===== University of Bergen suturing skills assessment tool (UBAT) =====

==== Introduction ====

This is not a microsurgery specific score, but one used of suturing in general.

==== Tool ====

^Quality indicators	^Yes	^No            ^
|Grabs the needle with the instruments? (Not with fingers)	|1	|0|
|Holds the forceps correctly?	|1	|0|
|Penetrates the tissue with a 90° angle? (Penetrates and pulls needle out on the curve)	|1	|0|
|Grabs the suture (thread) in a correct fashion? (Not in a way that potentially could lead to suture breakage)	|1	|0|
|Manages the suture without tangling the ends in the knot? (Incorrect when: leaves the ends of the suture too long and does not grab the thread at the end)	|1	|0|
|Ties a correct square knot?	|1	|0|
|Makes parallel sutures? (Equal length from the wound edge and equal depth on both sides)	|1	|0|
|Gentle tissue handling? (No tissue damage)	|1	|0|
|Number of correct items in above list	| 	| |
|Subjective assessment: Did the candidate display adequate suturing skills for safe clinical practice?	| 	| |

above adapted from: https://link.springer.com/article/10.1007/s00238-019-01615-w/tables/1

==== Comments ====

  - **mixes** process with outcome 
    - parallel sutures and square knot)
    - process 6, outcome 2
  - **conflates** measures
    - parallel sutures - depth and length are two independent measures
  - does not account for **frequency** of mistakes in score
  - equally **punitive** on less serious 'mistakes' e.g. grabbing needle with instrument
  - **limited 'global' rating** - but only "yes" or "no" for safe clinical practice

==== Reference ====
Almeland, S. K., Lindford, A., Sundhagen, H. P., Hufthammer, K. O., Strandenes, E., Svendsen, H. L., Guttormsen, A. B., & Hansson, E. (2020). The effect of microsurgical training on novice medical students’ basic surgical skills—A randomized controlled trial. European Journal of Plastic Surgery, 43(4), 459–466. https://doi.org/10.1007/s00238-019-01615-w

==== See also ====

  - [[ac:microsurgery_assessment]] for introduction into the topic
  - [[jnl:rajan2019]] for review of scoring systems