Microsurgery Fellows' Impression of Clinical and Educational Offerings during Fellowship Year

Abstract

Background Acquisition of microsurgical skill and clinical knowledge is the primary goal of a microsurgery fellowship. There has yet to be any comprehensive reporting in the literature of how American microsurgery fellows viewed their curricula and training at the conclusion of their fellowship year.

Methods An anonymous, electronic survey was developed and distributed to all 2016 to 2017 microsurgery fellows (n = 37) at the U.S.-based microsurgery fellowship programs (n = 23). Qualitative questions were assessed using either a Likert-type scale of 1 (not at all) to 5 (very), multiple choice, or free response.

Results Twenty-six of 37 fellows (70%) responded to the survey. Respondents reported a mean of 14.4 lectures offered, with a range of 0 to 100. Dry laboratory simulation training was formally incorporated into 32% of microsurgery fellowships and live animal simulation training was formally incorporated into 12%. The median number of free deep inferior epigastric perforator flap cases performed was 112.5, ranging from 60 to 230. A majority felt that an organized microsurgical educational curriculum would be “beneficial,” with 42% reporting that an organized microsurgery curriculum would be “very beneficial.” Twenty-six of the respondents (100%) said that they would choose to do a microsurgery fellowship again if given the choice.

Conclusion Respondent data show that microsurgery fellows are satisfied with training, clinical experience is variable but adequate, educational experiences and opportunities vary from program to program, simulation skills training are perceived to be underutilized, and a program-organized microsurgery curriculum is believed to be advantageous to optimize development of technical and clinical skills.

Keywords

microsurgery - education - plastic - fellowship - curriculum

• References

• 1 Masia J, Sanchez-Porro L, Vega C. , et al. New paradigms in reconstructive microsurgery education. Ann Plast Surg 2019; 83 (03) 243-246
• 2 Fletcher JD. Education and training technology in the military. Science 2009; 323 (5910): 72-75
• 3 Koons D. Applying Adult Learning Theory to Improve Medical Education. UConn Library; 2004: 51
• 4 Vaporciyan AA. Teaching and learning surgical skill. Ann Thorac Surg 2016; 101 (01) 12-14
• 5 Rostom M, Lam WL. Microsurgery fellowships-development of a clinical curriculum. J Reconstr Microsurg 2018; 34 (02) 145-150
• 6 Evgeniou E, Tsironi M, Riley D. Improving fellowship training in microsurgery: a threshold concepts perspective on the curricula of fellowship programs. J Reconstr Microsurg 2015; 31 (08) 579-589
• 7 Mueller MA, Pourtaheri N, Evans GRD. Microsurgery training resource variation among US Integrated Plastic Surgery Residency Programs. J Reconstr Microsurg 2019; 35 (03) 176-181
• 8 Pernar LI, Peyre SE, Hasson RM. , et al. Exploring the content of intraoperative teaching. J Surg Educ 2016; 73 (01) 79-84
• 9 Mehrzad R, Prsic A, Basta M, Bhatt R. A cross-sectional survey study among hand surgeons in the United States on standardizing microsurgery training. J Hand Microsurg 2019; 11 (01) 35-44
• 10 Cigna E, Bistoni G, Trignano E, Tortorelli G, Spalvieri C, Scuderi N. Microsurgical teaching: our experience. J Plast Reconstr Aesthet Surg 2010; 63 (06) e529-e531
• 11 Lascar I, Totir D, Cinca A. , et al. Training program and learning curve in experimental microsurgery during the residency in plastic surgery. Microsurgery 2007; 27 (04) 263-267
• 12 Nugent E, Joyce C, Perez-Abadia G. , et al. Factors influencing microsurgical skill acquisition during a dedicated training course. Microsurgery 2012; 32 (08) 649-656
• 13 Hui KCW, Zhang F, Shaw WW. , et al. Learning curve of microvascular venous anastomosis: a never-ending struggle?. Microsurgery 2000; 20 (01) 22-24
• 14 Dumestre D, Yeung JK, Temple-Oberle C. Evidence-based microsurgical skill-acquisition series part 1: validated microsurgical models--a systematic review. J Surg Educ 2014; 71 (03) 329-338
• 15 Evgeniou E, Walker H, Gujral S. The role of simulation in microsurgical training. J Surg Educ 2018; 75 (01) 171-181
• 16 Rodriguez JR, Yañez R, Cifuentes I, Varas J, Dagnino B. Microsurgery workout: a novel simulation training curriculum based on nonliving models. Plast Reconstr Surg 2016; 138 (04) 739e-747e
• 17 Costa AL, Cucinotta F, Fazio A. , et al. Anterolateral thigh flap in a chicken model: a novel perforator training model. J Reconstr Microsurg 2019; 35 (07) 485-488
• 18 Malik MM, Hachach-Haram N, Tahir M, Al-Musabi M, Masud D, Mohanna PN. Acquisition of basic microsurgery skills using home-based simulation training: a randomised control study. J Plast Reconstr Aesthet Surg 2017; 70 (04) 478-486
• 19 Webb TP, Weigelt JA, Redlich PN, Anderson RC, Brasel KJ, Simpson D. Protected block curriculum enhances learning during general surgery residency training. Arch Surg 2009; 144 (02) 160-166
• 20 Alfieri J, Portelance L, Souhami L. , et al. Development and impact evaluation of an e-learning radiation oncology module. Int J Radiat Oncol Biol Phys 2012; 82 (03) e573-e580
• 21 Satterwhite T, Son J, Carey J. , et al. The Stanford Microsurgery and Resident Training (SMaRT) scale: validation of an on-line global rating scale for technical assessment. Ann Plast Surg 2014; 72 (Suppl. 01) S84-S88
• 22 Satterwhite T, Son J, Carey J. , et al. Microsurgery education in residency training: validating an online curriculum. Ann Plast Surg 2012; 68 (04) 410-414