ABSTRACT
Microsurgery is a highly skillful component of Plastic and Reconstructive surgery with a steep learning curve. Due to COVID-19, reduced access to technical courses and hands-on theatre time has created significant challenges in microsurgical education . Trainees must therefore engage in self-education and be adept at accurate self-assessment to overcome this. The aim of this study was to assess the ability of trainees to self-assess technical performance while performing a simulated microvascular anastomosis. Novice and intermediate Plastic surgery trainees were recruited. All participants performed a simulated microvascular anastomosis using a high fidelity chicken femoral vessel model. Each participant objectively rated their anastomosis using the Anastomosis Lapse Index (ALI)[1]. Each anastomosis was then blindly rated by two expert microsurgeons. Selfscores and expert scores were compared using a Wilcoxon-Signed Rank Test. Thirteen surgical trainees completed the simulated procedure. Mean time to completion (TTC) was 22.2 minutes (range 14.2-31.9 minutes). Mean ALI self-score was 3.8 (range 3-5) whilemean ALI expert score was 5.27 (range 4.5-6). There was a significant difference between ALI self-score and expert score (p=0.001) with expert assessors consistently assigning a higher ALI score to the same anastomosis. There was no significant difference between male and female trainees or between novice and intermediate trainees in relation to TTC or ALI self-score. These findings suggest that while the ALI is an excellent training tool, surgical trainees tend to overestimate their technical performance. This emphasises the importance of expert feedback to accurately self-assess progress in the early stages of training.