Feedback Versus Compliments Versus Both in Suturing and Knot Tying Simulation: A Randomized Controlled Trial

Introduction: Suturing is an expected skill for students graduating from health professions programs.Previous studies investigated student experience with teaching sessions utilizing constructive feedback versus compliments but did not investigate the combination of both.Methods: Thirty-one participants were randomly divided into three groups: feedback (F), compliments (C), or feedback plus compliments (FC).Participants received instruction on simple interrupted suturing and two-handed knot-tying and were videotaped performing this skill before and after the intervention and performance evaluated using an Objective Structured Assessment of Technical Skills (OSATS).Participants completed a pre-and post-survey rating their task enjoyment and self-assessment of performance.Analysis was performed to determine differences between groups and comparisons pre-and post-intervention.Results: Participants in the FC group had largest improvement in their OSATS score, activity enjoyment and self-assessment compared to groups F or C. Median improvement for FC was 9.25 points (IQR 7.5-10.5)compared to 3 points (IQR -0.5-4.5) for group C and 8 points (IQR 6-9) for group F (p=0.001).FC learners reported a median self-assessed performance improvement of 4 (IQR 3-4) and enjoyment of 3.5 (IQR 2-4) for combined suturing and knottying tasks compared with C performance of 2 (IQR 1-2) and enjoyment of 0 (0-1) and F performance 1.5 (IQR 1-3) and enjoyment 0.5 (IQR 0-1) (p-value 0.01 and 0.001 respectively).Conclusion: The combination of corrective feedback plus compliments resulted in the greatest improvement in performance on suturing and knot-tying, as well as increased enjoyment of the activity and self-assessment in our participants compared to feedback or compliments alone.