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A portable, low-cost practice model for microsurgical skills training

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Abstract

Purpose

We describe a portable practice model for acquisition of microsurgical skills using widely available inexpensive tools and materials as a model in learning ophthalmic corneal suturing skills.

Methods

Interested participants without prior microsurgery experience affiliated with the Jacobs School of Medicine and Biomedical Sciences with no prior microsurgical experience qualified to participate. Each participant completed written informed consent. We developed a 3-dimensional micro-stellated icosahedron model using microtubules, monofilament fishing line, jewelers’ forceps, and a basic laboratory dissection microscope. We tested this model in improving microsurgical skills in a randomized, controlled intervention trial. Following a pre-assessment task of passing a microsurgical needle and performing a tie, participants were randomized to a control or an intervention (building the micro-stellated icosahedrons) group. The assessment task was repeated after two weeks. Videos of pre- and post-assessments were rated by two masked ophthalmologists. Technique scores and time to complete microsurgical tasks were analyzed to determine improvement in skills.

Results

A total of 27 microsurgically naïve participants were recruited and randomized (14 Intervention / 13 Control). Comparing pre- and post-assessments, the intervention group showed significant decrease in time required to pass the needle (P = 0.018) and significant improvement in technical scores. (P = 0.001). In the control group, there was no significant decrease in time or improvement in technical scores.

Conclusions

The portable inexpensive micro-stellated icosahedron skills acquisition model is an effective practice model to acquire skills necessary to perform a microsurgical tie. The similarity in dimensions between the model and the eye suggests translatability to ophthalmic surgery.

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Data availability

All data are available upon request.

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Funding

The research leading to these results received funding from in part, by the Buffalo Eye Bank Foundation Vision Research Support Fund (Buffalo, NY; support for materials and stipend, HDG-A) and facilities and resources provided by the VA Western New York Healthcare System (Buffalo, NY). Funding organization had no role in the design or conduct of this research. The contents of this work do not represent the views of the Department of Veterans Affairs or the United States government. Research reported in this publication was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under award number UL1TR001412. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. Funding organization had no role in the design or conduct of this research.

Author information

Author notes

  1. Chi Chen

    Present address: Novartis Institutes for Biomedical Research, Shanghai, 201203, China

  2. Jiwei Zhao

    Present address: Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, WI, USA

Authors and Affiliations

  1. Ross Eye Institute, Department of Ophthalmology, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, USA

    Henry D. Greyner-Almeida, Ali Mahdavi Fard & Sangita P. Patel

  2. Department of Biostatistics, School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, NY, USA

    Chi Chen & Jiwei Zhao

  3. Research and Ophthalmology Services, Veterans Administration of Western New York Healthcare System, Buffalo, NY, USA

    Sangita P. Patel

  4. Ross Eye Institute, 1176 Main Street, Buffalo, NY, 14209, USA

    Sangita P. Patel

Authors
  1. Henry D. Greyner-Almeida
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  2. Ali Mahdavi Fard
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  3. Chi Chen
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  4. Jiwei Zhao
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  5. Sangita P. Patel
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Contributions

HDG-A and SPP designed the study. HDG-A, AMF, and SPP performed the study. HDG-A, CC and JZ analyzed the data. HDG-A wrote the first draft of the manuscript which was edited by all authors. SPP supervised all stages of the study and manuscript preparation.

Corresponding author

Correspondence to Sangita P. Patel.

Ethics declarations

Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethical approval

This study was approved by the Institutional Review Board at the University at Buffalo (STUDY00001491) and adhered to the principles of the Declaration of Helsinki.

Consent for participate

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher's Note

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Trial Registration: ClinicalTrials.gov NCT04093063

Supplementary Information

Below is the link to the electronic supplementary material.

Instruction Manual. Instruction manual provided to participants in the intervention group (PDF 1240 KB)

Instructional Video. Video presented to all participants before each pre- and post-assessment microsurgical task, explaining detailed steps on how to perform a needle pass and a microsurgical task. Format: .mp4 (MP4 13758 KB)

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Greyner-Almeida, H.D., Mahdavi Fard, A., Chen, C. et al. A portable, low-cost practice model for microsurgical skills training. Int Ophthalmol 42, 2323–2333 (2022). https://doi.org/10.1007/s10792-022-02229-1

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  • DOI: https://doi.org/10.1007/s10792-022-02229-1

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