Ten-Hour Simulation Training Improved the Suturing Performance of Medical Students

Purpose: We evaluated the effectiveness of an original simulation training system in improving the suturing performance of medical students using a previously developed web application for scoring suturing performance. Methods: Medical students were recruited for this study and trained on vascular graft anastomosis. Prosthetic grafts were anastomosed and evaluated after orientation, and after 1 hr and 10 hr after training. Vascular surgeons were recruited as controls. Using a previously developed web application, suturing performance was evaluated on the basis of procedural time, coefficient of variation of bite (length of a stitch across the graft), coefficient of variation of pitch (interval between stitches), and skewness (symmetry of the angles between stitches). Results: Forty-eight medical students and 10 vascular surgeons were recruited. After 1 hr of training, only the students' procedural time improved. After 10 hr of training, all scores improved compared with those in the first trial, and all students' scores except procedural time were statistically similar to those of the vascular surgeons. Conclusions: Ten-hour training improved all factors, including bite, pitch, skewness, and time. Our simple and inexpensive training system and web application for calculating anastomosis scores can be a useful open educational resource.