The effect of microsurgical training on novice medical students’ basic surgical skills—a randomized controlled trial

Abstract

Background It has been demonstrated that medical students are capable of learning microsurgical techniques. We hypothesize that microsurgical training might give insight into the importance of delicate tissue handling and correct knot tying that could have a positive influence on macrosurgical skills. The primary aim of this study was to evaluate the effect of microsurgical training on macrosurgical suturing skills in novice medical students. Subjects and methods In 2018, 46 novice medical students were enrolled and randomized into two groups. The intervention group received both macro-and microsurgical training and the control group received only microsurgical training. Both groups underwent an assessment test that consisted of macrosurgical tasks of three simple interrupted sutures with a square knot and continuous three-stitch long over-and-over sutures. These tests were individually filmed and assessed using the University of Bergen suturing skills assessment tool (UBAT) and the Objective Structured Assessment of Technical Skill global rating scale (OSATS). Questionnaires regarding future career ambitions and attitudes towards plastic surgery were also completed both prior to and following the tests. Results The intervention group needed a longer time to complete the tasks than the control group (12.2 min vs. 9.6 min, p > 0.001), and scored lower on both the UBAT (5.6 vs. 9.0, p > 0.001) and the OSATS (11.1 vs. 13.1, p > 0.001) assessments. The microsurgery course tended to positively influence the students' attitudes towards a career in plastic surgery (p = 0.002). This study demonstrates poorer macrosurgical skills in the medical students group exposed to microsurgical training. The true effect of microsurgical training warrants further investigation. Level of evidence: Level I, diagnostic study.

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“…Naturally, as medical students progress through their clerkship in the medical school, their knowledge and perceptions regarding medical and surgical specialties should increase due to university-based instructions. 33 Studies comparing pre-clinical years 9 , 21 and clinical years, 12 , 16 , 17 , 23 found media to be a primary source of information. Ultimately, the lack of foundational knowledge in plastic surgery adversely impacted students who gravitate towards a career in plastic surgery and hindered their progression in this competitive field.…”

The LazyBox Educational Intervention Trial: Can Longitudinal Practice on a Low-Fidelity Microsurgery Simulator Improve Microsurgical Skills?

“…To our knowledge, no baseline test (pre-test) was performed, and skills were assessed only using a macrosurgical skill task for each group. A microsurgical task was conducted in the experimental group, but the scores were not compared to those of the control group as they did not perform the microsurgical task [25]. With 38 surgical residents (PGY1-3), this randomized controlled trial compared four surgical training sessions using a Penrose drain, a synthetic artery model, and turkey arteries either compressed in one day or spread across four weeks [14,26].…”

Microsurgical education in Greece: past, present, and future

“…Different objective assessments tools and scoring systems to determine the quality of the training provided to trainees. International consensuses on minimum standards for microsurgical courses [19,20], minimum microsurgery case requirements [21] and several validated training models with objective structured assessment of technical skills (OSATS) have been devised to evaluate the trainers' performance in microsurgery [22][23][24][25].…”