Validating a Scalable Approach to Microsurgery Education in Resource-Limited Countries

Area of Science:

• Microsurgery Training
• Medical Simulation
• Global Health

Background:

• Microsurgery is limited in sub-Saharan Africa due to training and instrument scarcity.
• Smartphones offer widespread, accessible magnification technology, even in low-resource settings.
• Previous studies explored smartphone simulators, but skill acquisition over time remains under-researched.

Purpose of the Study:

• To evaluate the effectiveness of smartphone-based simulation for microsurgery training.
• To assess microsurgical skills acquisition and retention over time in Ethiopian participants.
• To determine the utility of smartphones as a training tool in resource-limited environments.

Main Methods:

• A cohort of 13 Ethiopian plastic surgery trainees participated in a microsurgery workshop.
• Participants performed synthetic vessel repairs using smartphones for magnification before, after, and 6 months post-workshop.
• Microsurgical skills were assessed using the validated Stanford Microsurgery and Resident Training (SMaRT) scale.

Main Results:

• Overall SMaRT scores significantly improved from 2.05 to 2.72 post-workshop (p=0.001).
• Scores further increased to 3.05 at 6 months, with improvements maintained.
• Significant gains were observed in all SMaRT domains, with notable instrument handling improvement at 6 months.

Conclusions:

• Smartphones are valuable tools for microsurgery training in low-resource settings.
• Smartphone simulation training leads to significant short-term skill improvement and skill maintenance.
• Further research is needed on the long-term impact on clinical outcomes in resource-limited areas.