TASSL Curricula - Intermediate Open Knot-Tying and Suturing Skills Training Program

 

List of Tasks

  1. Tie at Depth
  2. Suture at Depth
  3. Tie on a Pass
  4. Suture Ligation (Stick Tie)
  5. Ties in Continuity
  6. Atraumatic Tie

Proficiency and Scoring

Like the Basic Open Skills Training Program, the Intermediate Open Skills Training Program is also 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 exercise.

Task Target Time (seconds) Maximum
Time Allotment (seconds)		 Errors Required Proficiency Score
1 Tie at Depth 19 60 Accuracy, gap, slippage, breakage 41 (19 seconds, no errors)
2 Suture at Depth 26 180 Accuracy, gap, slippage, breakage, palming, loading, avulse 154 (26 seconds, no errors)
3 Tie on a Pass 18 120 Accuracy, gap, slippage, breakage 102 (18 seconds, no errors)
4 Suture Ligation (Stick Tie) 25 120 Accuracy, gap, slippage, breakage 95 (25 seconds, no errors)
5 Ties in Continuity 39 180 Gap, cuff, slippage, breakage 141 (39 seconds, no errors)
6 Atraumatic Tie 20 60 Accuracy, gap, slippage, breakage, movement 40 (20 seconds, no errors)

 

ProficiencyScore = MaxTimeAllotment - Time - (10 X Errors)

Scoring Example: If you performed Task 1 in 12 seconds and the knot had a gap (a.k.a. "air knot"), then your proficiency score would be:

ProficiencyScore = 60 - 12 - (10 X 1)
ProficiencyScore = 60 - 12 - 10
ProficiencyScore = 38 (failure to demonstrate proficiency)

Your proficiency score must be greater than the required proficiency score on 2 consecutive trials before moving to the next task in the progression.

Files

Protocol

  1. Trainee completes baseline testing. This consists of one trial of each of the 12 tasks. Scores are recorded on the worksheets provided in the file "Open Intermediate Score Sheets".
  2. Trainee trains to proficiency on each of the 6 tasks. Scores are recorded on the worksheets provided in the file "Open Intermediate Score Sheets".
  3. Trainee completes posttesting. This consists of one trial of each of the 6 tasks. Scores are recorded on the worksheets provided in the file "Open Intermediate Score Sheets".