Microtools: A systematic review of validated assessment tools in microsurgery

Area of Science:

• Surgical Education and Training
• Microsurgery Techniques
• Skill Assessment Methodologies

Background:

• Microsurgery demands high technical skill, especially in time-sensitive, high-risk procedures.
• There is a growing need for validated methods to assess microsurgical skills prior to practice.
• This review aimed to analyze existing literature on validated microsurgical assessment tools.

Approach:

• A systematic literature search was conducted using keywords like 'microsurgery,' 'simulation,' and 'competence.'
• Inclusion criteria focused on simulation models assessing both training and skill acquisition simultaneously, including microvascular anastomosis.
• Tools were evaluated for validity, bias, complexity, fidelity, and reliability using PRISMA and SWiM guidelines.

Key Points:

• Thirteen distinct microsurgical assessment tools were identified and validated.
• All tools demonstrated construct validity; criterion validity was assessed for two.
• Interrater reliability was confirmed for 11 tools, with GRS and UWOMSA showing intrarater reliability.

Conclusions:

• Thirteen assessment tools exhibit variable validity for microsurgery skill evaluation.
• The End Product Intimal Assessment tool and Imperial College Surgical Assessment device are identified as valid for objective skill assessment.
• Further research may refine reliability and predictive validity of these essential surgical training tools.