Document Detail

Tracking the learning curve in microsurgical skill acquisition.
MedLine Citation:
PMID:  23018716     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Despite advances in surgical training, microsurgery is still based on an apprenticeship model. To evaluate skill acquisition and apply targeted feedback to improve their training model, the authors applied the Structured Assessment of Microsurgery Skills to the training of microsurgical fellows. They hypothesized that subjects would demonstrate measurable improvement in performance throughout the study period and consistently across evaluators.
METHODS: Seven fellows were evaluated during 118 microsurgical cases by 16 evaluators over three 1-month evaluation periods in 1 year (2010 to 2011). Evaluators used the Structured Assessment of Microsurgery Skills questionnaire, which measures dexterity, visuospatial ability, operative flow, and judgment. To validate the data, microsurgical anastomoses in rodents performed by the fellows in a laboratory at the beginning and end of the study period were evaluated by five blinded plastic surgeons using the same questionnaire. Primary outcomes were change in scores between evaluation periods and interevaluator reliability.
RESULTS: Between the first two evaluation periods, all skill areas and overall performance improved significantly. Between the second two periods, most skill areas improved, but only a few improved significantly. Operative errors decreased significantly between the first and subsequent periods (81 versus 36; p < 0.05). In the laboratory study, all skills were significantly (p < 0.05) or marginally (0.05 ≤ p < 0.10) improved between time points. The overall interevaluator reliability of the questionnaire was acceptable (α = 0.67).
CONCLUSIONS: The Structured Assessment of Microsurgery Skills questionnaire is a valid instrument for assessing microsurgical skill, providing individualized feedback with acceptable interevaluator reliability. Use of the questionnaire is anticipated to enhance microsurgical training.
Jesse C Selber; Edward I Chang; Jun Liu; Hiroo Suami; David M Adelman; Patrick Garvey; Matthew M Hanasono; Charles E Butler
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Plastic and reconstructive surgery     Volume:  130     ISSN:  1529-4242     ISO Abbreviation:  Plast. Reconstr. Surg.     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-09-28     Completed Date:  2012-12-14     Revised Date:  2014-10-13    
Medline Journal Info:
Nlm Unique ID:  1306050     Medline TA:  Plast Reconstr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  550e-557e     Citation Subset:  AIM; IM    
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MeSH Terms
Academic Medical Centers
Clinical Competence*
Education, Medical, Graduate / methods
Educational Measurement
Fellowships and Scholarships
Internship and Residency
Learning Curve*
Microsurgery / education*
Observer Variation
Reproducibility of Results
Task Performance and Analysis
Grant Support

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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