Learning, teaching, and training in microsurgery: A systematic review.

Area of Science:

• Medical Education
• Surgical Training
• Biomedical Engineering

Background:

• Traditional microsurgery training often relies on animal models, raising ethical and cost concerns.
• Developing alternative training methods is crucial to reduce animal use and enhance accessibility.
• Microsurgical skills require extensive practice for proficiency.

Purpose of the Study:

• To systematically review and catalog microsurgery learning methods using non-living materials.
• To define an educational program for initial microsurgical skill acquisition.
• To assess the suitability of various simulation materials for training.

Main Methods:

• A systematic literature search was conducted on the PubMed database for English and French articles.
• Keywords included "microsurgery", "non-living", "simulation", and "virtual reality".
• Included articles focused on initial microsurgery learning using inert, non-living, or digital materials.

Main Results:

• Out of 488 articles, 82 were included in the review.
• Microsurgery learning materials were classified into inert, cadaveric animal tissues, human cadaver, virtual reality, and digital technologies.
• A two-step educational program was proposed, starting with non-living materials before progressing to living models.

Conclusions:

• Non-living materials, particularly inert models, are ideal for foundational microsurgical skill development.
• Simulation-based training enhances precision, tremor management, and magnification skills.
• Alternative training methods address ethical, organizational, and economic constraints associated with animal models.