Current status of simulation and training models in microsurgery: A systematic review

Area of Science:

• Medical Education
• Surgical Simulation
• Microsurgery Training

Background:

• Simulation-based training is increasingly adopted for microsurgery.
• A comprehensive review of available microsurgical simulation models and their validation is needed.

Purpose of the Study:

• To systematically review microsurgical simulation and training models.
• To assess their validation status, associated studies, and levels of evidence (LoE).
• To establish a level of recommendation (LoR) for each training model.

Main Methods:

• Systematic search of MEDLINE, Embase, and Cochrane Library for English articles on microsurgery simulators and validation.
• Assessment of studies for LoE using a modified Oxford Centre for Evidence-Based Medicine classification.
• Awarding LoR to each model based on evidence.

Main Results:

• Identified 64 models and simulators across various modalities (bench, cadaveric, virtual reality, etc.) from 86 studies.
• 49 simulators had validation studies assessing face, content, construct, and transfer validity.
• The cryopreserved rat aorta model received the highest LoR, followed by chicken wing, chicken thigh, and practice cardboard models.

Conclusions:

• Microsurgery simulation is a rapidly expanding field with numerous training models.
• There is a limited number of validation studies with high LoE currently available.
• Rigorous evaluation of training model validity and efficacy is crucial for effective microsurgical skills acquisition.