Geoghegan Luke, Papadopoulos Dimitrios, Petrie Nicola, Teo Isabel, Papavasiliou Theodora
Department of Plastic Surgery, Oxford University Hospitals, John Radcliffe Hospital, Headington, Oxford, UK.
Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, UK.
Plast Reconstr Surg Glob Open. 2023 Apr 3;11(4):e4898. doi: 10.1097/GOX.0000000000004898. eCollection 2023 Apr.
Simulation is integral to the development and maintenance of micro- surgical skills. Several simulation models have been described ranging from bench- top to live animal models. High fidelity models are often burdened by cost and ethical issues limiting widespread implementation. This study aims to determine the feasibility of a microsurgical training platform using the Konjac noodle model.
A prospective cohort study was conducted at our institution. A progressive microsurgical training curriculum was developed. A bespoke three-dimensional printed training platform was produced to enable residents to record training and assessment tasks. Microsurgical skills were blindly assessed before and after completing the training program using the University of Western Ontario Microsurgical Skills Assessment instrument.
Plastic surgery residents at various stages of training were recruited (n = 10). A significant improvement in vessel preparation from a pre-training median of 3 (IQR 2 -4) versus a post-training of 4 (IQR 3 -5, = 0.0035) and suturing with a pre-training median of 3 (IQR 2 -4) versus a post-training of 4 (IQR 3 -5, = 0.0047) domains of the University of Western Ontario Microsurgical Skills Assessment score was demonstrated after completion of the training program. There was a significant improvement in the global rating score (3 ± 1 versus 5 ± 1, = 0.0045). Participants felt more confident performing a microsurgical anastomosis following the training program.
The use of the Konjac noodle model and video-based assessment using a three-dimensional printed model is an effective teaching tool that improves resident's microsurgical skills.
模拟对于显微外科技能的发展和维持至关重要。已经描述了几种模拟模型，从台式模型到活体动物模型。高保真模型常常受到成本和伦理问题的困扰，限制了其广泛应用。本研究旨在确定使用魔芋面条模型的显微外科训练平台的可行性。
在我们机构进行了一项前瞻性队列研究。制定了一个渐进的显微外科训练课程。制作了一个定制的三维打印训练平台，使住院医师能够记录训练和评估任务。使用西安大略大学显微外科技能评估工具在完成训练计划前后对显微外科技能进行盲法评估。
招募了处于不同训练阶段的整形外科住院医师（n = 10）。完成训练计划后，西安大略大学显微外科技能评估分数的血管准备领域从训练前的中位数3（四分位间距2 - 4）显著提高到训练后的4（四分位间距3 - 5，P = 0.0035），缝合领域从训练前的中位数3（四分位间距2 - 4）显著提高到训练后的4（四分位间距3 - 5，P = 0.0047）。整体评分分数有显著提高（3±1对5±1，P = 0.0045）。参与者在完成训练计划后进行显微外科吻合时感觉更有信心。
使用魔芋面条模型和基于视频的三维打印模型评估是一种有效的教学工具，可提高住院医师的显微外科技能。
