Evaluation of a Microsurgery Training Curriculum

Abstract

Background Microsurgery is one of the most challenging areas of surgery with a steep learning curve. To address this educational need, microsurgery curricula have been developed and validated, the majority focus on technical skill only. The aim of this study was to report on the evaluation of a well-established curriculum using the Kirkpatrick model. Methods A training curriculum was delivered over 5 days between 2017 to 2020 focusing on: 1) microscopic field manipulation, 2) knot tying, non-dominant hand usage, 3) 3D models/anastomosis, 4) tissue experience. The four levels of Kirkpatrick's evaluation model were applied:1) participants feedback 2) skills development using a validated, objective assessment tool (GAS form) and CUSUM charts were constructed to model proficiency gain 3) and 4) assessing skill retention/long-term impact. Results 155 participants undertook the curriculum, totalling 5,425 hours of training. More than 75% of students reported the course as excellent, with the remaining voting for 'good'. Unanimous agreement among the learners that the curriculum met expectations and would recommend it. Significant improvement in anastomosis attainment scores between days 1—3 (median score 4) and days 4—5 (median score 5) (W = 494.5, p = 0.00170). The frequency of errors reduced with successive attempts (Chi-sq = 9.81, p = 0.00174). The steepest learning curve was in anastomosis and patency domains, requiring eleven attempts on average to reach proficiency. 88.5% survey respondents could apply the skills learnt and 76.9% applied the skills learnt within 6 months. Key areas of improvement were identified from this evaluation and actions to address them were implemented in following programmes. Conclusions Robust evaluation of curriculum can be applied to microsurgery training demonstrating its efficacy in reducing surgical errors with an improvement in overall technical skills that can extend to impact clinical practice. It allows identification of areas of improvement, driving refinement of training programmes.

A simple free flap strategy using end-to-side anastomosis to the main vessels in injured extremity

“…The usefulness of constructing a good educational system for disseminating microsurgical skills has been reported previously. 39 , 40 We believe that the AV-ETS strategy using the MPETS method ensures that preoperative planning and intraoperative procedures are uniform. Hence, the MPETS method is useful for passing on the free flap technique.…”

Evaluation of Level 2 of Kirkpatrick’s Model “Learning” Among the Masters of Health Professional Education Candidates of Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad

“…18 Another study conducted recently in 2023, in Griffin Institute United Kingdom on 155 health professionals attending a 5-days microsurgery curriculum delivered between 2017 and 2020 reported that increased time duration of training, improved learning outcomes significantly as 88.5% of the participants attained level 2 of Kirkpatrick evaluation model. 19 In a study conducted by Lauciphler MC and his colleagues, pre and post study of a group on Artificial Intelligence was conducted. Post analysis showed significant increase in perceived artificial intelligence readiness.…”

Rat Microvascular Model is Tolerant to Technical Errors

“…training. A competent proficiency to reach anastomosis patency may take over ten times of attempts and practice 28 . Therefore, the present study should prompt the microsurgical instructor to pay closer attention to individual suture quality rather than using patency as the gold standard to evaluate the anastomosis success and novice surgeons' skill levels because no relationship exists between the short-term patency and technical errors, except the few mentioned above.…”

“…This study was presented at the Plastic Surgery the Meeting (PSTM) 2021 in Atlanta, Georgia 28 . This article is protected by copyright.…”