Transcript Document

Microsurgical Institute 4
mSTAR
Micro-Surgical Training at Residence
Mohsan M Malik
Muaaz Tahir & Musab Hussein
Dhalia Masud & Nadine Haram
Ms. Pari-Naz Mohanna
Introduction
Time for
Training
Foundation for
Excellence
Sir John Temple
Prof. John Collins
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Current Training
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Proposed Model
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Tablet Trainer
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Low Cost Microscope
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Comparison
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Validating the Concept
RCT to assess construct validity of home based
training modalities on basic microsurgery skills
learning
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Enrolment
40 novices recruited
Blocked randomisation into 4
groups
Randomisation
(1:1 ratio)
Baseline skills testing
Drop out
n=1
Control (n=9)
Allocation
Theory and
demonstration; Chicken
vessel anastomosis
No training
sessions
Lab-based
training (n=10)
Once weekly
training
sessions for 1
month
Home
microscope
training (n=10)
Training at
home for 1
month
Post training assessment
Home iPAD
training (n=10)
Training at
home for 1
month
Chicken vessel
anastomosis
Primary outcome measures
Performance in chicken vessel anastomosis,
assessed before and after training
1. Objective markers:
•
•
Time taken
Suture Efficiency - Number of sutures placed/time taken
1. Quality markers:
•
Global Rating Scale – Structured Assessment of
Microsurgery Skills (SAMS); including presence of leak
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Results
• No inter-group differences at baseline in
– Time taken (p = 0.170)
– Suture Efficiency (p = 0.762)
– SAMS (p = 0.204)
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Total time taken to complete
p = 0.98
p = 0.06
p = 0.02
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Suture Efficiency
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Global Rating Score: SAMS
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Discussion
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Take Home Message
Training at home (using tablet computer OR low-specification
microscope) produces comparable outcomes on an
end-to-end arterial anastomosis model, when
compared with a 4-week laboratory based
training programme;
Thus being a cost-effective, accessible method
for training
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Thank you
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Acknowledgements
Mi4 Team
• Ms Pari-Naz Mohanna
• Ms Dhalia Masud
• Ms Nadine Hachach Haram
• Mr Muaaz Tahir & Mr Musab Hussein
and
• Mr Matt James
• Dr Sonia Panchal
• Health Education England
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Training sessions:
Rotate between 4 basic tasks
Multiple repetitions of each of the following:
1.
‘Round the clock’
– Time taken to complete
2.
‘In-out, up-down’
– Time taken to complete
3.
‘Star’s the limit’
– Time taken to complete
4.
Glove suturing task
– Number of sutures placed in 20 minutes
• Time taken to place a suture
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Home Curriculum
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