Improving Microsurgery Foundational Skills Acquisition Through Short Simulation Courses in Rwanda

Microsurgery is increasingly becoming the cornerstone of reconstructive surgical practice, yet training opportunities remain scarce in sub-Saharan Africa. To address this gap, a 2-day simulation-based microsurgery course was held in Kigali as part of the preconference activities of the Pan-African Conference in February 2025. This study aims to demonstrate the feasibility of short-term microsurgery training and evaluate the preliminary impact of the course on participants' microsurgical skills.

Pre- and posttraining surveys were administered to course participants, assessing comfort and confidence across 6 core skill domains: microscope handling, instrument manipulation, needle control, vessel preparation, end-to-end anastomosis, and judging the patency of an anastomosis as well as anxiety related to performing microsurgery. Responses were recorded on a Likert-type scale using a 0-100 format. Paired analysis was performed using Wilcoxon rank sum tests. Qualitative feedback was also collected to assess the perceived value and suggested improvements for future sessions.

Eighteen participants completed pre- and/or posttraining surveys (14 completed both). Statistically meaningful improvements were observed in participants' comfort and confidence across all skill domains (P < 0.05). Participants reported a significant decrease in anxiety (P < 0.02). Qualitative responses emphasized high satisfaction with the course, with many requesting more frequent sessions and earlier integration of microsurgical skills into training.

Short-duration, simulation-based microsurgery training had a positive, measurable impact on technical confidence and psychological readiness among surgical trainees in Rwanda. These findings highlight the feasibility and importance of expanding access to structured microsurgical education across sub-Saharan Africa and support efforts to integrate such training into national surgical training frameworks.