Acquisition of basic microsurgery skills using home-based simulation training: A randomised control study.
BACKGROUND
Acquisition of fine motor skills required in microsurgery can be challenging in the current training system. Therefore, there is an increased demand for novel training and assessment methods to optimise learning outside the clinical setting. Here, we present a randomised control trial of three microsurgical training models, namely laboratory tabletop training microscope (Laboratory Microscope, LM), low-cost jewellers microscope (Home Microscope, HM) and iPad trainer (Home Tablet, HT).


METHODS
Thirty-nine participants were allocated to four groups, control n = 9, LM n = 10, HM n = 10 and HT n = 10. The participants performed a chicken femoral artery anastomosis at baseline and at the completion of training. The performance was assessed as follows: structured assessment of microsurgery skills (SAMS) score, time taken to complete anastomosis and time for suture placement.


RESULTS
No statistically significant difference was noted between the groups at baseline. There was a statistically significant improvement in all training arms between the baseline and post-training for SAMS score, time taken to complete the anastomosis and time per suture placement. In addition, a reduction was observed in the leak rate. No statistical difference was observed among the training arms.


CONCLUSIONS
Our study demonstrated that at the early stages of microsurgical skill acquisition, home training using either the jewellers microscope or iPad produces comparable results to laboratory-based training using a tabletop microscope. Therefore, home microsurgical training is a viable, easily accessible cost-effective modality that allows trainees to practice and take ownership of their technical skill development in this area.
Dept. of Plastic and Reconstructive Surgery, Guys and St Thomas Hospital, Westminster Bridge Road, London, SE1 7EH, UK. Electronic address: mohsan.m.malik@gmail.com.
Mohsan M
MM
Malik
Dept. of Plastic and Reconstructive Surgery, Guys and St Thomas Hospital, Westminster Bridge Road, London, SE1 7EH, UK.
Nadine
N
Hachach-Haram
Kings College London School of Medicine, Strand, London, WC2R 2LS, UK.
Muaaz
M
Tahir
Kings College London School of Medicine, Strand, London, WC2R 2LS, UK.
Musab
M
Al-Musabi
Dept. of Plastic and Reconstructive Surgery, Guys and St Thomas Hospital, Westminster Bridge Road, London, SE1 7EH, UK.
Dhalia
D
Masud
Dept. of Plastic and Reconstructive Surgery, Guys and St Thomas Hospital, Westminster Bridge Road, London, SE1 7EH, UK.
Pari-Naz
PN
Mohanna
D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000193:education; D057868:Anastomotic Leak / Q000209:etiology; D000818:Animals; D002645:Chickens; D002983:Clinical Competence; D034201:Computers, Handheld; D005263:Femoral Artery / Q000601:surgery*; D006801:Humans; D008853:Microscopy / Q000295:instrumentation; D008866:Microsurgery / Q000193:education*; D009048:Motor Skills; D061646:Operative Time; D000066908:Simulation Training / Q000379:methods*; D013537:Sutures; D014656:Vascular Surgical Procedures / Q000193:education*
Microsurgery; Simulation; Tablet; Training