Halsted’s “See One, Do One, and Teach One” versus Peyton’s Four-Step Approach: A Randomized Trial for Training of Laparoscopic Suturing and Knot Tying

• DOI: 10.1016/j.jsurg.2017.07.025
• Publication Date: 2017-08-09T01:01:14Z
• Authors: Philipp Romero; Patrick Günther; Karl-Friedrich Ko...; Mirco Friedrich; Mona W. Schmidt; Sarah M. Trent; Javier R. De La G...; Beat P. Müller-Stich; Felix Nickel
• Keywords: Male; Students, Medical; Suture Techniques; 03 medical and health sciences; 0302 clinical medicine; Germany; Humans; Female; Laparoscopy; Clinical Competence; Educational Measurement; Simulation Training; Education, Medical, Undergraduate

This study aimed to compare the effectiveness of Halsted's method "see one, do one, and teach one" with Peyton's Four-Step Approach for teaching intracorporal suturing and knot tying (ICKT).Laparoscopically naïve medical students (n = 60) were randomized to teaching of ICKT with either Halsted's (n = 30) or Peyton's method (n = 30) for 60 minutes. Each student's first 3 and final sutures were evaluated using Objective Structured Assessment of Technical Skills (OSATS), procedural implementation, knot quality, total time, and suture placement accuracy.Performance score and OSATS-PSC always differed significantly in favor of Peyton's group (p = 0.001). OSATS-GRS (p = 0.01) and task time (p = 0.03) differed only in the summary of the first 3 sutures in favor of Peyton's group. There were no significant intergroup differences in knot quality and accuracy.Peyton's Four-Step Approach is the preferable method for learning complex laparoscopic skills like ICKT.