Abstract
Background–Laboratory training courses have traditionally offered an attractive method to learn
microsurgery in a low-risk environment. However, courses are often limited by cost,
accessibility, and their one-time, nonlongitudinal nature. Our aims were to (1) describe
our institution's microsurgical training course for hand surgery fellows, which is
longitudinal and integrated within our fellowship curriculum and (2) investigate how
this course affects the microsurgical confidence and competence of trainees throughout
their fellowship year.
Methods–All hand fellows who trained in our 1-year combined hand surgery fellowship from
2016 through 2018 participated in this study. Baseline data on the type and duration
of residency training, previous microsurgery experience and self-reported confidence,
knowledge, and interest in microsurgery were recorded. Self-reported scores were documented
using a continuous scale ranging from 0 to 10. An initial 3-day laboratory course
combining the use of didactic teaching, a nonliving synthetic model, and a live rat
model was conducted. Repeat laboratory training occurred thereafter at 6 and 12 months.
At the end of each session, fellows repeated the baseline questionnaire and faculty
assessed their microsurgical competence using a standardized global rating scale (GRS).
Results–A total of six fellows (2 years) were enrolled. At the end of the initial course,
there was a statistically significant increase in mean self-reported confidence in
microsurgery from 4.3 to 6.2 and knowledge from 4.7 to 6.5. Mean scores in interest
were unchanged, from 9.2 to 9.3. There was also an increase in mean GRS score from
day 3 to months 6 and 12.
Conclusion–A longitudinal microsurgical training course integrated within a hand surgery fellowship
is associated with increased confidence and microsurgical skill. This study describes
our approach and its feasibility.
Keywords
microsurgery - hand - curriculum - laboratory - educational - rat
