Assessment of time to completion, number of errors, and knot-holding capacity of square knots and Aberdeen knots tied by veterinary students and student perceptions of knot security and knot-tying difficulty

David A. Upchurch 1Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824.

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Yuheng Wang 2Department of Mechanical Engineering, College of Engineering, Michigan State University, East Lansing, MI 48824.

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Sheng Chen 2Department of Mechanical Engineering, College of Engineering, Michigan State University, East Lansing, MI 48824.

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Sara Roccabianca 2Department of Mechanical Engineering, College of Engineering, Michigan State University, East Lansing, MI 48824.

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James K. Roush 3Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506.

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Abstract

OBJECTIVE

To assess the time to completion, number of errors, and knot-holding capacity (KHC) for starting and ending square knots (SSKs and ESKs) of a continuous pattern and Aberdeen knots tied by veterinary students and to investigate student perceptions of knot security and knot-tying difficulty for the 3 knot types.

SAMPLE

16 second-year veterinary students.

PROCEDURES

Students created 3 (4-throw) SSKs, 3 (5-throw) ESKs, and 3 (3 + 1 configuration) Aberdeen knots with 2-0 polydioxanone on a custom test apparatus. Time to complete each knot, the number of errors in each knot, and student ratings of knot-tying difficulty and confidence in knot security were recorded. Each knot was tested to failure on a uniaxial tensiometer to determine KHC and mode of failure. Variables of interest were compared by repeated-measures ANOVA or the Friedman test with post hoc pairwise comparisons.

RESULTS

Mean knot completion time for Aberdeen knots was significantly less than mean completion time for SSKs or ESKs. Mean KHC was significantly lower for ESKs than for SSKs; KHC for Aberdeen knots was not compared with these values because of methodological differences. Median error rate was higher for ESKs than for other knot types. Mean difficulty rating for Aberdeen knots was lower than that for ESKs. Most tested knots failed by breakage at the knot.

CONCLUSIONS AND CLINICAL RELEVANCE

Aberdeen knots appeared to be easy for veterinary students to learn and were completed more rapidly and with fewer errors than ESKs. Including this type of knot in surgical skills curriculum for novices may be beneficial.

Abstract

OBJECTIVE

To assess the time to completion, number of errors, and knot-holding capacity (KHC) for starting and ending square knots (SSKs and ESKs) of a continuous pattern and Aberdeen knots tied by veterinary students and to investigate student perceptions of knot security and knot-tying difficulty for the 3 knot types.

SAMPLE

16 second-year veterinary students.

PROCEDURES

Students created 3 (4-throw) SSKs, 3 (5-throw) ESKs, and 3 (3 + 1 configuration) Aberdeen knots with 2-0 polydioxanone on a custom test apparatus. Time to complete each knot, the number of errors in each knot, and student ratings of knot-tying difficulty and confidence in knot security were recorded. Each knot was tested to failure on a uniaxial tensiometer to determine KHC and mode of failure. Variables of interest were compared by repeated-measures ANOVA or the Friedman test with post hoc pairwise comparisons.

RESULTS

Mean knot completion time for Aberdeen knots was significantly less than mean completion time for SSKs or ESKs. Mean KHC was significantly lower for ESKs than for SSKs; KHC for Aberdeen knots was not compared with these values because of methodological differences. Median error rate was higher for ESKs than for other knot types. Mean difficulty rating for Aberdeen knots was lower than that for ESKs. Most tested knots failed by breakage at the knot.

CONCLUSIONS AND CLINICAL RELEVANCE

Aberdeen knots appeared to be easy for veterinary students to learn and were completed more rapidly and with fewer errors than ESKs. Including this type of knot in surgical skills curriculum for novices may be beneficial.

Contributor Notes

Dr. Upchurch's present address is Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506.

Address correspondence to Dr. Upchurch (upchuda@vet.k-state.edu).
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