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P456: ESTABLISHING AN ASYNCHRONOUS SUTURING CURRICULUM FOR MEDICAL STUDENTS: A PILOT STUDY
Alankrita Raghavan, MD; Kennedy Carpenter; Caroline Folz, MD; Katherine McDaniel, PhD; Patrick Codd; Duke University

Suturing is a foundational skill for medical students and is recognized by the Association of American Medical Colleges as an essential competency to be mastered before graduation. Despite this, many medical schools lack longitudinal, structured opportunities to develop suturing skills with guided feedback. In a survey conducted at our institution, students reported that 88% did not have access to ongoing suturing training, and only one student indicated receiving adequate feedback on their suturing technique (Figure 1). 94% of surveyed students believed a longitudinal suturing curriculum would be very useful or extremely useful in their education. These findings highlight a critical training gap and a clear demand for structured opportunities to learn and refine basic surgical skills. 

We established a longitudinal suturing curriculum for medical students, building on an existing pilot program designed for neurosurgical residents (Figure 2). 22 medical students signed up to participate in the curriculum. The program focuses on mastering essential suturing techniques, including surgical knot tying and skin closures, in a graduated manner (Table 1). The program began with a one-hour in-person education session led by resident mentors. Students completed a pre-test that includes a subjective assessment of their confidence with completing certain suturing tasks and an objective timed assessment of (1) a 7 cm incision closure using a running baseball stitch with hand-tying and (2) a 7 cm simple interrupted closure with instrument tying. Students then practice independently and will complete six tasks with an optional seventh task over the course of six months (Table 1). Learners are asked to record two-minute videos of their work, which are submitted for asynchronous review by their resident mentors. At the conclusion of the program, students will repeat the objective and subjective assessments.

This pilot curriculum is designed with sustainability in mind, with voluntary enrollment and an asynchronous format to allow flexible participation. The pairing of medical students with resident mentors provides learners with role models while cultivating teaching skills in residents. The longitudinal structure of the curriculum ensures that students receive repeated practice opportunities and individualized feedback across multiple sessions. This program represents a structured, longitudinal, video-based suturing curriculum for medical students. By combining deliberate practice with asynchronous video feedback, we aim to bridge a gap in early surgical training and better prepare students for clinical clerkships and beyond. If successful, this curriculum can serve as a model for other medical schools seeking to provide scalable, sustainable opportunities for technical skill acquisition outside of the operating room.

Figure 1

Figure 2

Table 1.

Month	Task
1	Two-Handed Knot-Tying
2	One-Handed Knot-Tying
3	Simple Interrupted Stitch with Instrument Tie
4	Continuous Closure
5	Vertical Mattress
6	Horizontal Mattress
Optional	Subcuticular Closure

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