Grants We Funded

Abstract

Project Summary: The field of microsurgery has allowed for extraordinary surgical advancements in plastic surgery. Similarly, training in microsurgery has advanced significantly, from instructional videos and online modules, to hands-on practice. Because of its complexity, microsurgery cannot be learned simply by observation. How can we best train and improve microsurgical skills that is both efficient and effective? We must develop a validated model that training programs can utilize to allow residents to practice microsurgical skills in a timely yet effective manner. The concept of skill decay and spaced learning is well-studied. Short bursts of learning have been shown to be more effective than longer periods. Our long term goal is to demonstrate an effective method of teaching and practicing microsurgery to surgical residents through small increments of hands-on practice. The overall objective is to show that a spaced learning curriculum which provides short bursts of hands-on practice creating microsurgical anastomoses is the most effective method of microsurgical training. Specific aims: 1) To evaluate the competency of novice learners' microsurgical skills after a month-long period of training with either short bursts of practice versus longer training periods; and 2) To assess learner confidence in completing a microsurgical anastomosis over a month-long training period with either short bursts of practice versus longer training periods. Participants will be randomized into one of two groups: Group 1 will be the spaced learning cohort, and Group 2 will undergo bulk practice. Prior to beginning, participants will be given a survey to assess their level of confidence in microsurgery. Over a four week period, Group 1 will be provided four 15 minute practice sessions per week. Group 2 will be provided a once weekly hour long session. During the final week, a video recording of the final anastomosis will be obtained of each participant, which will be graded by microsurgery faculty using the validated SMaRT scale. Additional data points will include the time to complete the anastomosis, and if the anastomosis was immediately patent. The participants will be given the confidence survey again at the completion of the four week practice period. Results from our study will encourage residency programs to implement this strategy. Development of effective microsurgical training programs ultimately have profound implications on patient safety and wellbeing.

Impact Statement: We expect our data to show that learning microsurgery through short bursts of practice is the most effective and efficient way of developing procedural skills and confidence, compared to long periods of training. Time is a precious commodity. It is often difficult for surgical trainees to set aside long periods of time for microsurgical practice. Validating a model of spaced learning in microsurgical training would provide evidence-based research which would encourage residency programs to adopt this model. Improving training in microsurgery would ultimately have profound implications on patient safety and wellbeing. Data from our study could even be broadened to surgical education in general, lending support to establishing spaced learning programs in all surgical specialties.

Biography
Jessie Koljonen, MD is an integrated plastic surgery resident at Southern Illinois University. She graduated from Johns Hopkins University with a dual bachelor’s degree in Behavioral Biology and Spanish. As an undergraduate, she worked as a research assistant in a Language and Cognition Lab, which focused on understanding language acquisition and development in children. She later worked in a Behavioral Neuroscience Lab, which studied the neural mechanisms of reward dependent learning, where she assisted with behavioral conditioning of rodent subjects. These experiences provided a foundation for understanding basic and clinical science research processes. She earned a Master of Science in Biomedical Sciences degree from Tufts University, where she studied the topic of Substitution Therapy in the Treatment of Opiate Addiction. She earned her medical degree from the University of Arizona College of Medicine – Phoenix. As a medical student, she worked in a Translational Neuroscience Lab studying the effects of traumatic brain injury on the expression of ATP-Binding cassette transporters. Her senior thesis investigated a comprehensive methadone program for opiate-dependent pregnant women prisoners. Results of this study helped show the efficacy of methadone therapy at lowering rates of recidivism in this high-risk population. She aspires to be an academic reconstructive microsurgeon. Her research interests include microsurgical education, nerve regeneration, and patient outcomes.