Validated specialty-specific models for multi-disciplinary microsurgery training laboratories: a systematic review

Gareth Crouch; Gerald Wong; Jonathan Hong; Alex Varey; Roger Haddad; Zane Zhanxiang Wang; James Wykes; Nick Koutalistras; Jonathan R Clark; Michael Solomon; Paul Bannon; Kate E McBride; Sydney Ch'ng

doi:10.1111/ans.16721

Validated specialty-specific models for multi-disciplinary microsurgery training laboratories: a systematic review

ANZ J Surg. 2021 Jun;91(6):1110-1116. doi: 10.1111/ans.16721. Epub 2021 Mar 15.

Authors

Gareth Crouch^{1

2}, Gerald Wong^{1

3}, Jonathan Hong^{2

4}, Alex Varey^{5

6}, Roger Haddad^{7

8}, Zane Zhanxiang Wang⁹, James Wykes¹⁰, Nick Koutalistras^{1

9}, Jonathan R Clark^{2

10}, Michael Solomon^{1

2

4}, Paul Bannon^{1

2

11}, Kate E McBride^{1

2}, Sydney Ch'ng^{1

2

6

7

10}

Affiliations

¹ Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
² Insitute of Academic Surgery at Royal Prince Alfred Hospital, University of Sydney, Sydney, New South Wales, Australia.
³ Department of Anaesthetics, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
⁴ Department of Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
⁵ Department of Plastic and Reconstructive Surgery, Westmead Hospital, Sydney, New South Wales, Australia.
⁶ Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia.
⁷ Department of Plastic and Reconstructive Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
⁸ Department of Plastic and Reconstructive Surgery, St Vincent's Hospital, Sydney, New South Wales, Australia.
⁹ Transplantation Services, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
¹⁰ Sydney Head & Neck Cancer Institute, Chris O'Brien Lifehouse Cancer Centre, Sydney, New South Wales, Australia.
¹¹ Department of Cardiothoracic Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.

PMID: 33719142
DOI: 10.1111/ans.16721

Abstract

Background: Laboratory simulation is increasingly important for teaching microsurgical skills. Training microsurgeons of different specialties within the same simulation laboratory increases efficiency of resource use. For maximal benefit, simulations should be available for trainees to practice specialty-specific, higher-order skills. Selection of appropriate simulations requires knowledge of the efficacy and validity of the numerous described laboratory models. Here we present a systematic review of validated training models that may serve as useful adjuncts to achieving competency in specialty elements of microsurgery, and appraise the evidence behind them.

Methods: In setting up a multi-disciplinary microsurgery training course, we performed a systematic review according to preferred reporting items for systematic reviews and meta-analyses guidelines. EMBASE, MEDLINE, Cochrane and PubMed databases were searched for studies describing validated, microscope-based, specialty-specific simulations, and awarded a level of evidence and level of recommendation based on a modified Oxford Centre for Evidence-Based Medicine classification.

Results: A total of 141 papers describing specialty-specific microsimulation models were identified, 49 of which included evidence of validation. Eleven were in the field of neurosurgery, 21 in otolaryngology/head and neck surgery, two in urology/gynaecology and 15 plastic and reconstructive surgery. These papers described synthetic models in 19 cases, cadaveric animals in 10 cases, live animals in 12 cases and human cadaveric material in 10 cases.

Conclusion: Numerous specialty-specific models for use in the microscope laboratory are available, but the quality of evidence for them is poor. Provision of models that span numerous specialties may encourage use of a microscope lab whilst still enabling more specific skills training over a 'one-size-fits-all' approach.

Keywords: educational model; medical education; microsurgery; simulation training; surgical specialty.

Publication types

Review
Systematic Review

MeSH terms

Animals
Clinical Competence
Humans
Laboratories
Microsurgery
Otolaryngology*
Simulation Training*