TASSL Curricula - Needle Manipulation Training Program

 

List of Tasks

  1. Regular Needle Driver
  2. Castroviejo Needle Driver
  3. Castroviejo Needle Driver, Wearing Loupes

Overview
The Needle Manipulation Training Program is a series of 3 exercises. The exercises are designed to help students and residents gain proficiency with grasping the needle in the proper location/orientation, loading the needle in the field, estimating needle travel, suturing forehand, suturing backhand, and suturing at odd angles. The exercises are completed with regular and Castroviejo needle drivers.

Apparatus
The suturing model can be viewed in the image and videos linked below. The model is created by printing the concentric circle pattern on and then ironing on to fabric (Bull Denim 9 oz.). This fabric is then placed in a square embroidery hoop. This particular embroidery hoop allows for tension adjustment which keeps the fabric taught. The embroidery hoop can be placed in a holder to keep it steady while the resident is working on it. In the image below, the holder is made of 2x4 and metal clamps, bolts, and wing nuts. Any number of materials and constructions can be used, but the idea is that the embroidery hoop is held steady.

Proficiency and Scoring The Needle Manipulation Training Program is based on the concept of proficiency-based training, which recognizes the fact that learners progress at different rates. As such, individuals train to a mastery goal, rather than for a specified period of time. That is, learning time is allowed to vary among learners, but achievement is not. Learners are allowed to practice each skill as many times as necessary to achieve the designated mastery criterion listed below. The table below indicates the mastery criteria designated for each task.

Task Target Time (seconds) Errors
1 Regular Needle Driver, 26mm needle, no loupes 120 Locking, Breakage, Loading with Fingers, Missed Targets
2 Castroviejo Needle Driver, 13mm needle, no loupes 130 Locking, Breakage, Loading with Fingers, Missed Targets
3 Castroviejo Needle Driver, 13mm needle, wearing loupes 180 Locking, Breakage, Loading with Fingers, Missed Targets

 

Proficieny is achieved by completing the exercise in the allotted time with no errors on 2 consecutive trials before moving to the next task in the progression.

Files

Reference
Admire JR, Pounds LL, Adams AJ, Gomez PP, Willis RE. Development and construct validity of a low-fidelity training platform for driving large and small suture needles. J Surg Educ. 2015 May-Jun;72(3):387-93. doi: 10.1016/j.jsurg.2014.10.009. Epub 2014 Nov 15. PMID: 25456157.