struggled to learn knot-tying

[epsilonprodigy]

So we had a "suture clinic" run by the residents yesterday. I had done instrument ties, baseball stitches and simple interrupted stitches before with no notable difficulty. However, I really struggled with one-handed ties. (Yes, I know how to do two-handed ties.) I found it very hard to copy the positions and movements of someone across from me, and flat-out couldn't make it happen despite probably 20 minutes of repeated attempts. I finally got the hang of it, but I still have moments where I'm like "wait, what was that position again, should this be under here or over there," etc. while practicing. (I have not done my surgery rotation yet.)

Is it typical to have THAT much trouble, or does this bode particularly poorly for my aptitude? I've been diligently practicing since then, and it's getting easier, but it was a little worrisome. I hear over and over again not to worry about the skills, but surely there are a few people that are unteachable, or whose practice is seriously hindered by a lack of motor dexterity. Thoughts?

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[SLUser11]

So we had a "suture clinic" run by the residents yesterday. I had done instrument ties, baseball stitches and simple interrupted stitches before with no notable difficulty. However, I really struggled with one-handed ties. (Yes, I know how to do two-handed ties.) I found it very hard to copy the positions and movements of someone across from me, and flat-out couldn't make it happen despite probably 20 minutes of repeated attempts. I finally got the hang of it, but I still have moments where I'm like "wait, what was that position again, should this be under here or over there," etc. while practicing. (I have not done my surgery rotation yet.)

Is it typical to have THAT much trouble, or does this bode particularly poorly for my aptitude? I've been diligently practicing since then, and it's getting easier, but it was a little worrisome. I hear over and over again not to worry about the skills, but surely there are a few people that are unteachable, or whose practice is seriously hindered by a lack of motor dexterity. Thoughts?

If you get frustrated because you haven't mastered a complex technique after 20 whole minutes of practice, you will find residency exceptionally frustrating.

So, to answer your question: No, I wouldn't worry about your technical abilities. But, I would worry about your lack of self-awareness if you don't see how ridiculous your post is.

 

[epsilonprodigy]

If you get frustrated because you haven't mastered a complex technique after 20 whole minutes of practice, you will find residency exceptionally frustrating.

So, to answer your question: No, I wouldn't worry about your technical abilities. But, I would worry about your lack of self-awareness if you don't see how ridiculous your post is.

Ha! Fair enough. Of course I know that it takes practice, but I didn't think there'd be a period being totally unable to do it. The residents make it look so deceivingly simple! The experience definitely motivated me to practice and try to seek out some activities to boost my skills.

 

[armybound]

I was always told as a student you should only be two-hand tying anyway.

One handed is a lot easier for me for some reason. You just have to practice it and get used to it. Get one of the Ethicon practice boards, read the instruction booklet it comes with, watch some videos, and give it a shot.

 

[rigid]

Well what it does say is that you aren't in that special 1% or so of people who pick things up extremely quickly and look stellar, meaning that you are likely going to be about as good as everyone around you. Nothing wrong with that

 

[Buzz Me]

Took me months and months of practice as a student before I really became comfortable with one- and two-handed ties. First I practiced with the clumsy 0 and 2-0 silks. Then 3-0 and 4-0. Then monofilament - Prolene and PDS. Then with gloves. Then with dry gloves. Then at home, without looking (I would tie while watching TV). As I got better I learned how to tie one-handed with both my right and left hand. It'll become second nature, to the point where you'll KNOW when the knot is square without having to look at it.

There are lots of other nuances as well - following the knot down with your finger, tying delicately without yanking up on the tissue/knot, tying down into a hole or small space, using small, delicate suture (7-0 and 8-0 Prolene), avoiding the dreaded air knot, learning how to have the knot slide down when you want it, how to lock the knot, and how to unlock it.

 

[poorracerkid]

As a medical student you should not be doing anything other than two handed ties.

 

[Kahreek]

I remember when i first learned how to knot properly. At first i couldnt even tell the right from left shoe.

And btw one-handed ties vs two handed ties, if done properly both are one handed ties, in one left hand is dominant, the other is the right hand.

 

[Leforte]

There is much more control for the neophyte with a two-hand or instrument tie. If you can do these well, you are ahead of your peers.

I would worry about one-handed when you become a resident, after you have gotten the above two ways down pat.

The thing I notice is that when students are trying to impress with tying abilities, they often fail. Just go slow, use a two handed or instrument tie technique (depending on what is being sutured) and realise that we expect you to not know what you are doing, but we are giving you the time to make baby steps. What I hate is when someone tries a one-handed tie right away and ends up ripping or pulling the suture out of the tissue - very poor form.