Innovation in Precision Training Model for Tendon Suture: A Virtual-Assisted and Entity-Integrated Pathway with Multidimensional Dynamic Evaluation

Abstract

Background: Zone II flexor tendon repair—the slick, multistranded core sutures, the delicate balance between gapping and tightness—is precisely the kind of procedure that makes hand surgery rotations a proving ground for junior residents, whether they come from orthopedics, plastics, or the emergency room. However, traditional bedside apprenticeship has never really solved the exposure problem. Supervising faculty vary widely in their preferred techniques, and the trainee rarely gets to make—and learn from—catastrophic mistakes before the real tissue is already under the needle. This bottleneck has become particularly obstructive in our own tiered residency cohorts, where the gap between simulator-naive and simulator-trained performance kept widening. So instead of patching the old curriculum with sporadic dry-lab sessions, we decided to flip the sequence: put the Touch Surgery module right at the front end of the block, used it as a deliberate cognitive warm-up, and then immediately reinforced that virtual rehearsal with hands-on work on cadaveric specimens and silicone models. Using a randomized controlled design, we compared our hybrid pipeline against the conventional teaching stream. The simulation-first group demonstrated fewer technical deviations on objective checklists, and their attending physicians also consistently noted less trembling and hesitation during the first live-tissue pass. Methods: Fifty surgical residents (34 males, 16 females) from the surgical standardized training base of the First Affiliated Hospital of the University of South China were selected from December 2024 to June 2025. Using a random number table method, they were randomly divided into an experimental group (n = 25) and a control group (n = 25), receiving virtual-assisted and entity-integrated teaching and traditional teaching methods, respectively. After practical exercises, both groups underwent theoretical and operational assessments, and a multidimensional evaluation was conducted, with the results of the two groups compared and analyzed. Results: After training, the experimental group showed varying degrees of improvement in supervising expert scores, peer teacher scores, instructor scores, resident scores, SEEQ teaching satisfaction scores, theoretical knowledge mastery scores, operational skill level scores, and surgical guideline mastery scores (P < 0.05). Conclusion: The virtual-assisted and entity-integrated training model achieved good training outcomes in the training of resident doctors in tendon suturing, significantly improving their theoretical level, operational skills, and teaching satisfaction.