Undergraduate microsurgical training: a preliminary experience

Abstract

Microsurgical training is organised almost exclusively in a post-graduate setting, usually for residents of various surgical specialities. The aim of this study was to present an undergraduate microsurgical training model directed toward medicine students of clinical years. Curriculum design and results. Two six-participant groups of students interested in training were recruited. The programme consisted of 15 three-hour classes (2 hours’ work under the microscope) and divided into basic and advanced training parts. The simulation model used in this course was a chicken thigh. The basic training programme consisted of placing sutures on a latex glove followed by preparation of a chicken thigh neurovascular bundle and performing femoral nerve and artery anastomoses. The advanced part of the training consisted of practising the acquired skills and the introduction of new techniques such as end-to-side arterial anastomosis, artery and nerve repair with vein conduit. A “6-stitches test” was used as an outcome measure of the acquired microsurgical skills. After 15 weeks and 30 hours of training and performing 31 anastomoses the undergraduate microsurgical course was completed.

Conclusion The results of this study show that the undergraduate, facultative microsurgical training is effective in acquiring microsurgical skills, competence and confidence for participating students

Zusammenfassung

Die Ausbildung in der Mikrochirurgie wird beinah ausschließlich im Rahmen eines weiterführenden Studiums durchgeführt – normalerweise für Assistenzärzte in unterschiedlichen chirurgischen Fachgebieten. Diese Studie sollte ein Modell für die Ausbildung von Studenten in der Mikrochirurgie vorstellen, insbesondere für Medizinstudenten in den klinischen Jahrgängen. Design des Lehrplans und Ergebnisse: Wir rekrutierten zwei Teilnehmergruppen von je sechs Studenten, die sich für diese Ausbildung interessierten. Das Programm bestand aus 15 dreistündigen Klassen (je 2 Stunden Arbeit mit dem Mikroskop), die zwischen einführenden und fortgeschrittenen Ausbildungsabschnitten geteilt wurden. In diesem Kurs stellte der Hühnerschenkel das Simulierungsmodell dar. Das einführende Ausbildungsprogramm bestand aus drei Teilen: Nähte auf einen Latexhandschuh einzuführen, die Vorbereitung eines neurovaskulären Bündels aus dem Hühnerschenkel und die Vorbereitung von Anastomosen im femoralen Nerv und in der femoralen Arterie. Im fortgeschrittenen Teil mussten die angeworbenen Techniken geübt werden. Darüber hinaus lernten die Teilnehmer neue Techniken, zum Beispiel Ende-an-Seite Anastomose sowie Wiederherstellung von Arterien und Nerven mit einem venösen Abfluss. Ein 6-Stich Test wurde als Maß des Erwerbs der neuen mikrochirurgischen Fertigkeiten eingesetzt. Nach 15 Wochen, 30 Ausbildungsstunden und der Fertigstellung von 31 Anastomosen war der Studentenkurs in der Mikrochirurgie abgeschlossen.

Schlussfolgerung Die Ergebnisse belegen, dass die fakultative Ausbildung in der Mikrochirurgie einen wirksamen Ansatz für die Studenten darstellt, um mikrochirurgische Fertigkeiten, Können und Vertrauen zu erwerben.

Key words

Microsurgical training - Practice based learning - Undergraduate surgical curriculum

Schlüsselwörter

Mikrochirurgische Ausbildung - praktische Ausbildung - Studienlehrplan in der Chirurgie

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