IDEA Series: DIY Suture Kit Station

laceration suture repair closure

In medical training there is a lack of simulation based activities including procedural labs. Suturing is a critical skill for trainees to master in the emergency department. However, supervised practice is needed prior to suturing a real patient for the first time. This innovation allows early trainees to master suturing while on shift, using easy to find materials, which increases procedural competency and confidence. This activity allows the teacher to assess and correct the trainees procedural skills prior to attempting to suture a real patient.

Name of innovation

  • This Do-It-Yourself Suture Kit Station incorporates easy to find materials available in every emergency department, allowing early trainees to master suturing prior to suturing real patients.

Learners targeted

  • Medical students and early trainees who need suture practice

General group size

  • One-on-one student training is ideal, but can have multiple students who can practice using multiple suturing stations
  • If teacher unable to instruct while on shift, trainees can be shown a suture training video and practice alongside the video

DIY suture training kit for laceration repair

Materials needed

  • Blue chuck pad
  • Paper/cloth tape
  • Scalpel
  • Suture material
  • Suture kit

More detailed description of the activity and how it was run

  • Make the DIY Suture Kit Station (see above video):
    • Place a thick chuck pad on a flat sturdy surface.
    • Apply cloth tape to the entire surface of the chuck, and tape over the chuck. This is now the suturing pad.
    • Use a scalpel to make an incision to the pad.
    • Use the back blunt end of the scalpel to ‘fluff’ up incision edges to make laceration.
  • Use a laceration repair kit and suture to close the laceration.
  • Instruct the trainee on proper suturing technique on the suture station (or show a suture training video)
  • Have the trainee continue practicing until adequate comfort and proficiency level is achieved
  • Suture real patient!

Lessons learned, especially with regard to increasing resident and program buy in

  • Procedural skills require much repetition to gain proficiency. This is best done with video tutorials, supervision, and deliberate practice.
  • Practicing in a simulated environment greatly improves skill and confidence in real clinical practice.

Educational theory behind the innovation including specifics/styles of teaching involved

  • Simulation practice increases procedural competency.
  • Practicing on shift allows trainees to reach the number of repetitions required to gain mastery in suturing, Routt [1] showed that the number of repetitions required to gain proficiency was 41 times.
  • Competency in suturing is required even when cases are low. Wongkietachorn et al. demonstrated that tutoring suturing improves the trainees’ skillset. A practice suture kit helps improve retention for real-life scenarios [2].

Pearls

  • This DIY suture pad station technique is easily available and inexpensive.
  • To improve suturing techniques and enhance skill retention, medical students and early trainees need to learn with guided supervision on simulated task trainers.

 

References

  1. Routt E, Mansouri Y, de Moll EH, Bernstein DM, Bernardo SG, Levitt J. Teaching the Simple Suture to Medical Students for Long-term Retention of Skill. JAMA Dermatol. 2015 Jul;151(7):761-5. doi: 10.1001/jamadermatol.2015.118. PMID: 25785695.
  2. Wongkietkachorn A, Rhunsiri P, Boonyawong P, Lawanprasert A, Tantiphlachiva K. Tutoring Trainees to Suture: An Alternative Method for Learning How to Suture and a Way to Compensate for a Lack of Suturing Cases. J Surg Educ. 2016 May-Jun;73(3):524-8. doi: 10.1016/j.jsurg.2015.12.004. Epub 2016 Feb 20. PMID: 26907573.
By |2021-10-08T10:19:05-07:00Oct 15, 2021|IDEA series, Trauma|

Stanford’s INFODEMIC Conference on COVID-19 Misinformation: Open-access podcasts

In July 2021, Dr. Vivek Murthy became the first U.S. Surgeon General to declare health misinformation a public health crisis. Specifically, COVID-19 vaccine misinformation and disinformation on social media greatly affects vaccination rates in certain populations. Rapid increases in reliable health information about COVID-19 can be overshadowed by the spread of even greater amounts of misinformation, leading to an ‘infodemic.’

The World Health Organization defines an infodemic as:

“… too much information including false or misleading information in digital and physical environments during a disease outbreak. It causes confusion and risk-taking behaviours that can harm health. It also leads to mistrust in health authorities and undermines the public health response. An infodemic can intensify or lengthen outbreaks when people are unsure about what they need to do to protect their health and the health of people around them.”

INFODEMIC Conference on Social Media and COVID-19 Misinformation

On August 26, 2021, Stanford University’s Department of Emergency Medicine and Ethics, Society, and Technology Hub co-sponsored a unique conference to address this issue, “INFODEMIC: A Stanford Conference on Social Media and COVID-19 Misinformation.” Speakers presented virtually from around the world including experts in social media, health policy, ethics, and medicine. The conference focused on the causes of COVID-19 misinformation and mitigation strategies. Vaccine Confidence, Vaccine Hesitancy, and Vaccine Equity were among the main topics of the meeting. INFODEMIC also featured representatives from Facebook, Google, and Twitter, as well as physician influencers, to discuss the role of social media companies to address misinformation online.

Below are recordings of each of the INFODEMIC conference presentations, presented as podcasts. Video recordings of these presentations are also available to view online. The conference agenda and featured speakers are listed on the Stanford INFODEMIC website.

Podcasts

By |2021-10-06T19:40:30-07:00Oct 8, 2021|Academic, COVID19|

Peering into Peer Review: How can you participate in peer review?

As part of the ALiEM Faculty Incubator Program, Dr. Anthony Artino, Deputy Editor of the Journal of Graduate Medical Education (JGME) and Assistant Editor for Academic Medicine participated in a Google Hangout with Drs. Antonia Quinn and Teresa Chan where he provided expert insights into the peer review process. His advice and best practices are summarized below. In this interview, the discussion provides an insider perspective to the peer review process and peer reviewer development. This post is the first half of a longer interview with Dr. Artino with the second half discussing addressing peer review comments.

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EM Match Advice: Promoting Diversity and Inclusion in Training

Under-represented minorities (URM) in medicine continues to be a problem that many programs, especially in emergency medicine, are addressing head on with intentional, proactive strategies. Diversity matters. This EM Match Advice episode discusses how 3 different residency programs are championing for better representation through a variety of strategies.

Podcast Episode

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Expert Panelists

  • Dr. Joseph Moll (Virginia Commonwealth)
  • Dr. Tyson Pillow (Baylor)
  • Dr. Bonnie Kaplan (Denver Health)

Listen to all the episodes of the EM Match Advice Series

Additional Reading

  1. Academy of Diversity and Inclusivity in Emergency Medicine (ADIEM)
  2. AAMC: 2018-19 Applicants and Matriculation Data
  3. CORD: The Underrepresented Applicant Emergency Medicine Applying Guide
  4. NRMP: Main Residency Match Data and Reports
  5. Tunson J, Boatright D, Oberfoell S, et al. Increasing Resident Diversity in an Emergency Medicine Residency Program: A Pilot Intervention With Three Principal Strategies. Acad Med. 2016 Jul;91(7):958-61. Pubmed
By |2021-07-01T10:16:03-07:00Mar 1, 2019|EM Match Advice, Podcasts|

Perspectives on Program Evaluation: Interview with Drs. Megan Boysen-Osborn, Dara Kass, and Andrew King

As part of the ALiEM Faculty Incubator Professional Development Program, Drs. Megan Boysen-Osborn (Program Director at University of California-Irvine), Dara Kass (Editor-in-Chief FeminEM), and Andrew King (Assistant Program Director at The Ohio State University Wexner Medical Center) participated in a Google Hangout where they provided perspectives and expert advice on program evaluation. Their perspectives and wisdom are summarized below.

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EM Match Advice: Detroit Residency Programs

The EM Match Advice Series is back with another regional episode. This time, our team pulls the curtain back on the EM programs in Detroit, where residents learn to master EM while experiencing the city’s exciting rebirth. Outstanding clinical opportunities and collaboration with other programs in the area are just 2 of the many reasons to explore these residency programs. Co-hosted by Drs. Michael Gisondi (Stanford) and Michelle Lin (UCSF), watch the video or listen to the podcast to learn more about each one!
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By |2021-07-01T10:25:21-07:00Dec 5, 2017|EM Match Advice, Podcasts|
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