External validation and evaluation of an intermediate proficiency-based knot-tying and suturing curriculum

Pedro Pablo Gomez, Ross E. Willis, Breanne L. Schiffer, Aimee K. Gardner, Daniel J. Scott

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Purpose The purpose of this study was to perform external validation, examine educational effectiveness, and confirm construct validity of a previously developed "intermediate-level, proficiency-based knot-tying and suturing curriculum" in preparing residents to achieve proficiency in more advanced open surgical techniques.

Methods A total of 47 postgraduate year-1 (PGY-1) surgery residents completed 6 intermediate-level knot-tying and suturing exercises. Baseline trainee performance was compared with intermediate and senior (PGY-3 and PGY-4) residents (n = 12) and expert faculty (n = 4).

Results PGY-1 overall proficiency increased from 21.1% at baseline to 92.1% during posttest for all 6 exercises combined (p < 0.001). When compared with the PGY-3 and PGY-4 residents, at baseline intermediate and senior residents scored higher on half of the exercises. However, during posttesting PGY-1 residents not only matched, but also surpassed PGY-3 and PGY-4 residents' performance in 3 of 6 exercises. Significant differences on all 6 exercises were also found during pretesting when comparing interns against faculty, demonstrating construct validity. However, upon completion of the curriculum, PGY-1 residents' posttest scores were equivalent, if not significantly better than expert faculty performance.

Conclusion We obtained similar results as those previously reported, showing external validation. Additionally, we demonstrated that first-year surgical residents could achieve performance levels that match or exceed those of senior residents and experienced surgeons on these exercises with 4 weeks of training.

Original languageEnglish (US)
Pages (from-to)839-845
Number of pages7
JournalJournal of Surgical Education
Issue number6
StatePublished - Nov 1 2014


  • curriculum development and implementation
  • open knot-tying and suturing skills
  • proficiency-based skills training
  • simulation-basedsurgical training

ASJC Scopus subject areas

  • Education
  • Surgery


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