Research Priorities in Light of Current Trends in Microsurgical Training: Revalidation, Simulation, Cross-Training, and Standardisation

Abstract

Plastic surgery training worldwide has seen a thorough restructuring over the past decade, with the introduction of formal training curricula and work-based assessment tools. Part of this process has been the introduction of revalidation and a greater use of simulation in training delivery. Simulation is an increasingly important tool for educators because it provides a way to reduce risks to both trainees and patients, whilst facilitating improved technical proficiency. Current microsurgery training interventions are often predicated on theories of skill acquisition and development that follow a 'practice makes perfect' model. Given the changing landscape of surgical training and advances in educational theories related to skill development, research is needed to assess the potential benefits of alternative models, particularly cross-training, a model now widely used in non-medical areas with significant benefits. Furthermore, with the proliferation of microsurgery training interventions and therefore diversity in length, cost, content and models used, appropriate standardisation will be an important factor to ensure that courses deliver consistent and effective training that achieves appropriate levels of competency. Key research requirements should be gathered and used in directing further research in these areas to achieve on-going improvement of microsurgery training.

The new paradigm on microsurgical education: the international master degree on reconstructive microsurgery

“…It seems very important to cite a study published by Gawande, where he reported significantly important data regarding errors in surgery, considering that 53% occur due to inexperience or lack of competence in the area, 43% occur due to lack of communication and 33 % of these errors are attributed to fatigue and high workload [25]. For this reason, we consider it an essential requirement to acquire adequate training in MS, so that professionals are prepared before putting it into practice and thus minimize any risk of error when acting.…”

Developing a Three-Layered Synthetic Microsurgical Simulation Vessel

“…[1][2][3] These scores display the added advantage of construct validation, allowing the reproducible demonstration of progress and competency-based assessments in revalidation, or work-based assessments. 2,8 The translation of simulated experience to patient clinical outcomes has not yet been undertaken in microsurgical simulation 13 but this would provide the ultimate proficiency benchmark.…”

“…traditional high intensity, high cost, high fidelity courses are being augmented by local practice facilities in individual departments, and trainees are being encouraged to practice outside the operating room (OR). 6,8 Third, the increasing ethical drive to replace, refine, and reduce the use of living animals in microsurgical simulation training, [9][10][11] highlights our responsibility to optimize non-living options.…”

Simulating the IMA Recipient Site for DIEP Flap Surgery: A New Model for Dynamic Microsurgery Simulation with Real-Time Respiration and a Pilot Study

“…These time restrictions are increasing the need for simula-tion experiences outside of the operating room to expedite progress on the steep microsurgical learning curve. 13,14,[16][17][18][19][20][21][22] As such, we propose a new microsurgical model that provides a realistic microsurgical simulation of the DIEP free flap breast reconstruction with real-time respiratory excursion simulating the deep thoracic cavity. The aim of this study was threefold: to delineate realistic intraoperative measurements, to describe the simulation model based on these measures, and to conduct a pilot study evaluating the simulator as an educational resource.…”