Suturing competence in undergraduate medical education: Current evidence, educational strategies and future directions

Suturing is a fundamental clinical skill, yet many medical students graduate without consistent technical competence or confidence in basic wound closure. This structured narrative review synthesizes contemporary evidence on undergraduate suturing competence and educational strategies to improve technical performance, retention, and clinical readiness. Relevant literature was identified through structured searches of PubMed/MEDLINE, Scopus, and Google Scholar using predefined eligibility criteria and synthesized thematically. The evidence demonstrates substantial variation in suturing competence and frequent discrepancies between self-reported confidence and objectively assessed performance. Simulation-based training, particularly when combined with deliberate practice, feedback, and objective assessment, consistently improves short-term technical performance. Video-based and other digital approaches may improve accessibility and cognitive preparation but appear most effective when integrated with hands-on practice. Remote and technology-enhanced instruction is promising, although evidence remains heterogeneous in study design, learner populations, training duration, and outcome measures. Many studies focus on immediate post-intervention outcomes, limiting conclusions regarding long-term retention and transfer to clinical practice. Overall, undergraduate suturing education should prioritize objectively assessed competence over confidence alone. The available evidence supports structured, longitudinal training integrating simulation, deliberate practice, feedback, and validated assessment to prepare students for safe supervised clinical practice. Further studies using standardized competency outcomes and longer follow-up are needed to establish the durability and clinical relevance of educational gains.