying also showed significant improvements, with the most striking improvements in the ability to perform "Fast-Passes" without excessive movement and "Cross-Passes." The ability to take symmetrical bites on the suturing block also showed considerable improvement, as well as the ability to perform a simple interrupted knot. Overall, participants' interest in surgery increased significantly following the suture clinic experience. Qualitatively, student participant responses were analyzed in response to a prompt regarding the impact of the suture clinic experience on student interest in surgery, self-efficacy, and confidence. Thematic analysis highlighted students' lack of experience, safety, and proficiency of technique.

In sum, the results of this study support the use of near peer teaching in enhancing self-reported student confidence and performance regarding basic surgical skills in advance of clerkship training.