A Novel Mammoplasty Part-Task Trainer for Simulation of Breast Augmentation: Description and Evaluation.

INTRODUCTION: Since the introduction of competency-based education and the restriction of residents' working hours, simulator-aided training has obtained increasing attention for its role in teaching and assessing resident surgical skills. Within plastic surgery training, such simulators would be particularly useful for aesthetic surgery procedures such as augmentation mammoplasty where residents have fewer opportunities for hands-on experience. The aims of this study were to develop a part-task trainer that allows plastic surgery trainees to acquire skills necessary for augmentation mammoplasty and to assess its potential value as a training tool. METHODS: The mammoplasty part-task trainer (MPT) was designed to have a reusable and rigid thorax base and "soft" disposable layers to mimic the skin and subcutaneous tissues. A mock unilateral subglandular breast augmentation was performed by 4 board-certified plastic surgeons using standard instruments and scored using a 0 to 5 Likert scale where a score of 5 was considered the most satisfactory. RESULTS: Four board-certified plastic surgeons participated in the survey. On a scale of 0 to 5, the MPT's "value" as a training tool, "relevance to practice," and "physical attributes" scored highest, with mean values of 4.5, 4.3, and 4.1, respectively. "Realism of experience," "ability to perform tasks," and "realism of material" scored 3.9, 3.8, and 3.7, respectively. The observed average of the "global assessment" of the MPT was 4.3. The cost of fabrication of the MPT was estimated at approximately Can $113. CONCLUSIONS: This study describes a preliminary novel mammoplasty task trainer that was highly valued by experts as a potential training tool.

The Development of Assessment Tools for Plastic Surgery Competencies.

BACKGROUND: Objective tools to assess procedural skills in plastic surgery residency training are currently lacking. There is an increasing need to address this deficit in order to meet today's training standards in North America. OBJECTIVES: The purpose of this pilot study was to establish a methodology for determining the essential procedural steps for two plastic surgery procedures to assist resident training and assessment. METHODS: Following a literature review and needs assessment of resident training, the authors purposefully selected two procedures lacking robust assessment metrics (breast augmentation and facelift) and used a consensus process to complete a list of procedural steps for each. Using an online survey, plastic surgery Program Directors, Division Chiefs, and the Royal College Specialty Training Committee members in Canada were asked to indicate whether each step was considered essential or non-essential when assessing competence among graduating plastic surgery trainees. The Delphi methodology was used to obtain consensus among the panel. Panelist reliability was measured using Cronbach's alpha. RESULTS: A total of 17 steps for breast augmentation and 24 steps for facelift were deemed essential by consensus (Cronbach's alpha 0.87 and 0.85, respectively). CONCLUSION: Using the aforementioned technique, the essential procedural steps for two plastic surgery procedures were determined. Further work is required to develop assessment instruments based on these steps and to gather validity evidence in support of their use in surgical education.