Training program and learning curve in experimental microsurgery during the residency in plastic surgery

This article presents a comparison of microsurgical training of groups with different background. A protocol based on the rat femoral arterial anastomoses was used to provide an objective representation of the microsurgical skills progress. The performance is assessed by consistent (x4) patency of a standardized anastomosis. Three groups of beginner residents with progressive microsurgical experience and one group of experienced surgeons were observed. The patency curve of the beginner-groups was as an abrupt learning curve, and then a plateau was reached. There was no statistically significant difference in the patency rate between the beginner-groups after their first 32 anastomoses. No statistically significant difference was noted when the patency of the advanced group was compared with beginner-groups after different numbers of anastomoses (inverse proportional with their training experience). A slight or a plateau learning curve was found among the experienced group. The learning curve is a useful adjunct in the assessment of training.