Aim Several motor learning models have been used to teach highly complex procedural skills in medical education. The aim of this randomized controlled trial was to assess the efficiency of telementoring of open and laparoscopic suturing of medical students compared to conventional in-person teaching and training.

Methods After randomization, 23 medical students were assigned to either the telementoring or the in-person training group. Both groups were taught by surgically trained residence with a student–teacher ratio of 1:1 (teacher–student). Open suturing was assessed in a model of congenital diaphragmatic hernia and laparoscopic suturing in a model of bowel anastomosis. All subjects were trained according to the spaced learning concept for 3 hours. Primary end points were time, knot quality, precision, knot strength, and overall knotting performance/competency. Furthermore, we utilized the Surgery Task Load Index to evaluate the cognitive load of both teaching techniques. Students' subjective progress regarding skill acquisitions and acceptance of telementoring was assessed using a nine-item questionnaire.

Results All 23 trainees significantly improved after training in all knot attributes. More than 90% of all subjects reached proficiency in both groups. In-person training and telementoring were similarly practical, and no significant differences regarding speed, knot quality, precision, knot stability, and procedure performance/competency were found. Students perceived no difference in acquisition of factual or applicational knowledge between the two groups. General acceptance of telementoring was moderate in both groups before training, but increased during training in students actually assigned to this group, in comparison to students assigned to conventional teaching.

Conclusion The current study shows that telementoring of open and laparoscopic suturing is an ideal answer to the current coronavirus disease 2019 pandemic, ensuring continuous training. On-site training and telementoring are similarly effective, leading to substantial improvement in proficiency in intracorporeal suturing and knot tying. Likewise, students' subjective progress regarding skill acquisitions and cognitive load does not differ between teaching methods. Skepticism toward telementoring decreases after exposure to this learning method. Given our results, telementoring should be considered a highly effective and resource-saving educational approach even after the current pandemic.

目标 几种运动学习模型已被用于教授医学教育中高度复杂的程序技能。这项随机对照试验的目的是评估与传统的面对面教学和培训相比，对医学生进行开腹和腹腔镜缝合的远程指导效率。

方法 随机分组后，23 名医学生被分配到远程指导组或面对面培训组。两组均由接受过外科手术训练的住所教授，师生比例为 1:1（教师-学生）。在先天性膈疝模型中评估开放缝合和在肠吻合模型中进行腹腔镜缝合。所有受试者都根据间隔学习概念进行了 3 小时的培训。主要终点是时间、打结质量、精度、打结强度和整体打结性能/能力。此外，我们利用手术任务负荷指数来评估两种教学技术的认知负荷。使用九项问卷评估学生在技能获得和接受远程指导方面的主观进展。

结果 所有23名学员在所有结属性训练后都有显着提高。超过 90% 的所有受试者在两组中都达到了熟练程度。面对面培训和远程指导同样实用，在速度、结质量、精度、结稳定性和程序性能/能力方面没有发现显着差异。学生认为两组之间在获取事实或应用知识方面没有差异。与分配到传统教学的学生相比，两组在培训前对远程辅导的普遍接受程度均适中，但在实际分配到该组的学生的培训期间有所增加。

结论 目前的研究表明，开放式和腹腔镜缝合的远程指导是应对当前 2019 年冠状病毒病大流行的理想答案，可确保持续培训。现场培训和远程指导同样有效，显着提高了体内缝合和打结的熟练程度。同样，学生在技能获得和认知负荷方面的主观进步在教学方法之间也没有差异。接触这种学习方法后，对远程指导的怀疑就会减少。鉴于我们的结果，即使在当前的大流行之后，远程辅导也应被视为一种高效且节省资源的教育方法。