Taking advantage of asynchronous digital feedback: development of an at-home basic suture skills training program for undergraduate medical students that facilitates skills retention

PURPOSE: To date, there are no training programs for basic suturing that allow remote deliberate practice. This study seeks to evaluate the effectiveness of a basic suture skills training program and its 6-month skill retention applying unsupervised practice and remote digital feedback. METHODS: Fourth-year medical-student trainees reviewed instructional videos from a digital platform and performed unsupervised practice as needed at their homes. When they felt competent, trainees uploaded a video of themselves practicing the skill. In < 72 h, they received expert asynchronous digital feedback. The course had two theoretical stages and five video-based assessments, where trainees performed different suturing exercises. For the assessment, a global (GRS) and specific rating scale (SRS) were used, with a passing score of 20 points (max:25) and 15 (max:20), respectively. Results were compared to previously published work with in-person expert feedback (EF) and video-guided learning without feedback (VGL). A subgroup of trainees underwent a 6-month skills retention assessment. RESULTS: Two-hundred and forty-three trainees underwent the course between March and December 2021. A median GRS of 24 points was achieved in the final assessment, showing significantly higher scores (p < 0.001) than EF and VGL (20.5 and 15.5, respectively). Thirty-seven trainees underwent a 6-month skills retention assessment, improving in GRS (23.38 vs 24.03, p value = 0.06) and SRS (18.59 vs 19, p value = 0.07). CONCLUSION: It is feasible to teach basic suture skills to undergraduate medical students using an unsupervised training course with remote and asynchronous feedback through a digital platform. This methodology allows continuous training with the repetition of quality practice, personalized feedback, and skills retention at 6 months.