Acquiring Proficiency in Microsurgery: Utility of Self-Study Training Text in Improving Resident Surgical Aptitude

Microsurgery technique is a basic skill acquired in general surgery residency training and a necessary skill in many other surgical specialties. Despite work hour constraints, the surgical knowledge base and technical aptitude that residents acquire is expanding. This study was designed to evaluate the effectiveness of a microsurgery self-study training text in improving proficiency in general surgery residents.

Two resident cohorts with similar microsurgery experience completed 20 rat femoral artery anastomoses. Prior to participation, the experimental cohort completed Dr. Acland's “Practice Manual for Microvascular Surgery” (2nd ed.) The control resident cohort utilized no preparatory materials. Using laser flow Doppler, blood flow measurements prior to arterial transection (Pre), immediately following reanastomosis (Post), and at 24 hr, recorded as percent change (Flow % Change), along with operative times, were compared between cohorts. Paired t-test (p < .05) determine significance.

Reduced operative time and greater 24-hr blood flow in the experimental over the control cohort was demonstrated with statistical significance, suggesting an advantage to home-study microsurgery training. This could be a cost effective and time efficient alternative for improving resident microsurgery proficiency. Design and implementation of similar methods for other aspects of surgery training may be warranted.