Laboratory based training in urological microsurgery with bench model simulators: a randomized controlled trial evaluating the durability of technical skill.
OBJECTIVE
We evaluated the durability of laboratory based technical skills training in urological microsurgery using bench model simulators.


METHODS
A total of 50 junior surgery residents (post-graduate years 1 to 3) were recruited to participate in a focused training program in urological microsurgery. Prior to training subjects were randomized to receive hands-on training with bench model simulators (silicone tubing or live rat vas deferens, 40) or didactic training alone (10). Four months following the original training program the technical performance of 18 returning subjects (13 from the bench model and 5 from the didactic training group) was reevaluated using a high fidelity, live animal model (vasovasostomy and rat vas deferens). Outcome measures included blinded, expert assessment of videotaped performance using checklists and global rating scores, and evaluation of anastomotic patency.


RESULTS
The retention test checklist (p <0.001), global rating scores (p <0.001) and anastomotic patency rates (p = 0.05) in the live animal model remained significantly higher for subjects who originally received hands-on bench model training compared with those who received didactic training alone. The number of interim practice opportunities with microsurgery correlated significantly with expert global ratings of surgical performance irrespective of the nature of training (r = 0.54, p = 0.02).


CONCLUSIONS
Laboratory based technical skills training with bench models can lead to a significant retention of technical skill by novice surgeons. Measured performance improvements appear to be durable with time. However, the opportunity for repeat hands-on practice appears to maximize the retention of technical skill.
Grober
Ethan D
ED
Wilson Centre for Research in Education, Faculty of Medicine and the Division of Urology, University of Toronto, Toronto, Ontario, Canada.
Hamstra
Stanley J
SJ
Wanzel
Kyle R
KR
Reznick
Richard K
RK
Matsumoto
Edward D
ED
Sidhu
Ravindar S
RS
Jarvi
Keith A
KA
D000328:Adult; D000714:Anastomosis, Surgical; D000818:Animals; D002983:Clinical Competence; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008866:Microsurgery / Q000193:education*; D051381:Rats; D014572:Urology / Q000193:education*; D014649:Vas Deferens / Q000601:surgery