Basic Technical Skills Curriculum
Authors: Andrew Wright MD, Aaron Jenson MD, Sarah Kim PhD, Karen Horvath MD
We have developed a basic technical skill curriculum designed for interns in surgical and procedural specialties. It covers instrument handling, sutures and knot tying, wound closure, and hemostasis techniques. This curriculum has been well validated and has now been adopted nationally and internationally. Completion of this self-guided curriculum has been shown in several research studies to significantly accelerate technical skill acquisition.
A few notes:
- Perfect practice makes perfect
- Focus on accuracy at first. Speed will come later after the basics are mastered. If you focus on speed too early, it is easy to learn bad habits which are difficult to break later on.
- The goal is to practice until the movement become automatic, so that you can perform the task without thinking of the individual steps.
- The best way to reach this automatic state is to ingrain the movements in your motor memory by repetition over multiple sessions. Learning works best when you come back over and over again to practice over multiple shorter sessions (“distributed practice”) instead of one long session. This helps ingrain the skills in your long-term motor memory.
In order to guide your skill practice we have developed two sets of assessments. One is a self-assessment, that is designed for it to be easy for a novice learner to evaluate their own skills using simple metrics. The other is a more nuanced “expert assessment” that breaks each skill down into its component parts and allows for evaluation of the task performance beyond just time and accuracy. You can and should look at and use both sets of assessment tools as you practice.
Self Assessment:
open_technical_skills_self_assessment_test
Expert Assessment:
open_technical_skills_expert_assessment_test
Modules:
Instrument Handling
Knot Tying
- Two-handed Tie
- One-handed Tie
- Instrument Tie: (this skill is easiest to perform when suturing, and therefore is included in the simple interrupted wound closure page)
Wound Closure
- Simple Interrupted and Running Closure
- Subcuticular Interrupted and Running Closure
- Mattress and Purse String Sutures
Hemostasis
References:
Laboratory-Based Instruction for Skin Closure and Bowel Anastomosis for Surgical Residents
Acquiring basic surgical skills: Is a faculty mentor really needed?
Validation of novel self- and expert-administered assessment tools for basic open technical skills