Off-the-job microsurgical training on dry models: Siberian experience.
BACKGROUND
Microsurgical training has become an obligatory part of many neurosurgical training programs.


OBJECTIVE
To assess the cost and effectiveness of acquiring and maintaining microneurosurgical skills by training on an off-the-job basis using dry models.


METHODS
A dry off-the-job microneurosurgical training module was set up. Training exercises involved microdissection in a deep operation field, suturing and tying on gauze, untying, pushing of thread end, and microanastomosis. The time to complete the task and success rate were evaluated. The total cost of all necessary equipment and expendables for the training module was US$910.


RESULTS
Fifteen residents participated in the continuous off-the-job training. The average time taken to perform the anastomosis decreased after the month of training from 90 to 20 minutes. Authors revealed that at 2 months, the total time and time to complete anastomosis increased significantly for the participants who discontinued practice after the first month, compared with those who just practiced suturing on gauze after the first month (P < 0.01). The average Northwestern Objective Microanastomosis Assessment Tool score was 36 for novice and 65 for experienced participants.


CONCLUSIONS
The dry off-the-job training showed to be readily available and can be helpful for microsurgical training in the low-income regions of the world. Our data suggest that microsurgical training should be continuous and repetitive. Simulation training may benefit from models for repetitive training of relevant technical part-skills.
Scientific Center of Reconstructive and Restorative Surgery, RAMS, Siberian Branch, Irkutsk, East Siberia, Russia. Electronic address: e.belykh@yandex.ru.
Evgenii
E
Belykh
Scientific Center of Reconstructive and Restorative Surgery, RAMS, Siberian Branch, Irkutsk, East Siberia, Russia; Department of Traumatology, Orthopedics and Neurosurgery, Irkutsk State Medical Academy of Continuous Education, Irkutsk, East Siberia, Russia; Department of Hospital Surgery and Neurosurgery, Irkutsk State Medical University, Irkutsk, East Siberia, Russia; Department of Neurosurgery, Irkutsk Rail Road Clinical Hospital, Irkutsk, East Siberia, Russia.
Vadim
V
Byvaltsev
D000714:Anastomosis, Surgical; D001921:Brain / Q000033:anatomy & histology / Q000601:surgery; D002196:Capillaries / Q000033:anatomy & histology / Q000601:surgery; D002983:Clinical Competence; D003365:Costs and Cost Analysis; D006801:Humans; D007396:Internship and Residency; D042282:Microdissection; D008853:Microscopy; D008866:Microsurgery / Q000191:economics / Q000193:education*; D008953:Models, Anatomic; D009493:Neurosurgery / Q000191:economics / Q000193:education*; D012800:Siberia; D013525:Surgical Instruments
Microneurosurgery; NOMAT; Simulation; Training