Video self-assessment of basic suturing and knot tying skills by novice trainees

Background: Self-assessment is important to learning but few studies have utilized video self-assessment of basic surgical skills. We compared a video self-assessment of suturing and knot tying skills by novice trainees to the assessment by a senior attending surgeon. Methods: Sixteen senior medical students and 7 beginner surgical interns were video-recorded while performing five suturing and knot tying tasks. All videos were analyzed using an objective structured assessment of technical skills (OSATS) metrics (1-5 scale; 1 = novice, 5 = expert). Video self-assessment was carried out within 4 weeks of an instructional session and subsequently by one senior surgery instructor (blinded to the individual). Both a Global score and total combined OSATS scores were analyzed. Total possible OSATS scores were: interrupted suture - 30, subcuticular closure - 30, one and two-handed knot tying - 25 each, tying in a restricted space 20; maximum combined score - 130 points). Confidence levels in performing the tasks pre-test and the value of video self-assessment were rated on a 1-5 Likert scale (1 = low and 5 = high). Data are mean±SD and statistical significance was evaluated using Friedman's test. Results: Self-assessment scoring was significantly higher than the assessment by a senior instructor for three tasks by global score and all five tasks by combined OSATS score (self-assessment 71.8±16.7 vs attending assessment 56.7±11.0, p = 0.007). Mean self-assessment Global scores ranged from 2.5 to 2.8 for all tasks performed compared to 1.8-2.3 for attending surgeon assessment (p<0.05). Confidence levels demonstrated no correlation to performance speed or proficiency. The video self-assessment was rated as a highly valuable (mean 4.3±0.8) component to skills training. Conclusions: Novice trainees over-estimate their basic technical skills performance compared to the assessment by a senior surgeon. Video self-assessment may be a valuable addition to a pre-residency and surgical internship preparatory curriculum in basic suturing and knot tying.