Induction Based Training leads to Highly Significant Improvements of Objective and Subjective Suturing Ability in Junior Doctors

Background: Simulation based training has shown to be of benefit in the education of medical students. However, the impact of induction based clinical simulation on surgical ability of qualified doctors remains unclear. The aim of this study was to establish if a 60 minute teaching session integrated into an Emergency Medicine speciality induction program produces statistically significant improvements in objective and subjective suturing abilities of junior doctors commencing an Emergency Medicine rotation. Methods: The objective suturing abilities of 16 Foundation Year Two doctors were analysed using a validated OSATs scale prior to a novel teaching intervention. The doctors then undertook an intensive hour long workshop receiving one to one feedback before undergoing repeat OSATs assessment. Subjective ability was measured using a 5 point likert scale and self-assessed competency reporting interrupted suturing before and after the intervention. Photographs of wound closure before and after the intervention were recorded for further blinded assessment of impact of intervention. A survey regarding continued ability was repeated at four months following the intervention. The study took place on 7/12/16 during the Belfast Health and Social Care Trust Emergency Medicine induction in the Royal Victoria Hospital Belfast. The hospital is a regional level 1 trauma centre that has annual departmental attendances in excess of 200,000. All new junior doctors commencing the Emergency Medicine rotation were invited to partake in the study. All 16 agreed. The group consisted of a mixture of undergraduate and postgraduate medical doctors who all had 16 months experience working in a variety of medical or surgical jobs previously. Results: Following the teaching intervention objective and subjective abilities in interrupted suturing showed statistically significant improvement (P 0.005). Self-reporting of competency of independently suturing wounds improved from 50% pre intervention to 100% post intervention. At four month follow up responding participants reported continued increase in confidence and independence in interrupted suturing. Conclusion: This study suggests that induction based teaching is a practical and robust means of producing lasting improvement in the subjective and objective suturing abilities of medical staff commencing Emergency Medicine placements. We would suggest that the results are also translatable to doctors starting other surgical rotations and practical induction based teaching should be considered for all new trainees.