A low cost silicone mandibular model for suturing skills training among undergraduate medical students: development...

Simulation based suturing training allows novice learners to practise technical skills before clinical application. Conventional flat suturing pads are useful for early repetitive practice but provide limited anatomical context. This study aimed to develop an affordable silicone mandibular model for suturing skills training among undergraduate medical students and to compare students' perceptions of this model with those of a conventional flat silicone suturing pad.

A dry human mandible from an anatomy education inventory was scanned using a three dimensional scanner. The digital model was modified in Blender and a two component negative mould was designed and printed. A platinum based RTV-2 silicone was used to produce the mandibular suturing model. Third year undergraduate medical students practised simple interrupted sutures on both the mandibular model, labelled as Model A and a conventional flat suturing pad, labelled as Model B. Participants evaluated both models using the same anonymous structured questionnaire. Likert scale responses were compared using the Wilcoxon signed rank test. Internal consistency was assessed using Cronbach's alpha. Holm correction was applied across the 17 item level comparisons.

A total of 107 students completed the questionnaire. The mean age was 21.85 ± 1.39 years; 52 participants were female and 55 were male. Cronbach's alpha was 0.982 for Model A and 0.983 for Model B. The total questionnaire score was slightly higher for Model B than for Model A, but the difference was not statistically significant (median 69 [63-79] vs. 74 [63-83], p = 0.060). Unadjusted item level comparisons showed higher ratings for the flat pad in four domains. After Holm correction for 17 item level comparisons, only realistic needle passage remained statistically significant in favour of the flat pad (Holm adjusted p = 0.014). No item showed a statistically significant advantage in favour of the mandibular model. The estimated material cost of each mandibular model was approximately 2 USD, excluding the reusable upper mould.

The silicone mandibular model did not demonstrate superiority over the conventional flat silicone suturing pad in students' evaluations. After correction for multiple comparisons, only realistic needle passage was rated significantly higher for the flat pad. However, the mandibular model was affordable, reproducible and openly shareable and received learner ratings of similar magnitude for anatomical realism, spatial awareness, difficult access practice, durability and overall satisfaction. These perception based findings suggest that the model may have potential as a complementary tool for anatomically contextualized suturing practice rather than as a replacement for conventional flat pads. Future studies using objective performance measures are needed to evaluate its effect on suturing competence and skill transfer.