Home Program for Acquisition and Maintenance of Microsurgical Skills During the Coronavirus Disease 2019 Outbreak

Abstract

BACKGROUND: During the current global crisis unleashed by the severe acute respiratory syndrome coronavirus 2 outbreak, surgical departments have considerably reduced the amount of elective surgeries. This decrease leads to less time in the surgical room to develop and improve the surgical skills of residents. In this study, we developed a training program to obtain and maintain microsurgical skills at home, using a smartphone camera and low-cost materials, affordable for everyone.-METHODS: Using a smartphone camera as a magnification device, 6 participants performed 5 exercises (coloring grids, grouping colors, unraveling of a gauze, knots with suture threads, and tower of Hanoi), both with the dominant and with the nondominant hand, for 4 weeks. We compared performance at the beginning and at the end of the training process. Each participant filled out an anonymous survey.-RESULTS: When we compared the performance at the beginning and at the end of the training process, we found significant improvements (P [ 0.05) with the dominant as well as the nondominant hand in all the exercises. All participants were satisfied or very satisfied with the definition of the objectives of the training process, material availability, the exercises performed, the choice of the time to train, and general satisfaction with the training program.-CONCLUSIONS: We developed a microsurgical skills training program to be performed at home, which can be easily reproduced. It allows residents to improve manual coordination skills and is regarded as a feasible adjunct for ongoing training for surgical residents.

The impact of the COVID-19 pandemic on global neurosurgical education: a systematic review

“…However, this does not compensate for teaching hands-on surgical techniques; thus, other solutions were needed. Some studies point to alternative simulations, such as 3D printed simulation devices and a smartphone centred microsurgical skill training programme, in order to maintain training of manual skills [20,30]. Simulation has been demonstrated to be highly beneficial to improve procedural knowledge and technical skills, with a growing trend of adopting neurosurgical simulators [35].…”

“…This reduction was shown to negatively impact neurosurgical trainees, especially regarding the reduced quantity and variety of cases available. This led to reduced procedural skills' subspecialisation, reduced responsibilities, poor independent management and hospital access [15,[19][20][21][22]. In some centres, these reductions in case load have been more apparent for residents, with one US teaching hospital observing a 59% decrease in bedside procedures for residents when compared with previous years [16].…”

“…In the operating theatre, camera-embedded surgical lights were routed to an in-room audio-visual interface to keep residents in contact with the operating room [14,29]. To maintain surgical hand skills education at a distance, an at home microsurgical skill training programme was developed and implemented in Argentina, in which participants used a set of instruments and smartphones as magnification devices in order to perform several exercises-explained in advance via video [20]. In addition, in the USA, a 3D printed low-cost and openaccess simulation device of the lumbar spine was developed for anatomical learning and spine surgical simulation, allowing neurosurgical trainees to learn remotely [30].…”

Creating a Proficiency-based Remote Laparoscopic Skills Curriculum for the COVID-19 Era

“…Multiple publications report various attempts to creatively maintain skills training via remote methods. These curricula have focused on using at-home or easily accessible products, a variety of low- to high-fidelity products, and spanned many different disciplines of surgery 1 , 2 , 3 , 4 , 5 .…”

No Microscope? No Problem: A Systematic Review of Microscope-Free Microsurgery Training Models

“…To address these barriers, microsurgical training models that leverage digital technologies to replace costly operating microscopes have emerged. For example, microsurgical training models that use smartphone camera magnification [13][14][15][16][17][18][19][20][21][22] or virtual reality (VR) simulators [23][24][25][26] now exist, offering trainees the ability to practice microsurgery with easily accessible technologies. These training models vary in components, cost, magnification, and portability which ultimately impacts their training value and ability to enhance trainee microsurgical skills.…”