Evaluation of a Longitudinal Residency-Integrated Microsurgery Course
Miranda Chacon, B.S., Paige Myers, M.D., Alap Patel, B.A., Drew Mitchell, B.A., Howard Langstein, M.D., Jonathan Leckenby, M.B.B.S., Ph.D..
University of Rochester, Rochester, NY, USA.
Title: Evaluation of a Longitudinal Residency-Integrated Microsurgery Course (RIMC)
Authors: M Chacon, P Myers, A Patel, D Mitchell, H Langstein, J Leckenby
Introduction: Current microsurgical training courses average five consecutive eight-hour days and cost $1500-$2000/individual, making training a challenge for residents who cannot take leave from clinical duties. This course was developed for integration with a residency program, averaging three hours/week over seven weeks with a more modest cost of approximately $300 in nonrenewable resources per student. It allows for one-on-one training, beginning with synthetic tissue products and concluding with in vivo simulation models. This study was developed to validate this longitudinal, microsurgical training course.
Methods: After recruitment and prior to beginning coursework, subjects completed a baseline anastomosis without guidance and a survey regarding microsurgical experience. Subjects completed 1-4 hours of practical exercises weekly, graduating from synthetic to in vivo models with the supervision of an attending microsurgeon. A minimum of nine anastomoses of increasing complexity were completed, each assessed with the Anastomosis Lapse Index (ALI) and the Stanford Microsurgery and Residency Training (SMaRT) Scale. Scoring was independently performed by three reviewers and averaged. Time to completion, ALI scores, and SMaRT Scale results were compared for each anastomosis completed on a synthetic model.
Results: Five subjects have completed the course thus far with additional subjects enrolled for future sessions. The average experience level was “novice.” Surveys revealed a modest increase in theoretical knowledge, technical ability, and ability to manage complications. All competencies evaluated by the SMaRT Scale were significantly improved, and the total number of errors measured by ALI score was significantly decreased. The time to completion of anastomosis was significantly reduced by an average of four minutes.
Conclusions: While data collection is ongoing, evaluation thus far has shown that the RIMC leads to significant and quantifiable improvement in resident microsurgical skill and efficiency. The course is manageable in sessions which occur once weekly, making it an ideal training program for surgical residents who are unable to take leave from clinical duties.
Back to 2019 Abstracts