LABORATORY BASED TRAINING IN UROLOGICAL MICROSURGERY WITH BENCH MODEL SIMULATORS: A RANDOMIZED CONTROLLED TRIAL EVALUATING THE DURABILITY OF TECHNICAL SKILL

TLDR

The study evaluated whether laboratory‑based bench‑model training preserves technical microsurgical skills in junior residents over time. Forty residents received hands‑on bench‑model training and ten received didactic instruction; four months later all were reassessed on a live animal vasovasostomy model using blinded expert checklists and global ratings. Bench‑model training produced significantly higher retention of microsurgical skill, with higher checklist scores, global ratings, and patency rates, and more interim practice opportunities further improved performance.

Abstract

We evaluated the durability of laboratory based technical skills training in urological microsurgery using bench model simulators.A total of 50 junior surgery residents (post-graduate years 1 to 3) were recruited to participate in a focused training program in urological microsurgery. Prior to training subjects were randomized to receive hands-on training with bench model simulators (silicone tubing or live rat vas deferens, 40) or didactic training alone (10). Four months following the original training program the technical performance of 18 returning subjects (13 from the bench model and 5 from the didactic training group) was reevaluated using a high fidelity, live animal model (vasovasostomy and rat vas deferens). Outcome measures included blinded, expert assessment of videotaped performance using checklists and global rating scores, and evaluation of anastomotic patency.The retention test checklist (p <0.001), global rating scores (p <0.001) and anastomotic patency rates (p = 0.05) in the live animal model remained significantly higher for subjects who originally received hands-on bench model training compared with those who received didactic training alone. The number of interim practice opportunities with microsurgery correlated significantly with expert global ratings of surgical performance irrespective of the nature of training (r = 0.54, p = 0.02).Laboratory based technical skills training with bench models can lead to a significant retention of technical skill by novice surgeons. Measured performance improvements appear to be durable with time. However, the opportunity for repeat hands-on practice appears to maximize the retention of technical skill.