Effects of a retention interval and refresher session on intracorporeal suturing and knot tying skill and mental workload

Surgery. 2017 May;161(5):1209-1214. doi: 10.1016/j.surg.2016.11.011. Epub 2016 Dec 20.


Background: The effects of refraining from practice for different intervals on laparoscopic suturing and mental workload was assessed with a secondary task developed by the authors. We expected the inability to practice to produce a decrease in performance on the suturing, knot tying, and secondary task and skills to rebound after a single refresher session.

Methods: In total, 22 surgical assistant and premedical students trained to Fundamentals of Laparoscopic Surgery proficiency in intracorporeal suturing and knot tying were assessed on that task using a secondary task. Participants refrained from practicing any Fundamentals of Laparoscopic Surgery tasks for 1 or 5 months. At the time of their return, they were assessed immediately on suturing and knot tying with the secondary task, practiced suturing and knot tying for 40 minutes, and then were reassessed.

Results: The mean suture times from the initial reassessment were greater than the proficiency times but returned to proficiency levels after one practice session, F(2, 40) = 14.5, P < .001, partial η2 = .420. Secondary task scores mirrored the results of suturing time, F(2, 40) = 6.128, P < .005, partial η2 = .235, and were moderated by retention interval.

Conclusion: When participants who reached proficiency in suturing and knot tying were reassessed after either 1or 5 months without practice, their performance times increased by 35% and secondary task scores decreased by 30%. These deficits, however, were nearly reversed after a single refresher session.

MeSH terms

  • Adult
  • Clinical Competence
  • Curriculum*
  • Female
  • Humans
  • Laparoscopy / education*
  • Male
  • Retention, Psychology*
  • Suture Techniques / education*
  • Time Factors
  • Workload
  • Young Adult