Achieving Microsurgical Competency in Orthopaedic Residents Utilizing a Self-Directed Microvascular Training...

Area of Science:

• Orthopaedic Surgery
• Microsurgery Education
• Surgical Skills Training

Background:

• Microvascular surgery training faces challenges due to limited experience and high complication risks.
• Live-animal models are often inaccessible and costly for training purposes.
• Developing effective and affordable training methods is crucial for resident education.

Purpose of the Study:

• To evaluate the effectiveness of a self-directed microvascular curriculum.
• To assess the cost-efficiency of using synthetic microvessels and nonliving models.
• To improve surgical skills in orthopaedic residents.

Main Methods:

• Twenty-five orthopaedic residents (PGY-1 to PGY-4) participated in a curriculum using nonliving models and 1-mm synthetic microvessels.
• Outcomes measured included Global Rating Scale (GRS) scores, anastomosis time, patency, and comfort levels.
• Blinded faculty assessments of pre- and post-curriculum anastomoses were conducted.

Main Results:

• Significant improvements were observed in anastomosis time (40 to 22 mins), GRS scores (12 to 18), and patency rates (44% to 96%).
• Resident comfort levels and blinded qualitative scores for anastomoses also showed significant improvement (p < 0.0001).
• The curriculum was completed in 5.5 hours with high utility ratings (8/10) and low costs ($1,795 setup, $42/resident/year).

Conclusions:

• A self-directed curriculum using synthetic models effectively enhances microvascular surgical skills in orthopaedic residents.
• This training approach offers a cost-effective solution with modest startup and low maintenance costs.
• The curriculum provides a valuable and accessible method for improving microsurgical competency.