Innovating Microsurgery Training: A Simulation and Video-Based Curriculum

PURPOSE: Microsurgical technique is essential to the plastic surgeon’s armamentarium. Herein, the purpose of this project was to develop a simulation and video-based curriculum to accelerate the microsurgical learning curve of junior trainees. METHODS: A 3D printed microsurgical simulator was developed, with silicone mock vessels of various sizes (Figure 1). To guide learners, we produced a video-based curriculum with stepwise “Needle Control”, “Knot Tying”, and “Vessel Work” drills. Learners navigate this portable training regimen from home. In this pilot study, we gave 10 medical students curriculum access for 2 weeks. Before and after, the participants filled out surveys and performed live rat femoral artery anastomoses under a recording microscope (Figure 2). Videos from 3 chief plastic surgery residents served as our control group. Two attendings graded all anonymous videos using the Stanford Microsurgery and Resident Training (SMaRT) Scale. RESULTS: Following the 2-week training program, student participants demonstrated statistically significant improvements (p<0.01) across all SMaRT Scale metrics and approached the scores of the chief plastic surgery residents (Figure 3). Student live rat anastomosis times improved from 71.2 to 32.1 minutes (control group = 26.7 minutes) (Figure 4). Student anastomosis patency rates improved from 30% to 80% (control group = 100%) (Figure 5). CONCLUSIONS: An accessible simulation and video-based microsurgical curriculum was developed. A pilot group of 10 medical students improved in terms of subjective confidence, objective microsurgical skill, and speed. Based on this pilot project’s success, the curriculum has since been incorporated into the formal Plastic Surgery training at our institution.