Developing Microsurgery Skills Outside of the Operating Room

Abstract

Background: The complex skills required to perform microsurgery are primarily taught in the high-stakes environment of the operating room. However, learners would benefit from developing these abilities in lower-stakes environments beforehand, allowing them to focus on higher-level tasks intraoperatively. This article outlines available resources for developing microsurgical skills outside the operating room and evaluates their alignment with best practices for performance enhancement, thereby identifying ways to improve microsurgical education. Methods: A systematic review and web search were performed in April 2024 to identify available microsurgical skills courses. Descriptive data were extracted from these resources, including course objectives, unique features, model used, and curriculum. Results: Literature and web search revealed 7 online video courses addressing microsurgical skill development. These had freely available multimedia content and used low-fidelity models with widely accessible materials. Six offered a curriculum. By contrast, 14 in-person flap and microsurgery courses in the United States were identified. These occurred over 2–5 days, cost thousands of dollars, and used high-fidelity models with guidance from experts. Finally, there were many simulation platforms ranging from low-fidelity synthetic models to cadaveric tissue to high-fidelity live animal models. These also encompassed technology-based practices such as virtual reality. Conclusions: Compared with high-fidelity training, low-fidelity models are more affordable, are reusable, and allow for dedicated educational opportunities that are better aligned with best practices for knowledge and skill acquisition. Consequently, they have the potential to reach a broader range of trainees and accelerate the learning curve, and therefore should be integrated into every microsurgery training program.