**4. Development of the online module to teach micro suturing skills**

Using the tool for surgical skill training as a guide (as seen in **Figure 4**), the key tasks for micro suturing were identified and were listed as the expected learning outcomes with clearly stated essential tasks and competency levels. An expert review panel was identified and invited to perform a think-aloud cognitive walkthrough of these key skills. We conducted content and task analysis with the results and developed a detailed mental script for micro suturing. The mental script was incorporated into the instructional materials of the online module. The development of the online module was based on the framework of multimedia learning of the surgical procedure [37]. This online module consisted of instructional videos of the expert surgeons' live demonstration of micro suturing, with the concurrent narration of the mental script.

The participants in the experimental phase used this online module to practice. Combining the video and the mental script allowed the participants to learn from expert surgeons anytime and anywhere. In addition, this online module was augmented with deliberate practice using the low-cost rubber glove practice model.

*Redefining Surgical Skill Acquisition DOI: http://dx.doi.org/10.5772/intechopen.99408*

#### **Figure 6.**

*Diagram of the pilot experiment using the learning module for micro suturing.*

The online module allowed trainees to observe expert performance, followed by mental practice with motor imagery, and then deliberate practice to reach the mastery level, as summarised in the tool for developing instructional materials in **Figure 4**. The training module created was then evaluated in a pilot study using an experimental design (**Figure 6**).
