High Fidelity Microsurgical Simulation: The Thiel Model and Evaluation Instrument

Area of Science:

• Medical Simulation
• Surgical Training
• Microsurgery

Background:

• The Thiel embalmment method is increasingly used in medical simulation.
• This study explores Thiel vessels for high-fidelity microvascular simulation.
• A novel checklist-based instrument is proposed for microsurgical training evaluation.

Purpose of the Study:

• To evaluate Thiel embalmed vessels as a high-fidelity model for microvascular simulation.
• To introduce and validate a new evaluation instrument for microsurgical training.

Main Methods:

• Thiel embalmed arteries were used for microvascular anastomoses by residents and attending microsurgeons.
• The Microvascular Evaluation Scale (MVES) was used by fellowship-trained microsurgeons for evaluation.
• Internal validity was assessed via Cronbach's coefficient and external validity via regression models.

Main Results:

• The MVES demonstrated excellent reliability (intra-class correlation of 0.89).
• Attending surgeons and senior residents (PGY 4-5) scored significantly higher than junior residents (PGY 1-3).
• Microsurgical experience significantly impacted scores, with advanced experience yielding better results.

Conclusions:

• Thiel cadaveric vessels serve as a high-fidelity model for microsurgical simulation.
• The Microvascular Evaluation Scale (MVES) exhibits excellent internal and external validity.
• A score of 8 on the MVES indicates competence for clinical microsurgery.