Guided Education and the Fundamentals of Arthroscopy Surgery Training (FAST) Workstation Improve Surgical Resident Knot-tying Skills

Purpose

To evaluate the influence of guided education on the mechanical resilience of knots tied by surgical residents using the Fundamentals of Arthroscopy Surgery Training (FAST) workstation as a quantitative tool.

Methods

Surgical residents in postgraduate year (PGY) 1 through 5 were asked to tie knots first in a pre-education phase. Next, residents were provided an instructional video demonstrating high-level knot-tying instructed by a fellowship-trained shoulder and elbow surgeon. After the video demonstration, residents were asked to tie knots again in a posteducation phase. Using the FAST workstation, the mechanical resilience of each knot was quantified by suture loop elongation. The McNemar test was used for statistical analysis.

Results

Forty-one surgical residents were enrolled into this investigation. Among all participants, there was significantly greater knot-tying success in the posteducation phase after review of the instructional video as compared with the pre-education phase (P < .001). Subgroup analysis was conducted for each PGY level (1-5), and significant findings of greater knot-tying success in the posteducation phase was notable for the PGY-1 and PGY-2 residents (P < .001 and P = .002, respectively).

Conclusions

Guided education with the use of an instructional video and a FAST workstation significantly enhances the mechanical resilience of surgical resident knots, particularly for those in their early PGYs. However, the permanency of this improvement is unknown.

Clinical Relevance

It is important to evaluate tools that can improve surgical education. Information from this study can be used by residency programs to ensure the proficiency of their trainees.