Gasteratos Konstantinos, Paladino Joseph Robert, Akelina Yelena, Mayer Horacio F
Department of Plastic and Reconstructive Surgery, Papageorgiou General Hospital, Thessaloniki, Greece.
Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA USA.
Eur J Plast Surg. 2021;44(2):167-176. doi: 10.1007/s00238-021-01798-1. Epub 2021 Feb 11.
Many studies are investigating the role of living and nonliving models to train microsurgeons. There is controversy around which modalities account for the best microsurgical training. In this study, we aim to provide a systematic literature review of the practical modalities in microsurgery training and compare the living and nonliving models, emphasizing the superiority of the former. We introduce the concept of non-technical skill acquisition in microsurgical training with the use of living laboratory animals in the context of a novel proposed curriculum.
A literature search was conducted on PubMed/Medline and Scopus within the past 11 years based on a combination of the following keywords: "microsurgery," "training," "skills," and "models." The online screening process was performed by two independent reviewers with the Covidence tool. A total of 101 papers was identified as relevant to our study. The protocol was reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.
Living models offer the chance to develop both technical and non-technical competencies (i.e., leadership, situation awareness, decision-making, communication, and teamwork). Prior experience with ex vivo tissues helps residents consolidate basic skills prior to performing more advanced techniques in the living tissues. Trainees reported a higher satisfaction rate with the living models.
The combination of living and nonliving training microsurgical models leads to superior results; however, the gold standard remains the living model. The validity of the hypothesis that living models enhance non-technical skills remains to be confirmed.Level of evidence: Not ratable.
许多研究正在探究活体和非活体模型在培训显微外科医生方面的作用。关于哪种方式是最佳显微外科培训方式存在争议。在本研究中，我们旨在对显微外科培训的实际方式进行系统的文献综述，并比较活体和非活体模型，强调前者的优越性。我们在一个新提出的课程背景下，引入了使用活体实验动物进行显微外科培训中获取非技术技能的概念。
在过去11年中，基于以下关键词组合在PubMed/Medline和Scopus上进行文献检索：“显微外科”、“培训”、“技能”和“模型”。在线筛选过程由两名独立评审员使用Covidence工具进行。共确定101篇与我们研究相关的论文。该方案按照系统评价和Meta分析的首选报告项目（PRISMA）声明进行报告。
活体模型提供了发展技术和非技术能力（即领导力、态势感知、决策、沟通和团队合作）的机会。在体外组织上的先前经验有助于住院医师在对活体组织进行更高级技术操作之前巩固基本技能。培训学员对活体模型的满意度更高。
活体和非活体培训显微外科模型相结合可产生更好的效果；然而，金标准仍然是活体模型。活体模型增强非技术技能这一假设的有效性仍有待证实。证据水平：不可评级。
