Evaluation of technical skills in sutures in medical students in the post-COVID era

Abstract

Introduction: The COVID-19 pandemic has negatively impacted undergraduate medical training. Several studies have evaluated the surgical skills of medical students. However, most of these studies are qualitative. An objective assessment of skills for subsequent intervention at specific mistake would improve the skill development process. Aim: The main objective of this study is to objectively assess the surgical skills of undergraduate medical students in basic suturing techniques using the validated OSATS scale to establish the level of competence and subsequently plan learning strategies focused on areas of deficiency. Methodology: A hybrid, qualitative and quantitative, cross-sectional, observational, descriptive, non-analytical study was conducted at a university center in Ecuador. The OSATS scale was administered in a simulation center by a surgical expert with training in education. Inclusion criteria: undergraduate medical students currently enrolled in surgery and who had received practical workshops in general surgery; exclusion criteria: students who had previously completed general surgery. The OSATS scale applied consists of 9 items with scores from 1 to 5, categorized as deficient, intermediate, and advanced. Descriptive statistics were used to report the findings.

Results and Discussion: A total of 27 eighth-semester undergraduate students were evaluated. The mean age of participants was 21 years, 85% of whom were male. A score <3 was defined as poor, 3-4 as medium, and ≥5 as excellent. The suture techniques evaluated were single stitch, inverted single stitch, vertical mattress stitch, horizontal mattress stitch, and intradermal suture. Participants showed deficient skills in all the techniques evaluated. This assessment is considered, according to current educational models, as a starting point for an educational intervention focused on the deficient areas based on the qualitative component according to the areas identified by the evaluator. In a second phase, strategies to improve skills will be planned and implemented for a subsequent re-evaluation of the methodology. Conclusion: Surgical skills assessed in the participants were deficient in the suturing techniques evaluated. This constitutes a starting point for developing training strategies.