All but forgotten in today’s COVID-19 headlines is the fact that many of today’s soon-to-be doctors have not been able to learn some of the skills essential to their chosen profession due to lockdowns, social-distancing rules and a host of other circumstances brought on by the pandemic.
One of those skills is suturing or the use of stitches, which are essential for closing lacerations or open wounds, incisions made during surgeries (including cardiovascular and neurological procedures), as well as on muscles, blood vessels and internal organs.
The need for students to learn suturing, despite the pandemic, led Dr. Alan Durkin of Ocean Drive Plastic Surgery to think ‘outside the box’ and team up with Florida State University’s school of medicine to teach 30 medical students the art of suturing or ‘stitches’ right here in Vero Beach.
“For the safety of their students and faculty,” Durkin explains, “the university has taken a leadership role regarding this pandemic and they are taking social distancing/personal safety very seriously.
“As a state school,” Durkin continues, “they [were] in no position to disregard CDC guidelines nor did they want to. This resulted in rules that disallowed more than 10 people in a lecture at a time. However, teaching a surgical practicum [such as suturing] requires hands-on training.”
That led to a “lightbulb” moment.
Having recognized the aggressive nature of the COVID-19 virus early on, Durkin had closed his practice to the public back on March 17, so he had the space to do instruction. And as a clinical assistant professor of Plastic and Reconstructive Surgery at the FSU college of medicine since 2014, he had the skills to help.
Together with FSU, Durkin says, he and his team at Ocean Drive Plastic Surgery “developed a process that we call ‘classroom inversion’ where, instead of all 30 students gathering for a single lecture, we created break-out sessions and had students work in smaller pods. In this manner, we created separate hands-on workstations and distributed the student body to limit the number of trainees per group.”
Are these 30 med students now ready to sew stitches in a coronary bypass procedure? No, they’re not.
But, as Durkin points out, “at the medical student level, the goal is primarily to introduce the students to the concepts of surgical closure and to experience without reprisal the motions of manually closing wounds. We hope to create a general, basic proficiency at our course, but to become an expert in surgical procedures, further surgical training is required. That further training is done in the context of internships and residencies rather than medical school.”
Still, it’s important to note that, according to the National Institutes of Health, the traditional method of teaching suturing is “summarized by the adage, ‘See one, do one, teach one,’ which means that medical students are expected to learn a skill by observing it once, then doing it once, then teaching it once.”
Clearly, to Durkin’s way of thinking, once is not enough.
And just what were these medical students suturing?
When asked if he had imported cadavers into his offices for these suture sessions, Durkin laughs.
“A longstanding tradition in medical training,” Durkin explains, “is suturing a pig’s foot. We obtained them from Publix. Pigs’ feet have been used in this context for over 50 years. When I was in medical school, I sewed on a pig foot.”
Dr. Julia Lomax-Homier, dean of the Florida State University college of medicine as well as a board-certified obstetrician-gynecologist, says “a second-year boot camp/skills testing program was cut short this year because of the pandemic. This boot camp would normally include a session dedicated to learning and gaining proficiency in the skills of suturing wounds, excision of lesions and, of course, knot-tying of sutures.
“We had a wonderful opportunity here,” Lomax-Homier continues. “Dr. Nancy Baker, the clerkship director for family medicine and a Vero Beach resident, facilitated the session [at Dr. Durkin’s office] and delivered the 35-minute dermatology lecture in the conference area three times, as the group rotated.
“Nikki Cowette, PAC, also a Vero Beach resident, our local physician assistant director, assessed the students’ clinical skills.
“Dr. Durkin used his operating room to host the students and offer individual tips on proper suture techniques and handling of surgical instruments. The students, all dressed in scrubs and masks, were thrilled to learn clinical skills directly from a plastic surgeon.”
“These students are part of the future of healthcare and my child will be treated by physicians now and in the future,” says Durkin.
Dr. Alan Durkin’s Ocean Drive Plastic Surgery at 5070 Highway A1A has now re-opened and is once again welcoming patients. The phone number is 772-234-3700.