Rostom Mai, Lam Wee-Leon
Department of Plastic and Reconstructive Surgery, St. John's Hospital, Livingston, Howden, United Kingdom of Great Britain and Northern Ireland.
J Reconstr Microsurg. 2018 Feb;34(2):145-150. doi: 10.1055/s-0037-1607435. Epub 2017 Oct 27.
Microsurgery fellowships have become an integral part of every plastic surgery training program. While each subspecialty differs in terms of reconstructive requirements, the basic tenets and skill sets remain the same. We explore the possibility of designing a clinical curriculum for microsurgery that can provide residents and fellows with a more foundational and structured approach to microsurgical training.
Thirteen core and desired skills to accommodate an "ideal" microsurgery curriculum were listed and categorized according to the level of difficulty. The curriculum was then sent to plastic surgery trainees, fellows, and consultants within Scotland in the form of a survey. They were asked to assign a level of difficulty, basic, intermediate, or advanced, to each of the 13 skill sets.
A total of 27 surgeons were surveyed; the majority of which were plastic surgery registrars. Overall a broad, generic clinical curriculum was felt to be lacking, but would be beneficial at the start of training. The curriculum should emphasize a step-wise progression, starting from achieving competency in safe, efficient anastomosis at the basic level to eventually mastering the principles of complex reconstruction at a more advanced level.
A generic clinical curriculum offers a framework for tracking progress, the potential for competency-based assessment, and aid in designing a microsurgery fellowship. The curriculum should reflect the evolving nature of the specialty and provide a foundational platform for future innovations.
显微外科研修项目已成为每个整形外科培训项目不可或缺的一部分。虽然每个亚专业在重建要求方面有所不同，但基本原则和技能组合是相同的。我们探讨了设计一个显微外科临床课程的可能性，该课程可以为住院医师和进修医师提供一种更基础、更结构化的显微外科培训方法。
列出了适应“理想”显微外科课程的13项核心技能和期望技能，并根据难度级别进行分类。然后，该课程以调查问卷的形式发送给苏格兰的整形外科实习生、进修医师和顾问。要求他们为这13项技能中的每一项指定一个难度级别，即基础、中级或高级。
共对27名外科医生进行了调查；其中大多数是整形外科住院医师。总体而言，人们认为缺乏一个广泛的通用临床课程，但在培训开始时会很有帮助。该课程应强调循序渐进，从在基础水平上实现安全、高效吻合的能力开始，最终在更高级别掌握复杂重建的原则。
通用临床课程为跟踪进展提供了一个框架，具有基于能力评估的潜力，并有助于设计显微外科研修项目。该课程应反映该专业不断发展的性质，并为未来的创新提供一个基础平台。
