Microsurgical skill acquisition in a one-day introductory course with performance evaluation using software-assisted scoring system.
BACKGROUND
Recent emphasis on microsurgical skill acquisition at an earlier stage of plastic surgery training has seen a shift toward objective competence-based assessment. Yet no objective measures of spacing or alignment exist, with few validated models that assess ability. The authors propose a novel software analysis scoring system to objectively measure spacing, alignment and the overall improvement in a 1-day, introductory course setting.


METHODS
Images of standard 4-mm latex strips that had been sutured by participants using the Microtrainer system were uploaded onto calibrated, online software. Sutures were analysed with regard to spacing, alignment and density. From these measurements, a total score was calculated, one on initial assessment at the course beginning (Score 1) and another on final assessment at the course end (Score 2), thereby facilitating measurement of the overall improvement.


RESULTS
A total of 38 microsurgical anastomoses from 19 participants ranging from postgraduate years 1-7 were analysed. Seventeen participants had no previous experience of microsurgery. The mean average Score 1 of participants was -2 (range -12 to +22) and Score 2 was 22 (range +12 to +32), thus showing a significant improvement in candidate ability throughout the course of the day (p < 0.0001).


CONCLUSIONS
Microtrainer system software analysis provides a novel, reliable, and consistent objective assessment for surgical trainees at all stages of training, without risk to patients. It has an associated cost for the initial setup, yet is timely, repeatable and can efficiently demonstrate progress in a 1-day course setting.
Department of Plastic Surgery, St John's Hospital, Livingston, UK. Electronic address: cjstewart7@doctors.org.uk.
C J
CJ
Stewart
Department of Hand and Reconstructive Microsurgery, National University Hospital, Singapore, Republic of Singapore.
S K M
SKM
Yusoff
Department of Plastic Surgery, St John's Hospital, Livingston, UK.
D
D
Widdowson
Department of Plastic Surgery, St John's Hospital, Livingston, UK.
W L
WL
Lam
D000328:Adult; D002983:Clinical Competence; D003194:Computer-Assisted Instruction / Q000379:methods*; D004502:Education, Medical, Continuing / Q000379:methods; D004521:Educational Measurement / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000193:education*; D019651:Plastic Surgery Procedures / Q000193:education / Q000379:methods; D012985:Software Design; D013663:Teaching; D006113:United Kingdom
Evaluation; Microsurgical-training; Objective; Software; Suturing