No description available.

<p>  </p> <p>Knot tying boards are low fidelity surgical simulators used to practice tying suture, but devices on the market currently provide no feedback and no way of changing out bands. A simple-to-use knot tying board with interchangeable bands capable of measuring force was designed. This board is comparable in cost to products currently available on the market. The knot tying board was then prototyped and tested. Four MD students completed trials of one-handed and two-handed knot tying with three throws per trail. In testing, the knot tying board was capable of measuring force data, such as peak force during knot tying and the final force the knot exerts on the bands. The device used in conjunction with experienced surgical skills coaches could prove a powerful tool for providing feedback to trainees, and a similar approach could be used with other low fidelity surgical simulators to improve feedback.</p>

Background Force feedback is a critical element for performing and learning surgical suturing skill. Force feedback is impoverished or not present at all in non-open surgery (i.e., in simulation, laparoscopic, and robotic-assisted surgery), but it can be augmented using different modalities. This rapid, systematic review examines how the modality of delivering force feedback influences the performance and learning of surgical suturing skills. Methods An electronic search was performed on PubMed/MEDLINE, Web of Science, and Embase databases to identify relevant articles. The results were synthesized using vote counting based on direction of effect. Results A total of nine studies of medium-to-low quality were included. The synthesis of results suggests that the visual modality could be more beneficial than the tactile and auditory modalities in improving force control and that auditory and tactile modalities could be more beneficial than the visual modality in improving suturing performance. Results are mixed and unclear with regards to how modality affects the reduction of force magnitude and unclear when unimodal was compared to multimodal feedback. The studies have a general low level of evidence. Conclusion The low number of studies with low methodological quality and low level of evidence (most were proof of concept) prevents us from drawing any meaningful conclusion and as such it is currently unknown whether and how force feedback modality influences surgical suturing skill. Speculatively, the visual modality may be more beneficial for improving the control of exerted force, while auditory and tactile modalities may be more effective in improving the overall suturing performance. We consider the issue of feedback modality to be highly relevant in this field, and we encourage future research to conduct further investigation integrating principles from learning psychology and neuroscience: identify feedback goal, context, and skill level and then design and compare feedback modalities accordingly.