Fast-track teaching in microsurgery

In France, microsurgery is taught in University diploma courses, for a mean 100hours (range, 45-120hours) extending over several months. This training, spread over the year, encounters problems of maintaining high-quality supervision and enduring acquisition of skills. These difficulties risk leading to withdrawal of certain courses, already suffering from funding issues and administrative requirements for animal welfare.

We report our experience with a 2-week module comprising nine 4-hour sessions (total, 36hours), with continuous supervision of 5 students in each of 2 groups (10 students), enabling personalized learning. At the end of each session, an assessment questionnaire was filled out by teachers and students.

Students' scores increased from a mean 23.9/30 points (range, 20 - 30) at session 3 to 26.9 points (range, 23 - 30) at session 9 (p=0.012). At the end of session 3, students were grouped as good, average or beginners, based on the first assessments: i.e., with differences in level between groups at session 3. At the end of session 9, all 3 groups showed statistically comparable levels. Comparison between student and teacher questionnaire responses showed a significant discrepancy in 7 of the 10 cases in week 1, and no significant discrepancy in 7 of the 10 cases by the end of week 2.

The efficacy of condensed learning is based on immediate repetition of exercises, following Ebbinghaus: without repetition, memory decays exponentially, whereas if the information is rapidly repeated, the curve flattens and memory is consolidated. The present rapid improvement in the acquisition of the principles of microsurgery stimulated the enthusiasm of both students and teachers for what is reputed to be a demanding type of training. The study showed that acquisition, assessed in terms of vascular suture reliability, was achieved by the end of a 36-hour module, regardless of the student's baseline level.