The Educational Impact of Bench Model Fidelity on the Acquisition of Technical Skill

TLDR

The study aimed to assess how bench model fidelity influences novice surgeons’ acquisition of microsurgical technical skill using clinically relevant outcome measures. Fifty junior residents were randomized to high‑fidelity live‑rat, low‑fidelity silicone, or didactic training, then evaluated immediately and 30 days later on procedure time, expert‑rated performance, anastomotic patency, suture precision, and product quality. Hands‑on training improved checklist and global ratings regardless of fidelity; immediate patency rose with higher fidelity, while delayed patency improved with any bench training; sperm presence was higher after high‑fidelity training versus didactic, but low‑fidelity training proved as effective as high‑fidelity for skill acquisition.

Abstract

To evaluate the impact of bench model fidelity on the acquisition of technical skill using clinically relevant outcome measures.Fifty junior surgery residents participated in a 1-day microsurgical training course. Participants were randomized to 1 of 3 groups: 1) high-fidelity model training (live rat vas deferens; n = 21); 2) low-fidelity model training (silicone tubing; n = 19); or 3) didactic training alone (n = 10). Following training, all participants were assessed on the high- and low-fidelity bench models. Immediate outcome measures included procedure times, blinded, expert assessment of videotaped performance using checklists and global rating scales, anastomotic patency, suture placement precision, and final product ratings. Delayed outcome measures (obtained from the live rat vas deferens 30 days following training) included anastomotic patency, presence of a sperm granuloma, and the presence of sperm on microscopy.Following training, checklist (P < 0.001) and global rating scores (P < 0.001) on the bench model simulators were higher among subjects who received hands-on training, irrespective of model fidelity. Immediate anastomotic patency rates of the rat vas deferens were higher with increasing model fidelity training (P = 0.048). Delayed anastomotic patency rates were higher among subjects who received bench model training, irrespective of model fidelity (P = 0.02). Rates of sperm presence on microscopy were higher among subjects who received high-fidelity model training compared with subjects who received didactic training (P = 0.039) but did not differ among subjects in the high- and low-fidelity groups.Surgical skills training on low-fidelity bench models appears to be as effective as high-fidelity model training for the acquisition of technical skill among novice surgeons.