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Surgical skills laboratories in plastic surgery residency training: A national survey of current practices and
Israel Falade1, Annie Chen-Carrington2, Jacquelyn Knox1
1Department of Surgery, Division of Plastic and Reconstructive Surgery, University of California San Francisco, San Francisco, CA, USA.
Background:
Surgical skills labs (SSLs) provide plastic surgery residents hands-on experience in surgical techniques in a controlled learning environment. Despite growing evidence supporting simulation-based education, the adoption and structure of SSLs vary widely across plastic surgery residency programs. This study aimed to characterize the prevalence, organization, and funding of SSLs nationwide, identify barriers to implementation, and highlight strategies used by programs with established labs.
Methods:
A cross-sectional survey was distributed in February 2024 to program directors of all accredited U.S. plastic surgery residency programs. Programs were categorized by the presence or absence of dedicated SSL. Survey items addressed curriculum design, instructional content, participants, costs, administrative support, facilities, and perceived barriers.
Results:
Of 93 programs surveyed, 29 (31%) responded, with 19 reporting a dedicated SSL and 10 did not. Among programs with SSLs, 79% reported structured curricula developed through faculty and resident input. Common instructional topics included microvascular surgery (95%), fracture plating (79%), splinting (74%), non-surgical aesthetic procedures (74%), and cadaver-based dissections (56%). Thirteen programs used cadaver and non-cadaver sessions, while six relied solely on non-cadaver training. Funding sources included plastic surgery divisions (63%), industry (53%), and general surgery departments (32%). Programs without SSLs relied on periodic hands-on sessions and industry-sponsored workshops. Most frequently cited barriers to SSL implementation were funding constraints, limited faculty availability, and lack of dedicated facilities.
Conclusion:
Considerable variability exists in the availability, structure, and institutional support of surgical skills laboratories across plastic surgery residency programs. Survey responses from programs with established skills laboratories identified reproducible best practices including structured, modular curricula, designated faculty leadership, protected scheduling, strategic resource utilization, resident engagement, and embedded competency-based assessment that may guide future program development. Adoption of these practices, alongside collaborative and regional resource-sharing efforts, may help expand equitable access to high-quality simulation-based training nationwide.
