Instructor-Assisted Synchronous Online versus Face-to-Face Suturing Training: Effects on Learning and 3-Month Retention in a Randomized Controlled Trial

BackgroundThis study evaluates the learning and retention of basic suturing skills among pre-graduate medical students through instructor-assisted synchronous online (ASO) vs face-to-face (FF) instruction.MethodsA randomized controlled experimental design was used in the practice laboratory of Cumhuriyet University Faculty of Medicine. Sixty second-year medical students without prior suturing experience were randomly assigned to FF or ASO groups. Both received identical training with the same materials and instructor. Performance was assessed via the Objective Structured Clinical Examination (OSCE) 1 day after training and again after 3 months. All assessments were conducted in a single testing room by a blinded assessor. The required sample size, determined via G-Power, was 42, but 60 eligible students participated.ResultsThe FF group outperformed the ASO group in both the first (28.3 ± 4.5 vs 23.5 ± 5.6, <i>P</i> = 0.001) and second OSCE (30.3 ± 4.7 vs 25.5 ± 5.7, <i>P</i> = 0.001) and completed the first exam in a significantly shorter time (<i>P</i> = 0.029). The overall average score improved in the second OSCE (27.9 ± 5.7 vs 25.9 ± 5.6, <i>P</i> < 0.001), but score changes over time did not significantly differ between groups (<i>P</i> = 0.927). The cut-off score for adequate knot-tying ability was 25.5 in both exams.ConclusionsThis study aimed to adapt face-to-face surgical training to an online format, as guidance on remote technical skills instruction is lacking. While the standardized online setting ensured methodological consistency, it limited real-life applicability. FF instruction yielded superior short- and long-term outcomes in suturing skills.