An Educational Evaluation of Thiel Cadavers as a Model for Teaching Suturing Skills to Dental Students during the COVID-19 Pandemic
Abstract
:1. Introduction
2. Materials and Methods
2.1. Part 1: Questionnaire Survey
2.2. Part 2: Focus Group
2.3. Part 3: Staff Reflective Accounts
2.4. Statistics
3. Results
3.1. Part 1: Student Questionnaire
Strengths“The slow step by step demonstration was very useful, followed by the faster full run through.”“The techniques were explained well, and the movie was easy to follow. It was good to have an idea of what we were doing before we entered the DR.”“The methods shown in the movie is a lot easier to understand as you can see the looping of the sutures rather than picturing it in your head with no real visual.”Weaknesses“I found the tying of the knots difficult to understand from the video but it made more sense in the practical session in the DR.”“The video was very good as a starter. But perhaps more footage from the perspective of the surgeon, so you can appreciate the hand movements better.”
“I feel that this session was really useful to me, and I have become more confident with suturing now. I would keep refreshing my mind with the video, so I won’t forget this technique in the longer term.”“The video beforehand was ideal and then the small groups and 1:1 tutorial session with the clinicians was great. I felt comfortable asking questions and the demo given was very relaxed and overall, it was an enjoyable learning experience.”“I tried several locations intraorally. This has given me a better understanding of orientation of instruments and being aware of local anatomy.”
3.2. Part 2: Focus Group
- Supportive materials;
- Thiel cadavers as a teaching model;
- The learning and teaching environment;
- Impact of COVID-19 on teaching;
- Potential improvements to teaching;
- Confidence.
3.2.1. Supportive Materials
Student 1: “Yeah, I agree. I think the video was good because you could actually see exactly what we were going to be doing in the cadavers. So it kind of meant that the time in the cadavers wasn’t like wasted.”Student 3: “I found it quite helpful and it allowed me to not only like read, so obviously we had that kind of a handout, but the video allowed me to kind of a kind of see that and then kind of put into my head what I would be doing at this session.”Student 3: “… and by also having the video beforehand that allow me to watch as many times as I wanted before we went in rather than it just being shown before we were with the cadavers and only seen it once. I was able to pause it and play it kind of as I wanted for my own learning.”Student 4: “Yeah, I’d imagine that the session would have taken a considerable amount of time longer than what we had …if we hadn’t had the pre-recorded material available. So, we’re able to kind of pick up the information in the skills a little bit quicker.”
3.2.2. Thiel Cadavers as a Teaching Model
Student 3: “Yeah, I was just trying to say that that I felt that although that was a disadvantage in sometimes you were kind of putting yourself into a contorted position to get to everywhere you needed to be that actually the benefits of what erm doing it outweighed it and that, that I actually gained so much more from that experience”.“So, I feel that even though that is a disadvantage and obviously you have to and we are aware that the patient would be in that position overall is actually a very beneficial process that we did.”Student 6: “Yeah. And I was actually going to say that I obviously everyone knows that I’m tiny, but and I have that problem. But there was a block to stand on and be honest with the block, and for anyone in other years, who was worried about that, like, I stood on the block and was able to have really good visual access so I could see everything really well. So I didn’t feel that that was something that hinders my visual access or anything like that. I still found it very beneficial.”
Student 3: “I also wanted to say that I found that by doing it repetitively in different areas of the mouth helped me rather than just doing it once over in the same kind of area by trying in the palate and then on the floor of the mouth and the gingivae and stuff, it allows you to kind of see different areas but also kind of get really get that technique ‘because repetition is the only way that I find that I learn things is just by constantly repeating it.”Student 4: “I found it quite beneficial that by working in the mouth, the confined spaces having to kind of change your angulation and think about where you’re trying to get the needle to without damaging other tissues etc. I found that was quite beneficial as well.”
Student 7: “I feel like with the right assistance with the staff Member, I’d probably be able to feel comfortable carrying a suture out.”
3.2.3. The Teaching and Learning Environment
Student 7: “Yeah, I think just this…. like from what everybody said, in my experience, I think it was a really kind of well thought out structured session from the handout to the video to the actual experience itself that one on one with the clinician asking as many questions as you want.”Student 6: “I was just gonna add to I think what someone said about it being really relaxed and I think that really helped me as well. cause I had been so nervous about it that because we were in first floor clinic groups which and everyone in my group would know that I would feel nervous about that kind of thing.”Student 7: “I keep coming back to the point of relax environment. But like was very relaxed and supportive environment. You could leave the session as soon like when you wanted and like until you were actually completely confident at doing the suture, you could stay as long as you wanted.”
Student 7: “I like that kind of relaxed environment that you kind of had you were able to kind of ask questions that you wanted. The relaxed environment was like almost like a one on one. It was very small group so you can have had that opportunity to ask as many questions as you wanted with the clinician which I found really helpful, I would say it’s hard to describe it.”
Student 3: “And then also do it yourself, but it wasn’t too many people that were in the group that you kind of lost interest. It was enough that you actually learned from other people.”Student 6: “And I don’t know if this has been said previously or emphasized, but I thought that the length of time that we’re in with the cadavers was like a really good amount of time. I think afterwards I came out feeling confident, I didn’t feel like the session was rushed, but I also didn’t feel that was there too long that I kind of lost kind of a concentration on it. So I think that the length of time that you’d kind of had is in for was an ideal. And I think that that would be good to kind of stay that way. You had enough time to do it and get confident, but it wasn’t too long.”
3.2.4. Impact of COVID-19 on Teaching
Student 3: “And I also want to say no, in a way like I understand [Student’s] point, but I also want to say that I’m not sure if you planned on having such small groups or whether it was because of COVID-19, but I think that by having such a small group when we actually got the teaching benefit, it does more. So I’m not sure if we didn’t have COVID-19 if numbers would have been larger in those groups, but if you were to ever do this again, I would suggest to keep them the size that you had with three or four students. And I felt that if that was COVID-19 related, that actually has benefited us in terms of the actual teaching…”
3.2.5. Potential Improvements to Teaching
Student 3: “Yeah, I remember a name. First year when we had the skulls and we got to bring them home from the anatomy lab and how beneficial that was just that when you were studying it, you were able to look at the skull and work from that and it would be kind of the same kind of principle of having that available at all times for whenever you’re studying, really.”Student 4: “I think one thing we could have done as an additional extra that would never require too much moving parts would have been maybe to do a video session with the tools at home. It’s kind of just walk through….of what you need to do if you didn’t have any understanding, maybe even a drop in session. Uh, where the clinician would be on, on a video demonstrating this, the way it’s done, even quite similar to what the video has in it, but with you being able to actually ask questions and then being able to explain why they’re doing certain things if they hadn’t gone through something in particular on the video.”
3.2.6. Confidence
Student 3: “And I don’t know if this has been said previously or emphasized, but I thought that the length of time that we’re in with the cadavers was like a really good amount of time. I think afterwards if came out feeling confident, I didn’t feel like the session was rushed, but I also didn’t feel that was there too long that I kind of lost kind of a concentration on it.”Student 3: “And I also wanted to say that there have been a few people in my group that have actually placed sutures, which has been good to even hear about their experience with a patient and although it’s been some time, I think the time is the only thing they have the distance between having that session with the cadavers and then actually being able to place a suture. You know the technique but actually the confidence kind of goes over time, but from hearing just other students doing it, and they’ve succeeded with it, it is just one of those things that builds you confidence back up”
3.2.7. General Thoughts on the Course
Student 6: “And, and like [Student] said, the small groups where perfect and I really enjoyed that and wouldn’t change it…”Student 7: “… it was very, very beneficial. So I’ve got nothing but positive things to say about this session.”
3.3. Part 3: Staff Reflective Accounts
Assessment
4. Discussion
Limitations of this Work
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Conflicts of Interest
References
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Questions | Score and Coding |
---|---|
2. I feel that the pre-course suture movie was easy to understand. | Likert score 1–5 |
3. I feel that the suture movie was useful for and supported my skill acquisition during the practical session. | Likert score 1–5 |
4. On a scale of 1–10 how useful was the movie for your learning? | 1 Not useful–10 Very useful |
5. Will you access the movie after your practical session? | 1 = Yes, 2 = No |
8. Did you look at other resource material before the practical session? | 1 = Yes, 2 = No, 3 = Other |
9. I understand the instruments used for suturing and feel comfortable using them. | 1 = Yes, 2 = No |
10. I found the mechanics of tying a suture to be... | 1 = Very easy, 5 = Very difficult |
11. In terms of the most useful for your understanding of the hands-on practical part of placing a suture, which were the most helpful? Please tick all that apply. |
|
12. The Thiel cadaveric model was suitable for the session and realistic. | Likert score 1–5 |
13. I now feel confident that I could place a simple suture in a live setting on a patient with some support. | Likert score 1–5 |
14. The aspects of the Oral Surgery Suturing Course that I found difficult were (select all that apply)... | Options 1–13 |
Number | Question |
---|---|
1 | Can you outline which aspects of the video were most useful to you and how each was useful/helped you in your learning? |
2 | Can you outline which aspects of the video you found least useful? |
3 | Can you describe how you found working with the Thiel cadavers as a model for teaching suture skills? |
4 | Can you outline what you think are the advantages of using the cadavers? |
5 | Can you outline what you think are the disadvantages of using the cadavers? |
6 | Did anyone have a pre-existing difficulty with the setting? If so, why? |
7 | In what way do you think that this teaching has prepared you to place sutures on patients? |
8 | How do you think the COVID-19 situation has impacted on your learning of suture skills and the teaching you may have received? |
9 | How do you think this teaching could be improved? |
10 | If another opportunity came about to use the cadavers for teaching, would you be interested and why? |
Score | No of Respondents | % Respondents |
---|---|---|
1–5 | 0 | 0 |
6 | 1 | 3 |
7 | 4 | 13 |
8 | 7 | 23 |
9 | 5 | 17 |
10 | 13 | 43 |
Question | Number of Responses | % of Respondents |
---|---|---|
Nothing was difficult, everything is fine | 5 | 17 |
How to hold the instruments | 4 | 13 |
Understanding suture complications | 5 | 17 |
Knowing how to tie the knot | 8 | 27 |
Manipulating the needle holders | 8 | 27 |
Manipulating the toothed tissue forceps | 4 | 13 |
Do not like working on cadavers | 4 | 13 |
How to position the needle | 5 | 17 |
What to do with the needle when tying the knot | 8 | 27 |
How to tighten the knot | 5 | 17 |
How to avoid complications | 11 | 37 |
Sweeping the needle through the tissues | 2 | 6 |
Other | 1 | 3 |
Global Score | 2018 n = 67 | 2019 n = 60 | 2022 n = 57 |
---|---|---|---|
Excellent | 11 | 11 | 10 |
Good pass | 20 | 14 | 20 |
Clear pass | 25 | 22 | 17 |
Borderline | 9 | 8 | 9 |
Fail | 2 | 5 | 1 |
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Share and Cite
Macluskey, M.; Anderson, A.S.; Gribben, M.; Shepherd, S.D. An Educational Evaluation of Thiel Cadavers as a Model for Teaching Suturing Skills to Dental Students during the COVID-19 Pandemic. Dent. J. 2022, 10, 125. https://doi.org/10.3390/dj10070125
Macluskey M, Anderson AS, Gribben M, Shepherd SD. An Educational Evaluation of Thiel Cadavers as a Model for Teaching Suturing Skills to Dental Students during the COVID-19 Pandemic. Dentistry Journal. 2022; 10(7):125. https://doi.org/10.3390/dj10070125
Chicago/Turabian StyleMacluskey, Michaelina, Angela S. Anderson, Mark Gribben, and Simon D. Shepherd. 2022. "An Educational Evaluation of Thiel Cadavers as a Model for Teaching Suturing Skills to Dental Students during the COVID-19 Pandemic" Dentistry Journal 10, no. 7: 125. https://doi.org/10.3390/dj10070125