BACKGROUND Suturing is a fundamental skill in undergraduate medical education. It can be taught by faculty-led, peer tutor-led, and holography-augmented methods; however, the most educationally effective and cost-efficient method for proficiency-based teaching of suturing is yet to be determined. METHODS We conducted a randomized controlled trial comparing faculty-led, peer tutor-led, and holography-augmented proficiency-based suturing training in pre-clerkship medical students. Holography-augmented training provided holographic, voice-controlled instructional material. Technical skill was assessed using hand motion analysis every ten sutures and used to construct learning curves. Proficiency was defined by one standard deviation within average faculty surgeon performance. Intervention arms were compared using one-way ANOVA of the number of sutures placed, full-length sutures used, time to proficiency, and incremental costs incurred. Surveys were used to evaluate participant preferences. RESULTS Forty-four students were randomized to the faculty-led (n = 16), peer tutor-led (n = 14), and holography-augmented (n = 14) intervention arms. At proficiency, there were no differences between groups in the number of sutures placed, full-length sutures used, and time to achieve proficiency. The incremental costs of the holography-augmented method were greater than faculty-led and peer tutor-led instruction ($247.00 ± $12.05, p < 0.001) due to the high cost of the equipment. Faculty-led teaching was the most preferred method (78.0%), while holography-augmented was the least preferred (0%). 90.6% of students reported high confidence in performing simple interrupted sutures, which did not differ between intervention arms (faculty-led 100.0%, peer tutor-led 90.0%, holography-augmented 83.3%, p = 0.409). 93.8% of students felt the program should be offered in the future. CONCLUSION Faculty-led and peer tutor-led instructional methods of proficiency-based suturing teaching were superior to holography-augmented method with respect to costs and participants' preferences despite being educationally equivalent.

中文翻译：

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在基于熟练程度的医学生缝合技能培训中优化资源利用：教师主导、同伴导师主导和全息增强教学方法的随机对照试验。

背景技术缝合是本科医学教育中的一项基本技能。它可以通过教师主导、同伴导师主导和全息增强的方法来教授；然而，尚未确定以熟练度为基础的缝合教学最具教育效果和成本效益的方法。方法 我们进行了一项随机对照试验，比较了由教师主导、同伴导师主导和全息增强的基于熟练度的缝合培训对实习前医学生的缝合培训。全息增强培训提供了全息、语音控制的教学材料。每十次缝合使用手部运动分析评估技术技能，并用于构建学习曲线。熟练程度由平均教员外科医生表现中的一个标准偏差定义。干预组使用单因素方差分析对放置的缝合线数量、使用的全长缝合线、熟练掌握时间和发生的增量成本进行比较。调查被用来评估参与者的偏好。结果 44 名学生被随机分配到教师主导 (n = 16)、同伴导师主导 (n = 14) 和全息增强 (n = 14) 干预组。在熟练程度方面，各组之间在缝合的数量、使用的全长缝合线和达到熟练程度的时间方面没有差异。由于设备成本高，全息增强方法的增量成本高于教师主导和同伴导师主导的教学（247.00 ± 12.05 美元，p < 0.001）。教师主导的教学是最受欢迎的方法（78.0%），而全息增强教学是最不受欢迎的方法（0%）。90. 6% 的学生表示对进行简单的间断缝合具有很高的信心，这在干预组之间没有差异（教师领导的 100.0%，同伴导师领导的 90.0%，全息增强的 83.3%，p = 0.409）。93.8% 的学生认为该项目应该在未来提供。结论 教师主导和同伴导师主导的基于熟练度缝合教学的教学方法在成本和参与者偏好方面优于全息增强方法，尽管在教育上是相同的。