Communication delay increases procedure time and instructor task load during simulated suturing by novices

Communication delay during remote instruction of simple interrupted suturing was evaluated by randomizing participants to near real-time or 4-second delayed communication conditions. The delay group required more time to complete five sutures, with diminishing effect by the fifth suture. Instructor-reported cognitive workload was higher under delayed conditions, but suturing quality did not differ between groups. These findings suggest remote guidance is operationally feasible for non-medically trained individuals performing uncomplicated interventions.