Acquisition of microvascular suturing techniques is feasible using objective measures of performance outside of the operating room

Abstract

The aim of this study was to determine the effectiveness of a microsurgical simulation course on a group of novice surgeons. The study also aimed to see whether a device to measure manual dexterity (Imperial College Surgical Assessment Device, ICSAD), a global rating scale and an end product assessment tool could be used to objectively measure performance. Thirty surgeons were recruited to take part and were evenly split into novice, intermediate, and expert groups. The novice group took part in a one-week microsurgical course. The assessment of performance was done with the surgeon anastomosing a harvested rat aorta. They were assessed using ICSAD, which records number of hand movements, distance moved by hands and time. The assessment was also video recorded and later watched by two assessors. The procedure performance was scored using a global rating scale and the final anastomosis was scored using an end product assessment tool. The novice surgeons took the assessment at the beginning and at the end of the course. The intermediate and expert group performed the assessment once to use as a comparison to the novice group. By the end of the course the novices performed significantly better in all parameters in comparison to their pre course assessment. The novice group performed similarly to the expert group in their end of course assessment in four out of the five assessment parameters. Simulation using objective measures of performance can be used to effectively to train a group of novice microsurgeons.

Keywords: Assessment; Microsurgery; Simulation; Skill; Training.