Home Program for Acquisition and Maintenance of Microsurgical Skills During the Coronavirus Disease 2019 Outbreak

Abstract

Background: During the current global crisis unleashed by the severe acute respiratory syndrome coronavirus 2 outbreak, surgical departments have considerably reduced the amount of elective surgeries. This decrease leads to less time in the surgical room to develop and improve the surgical skills of residents. In this study, we developed a training program to obtain and maintain microsurgical skills at home, using a smartphone camera and low-cost materials, affordable for everyone.

Methods: Using a smartphone camera as a magnification device, 6 participants performed 5 exercises (coloring grids, grouping colors, unraveling of a gauze, knots with suture threads, and tower of Hanoi), both with the dominant and with the nondominant hand, for 4 weeks. We compared performance at the beginning and at the end of the training process. Each participant filled out an anonymous survey.

Results: When we compared the performance at the beginning and at the end of the training process, we found significant improvements (P = 0.05) with the dominant as well as the nondominant hand in all the exercises. All participants were satisfied or very satisfied with the definition of the objectives of the training process, material availability, the exercises performed, the choice of the time to train, and general satisfaction with the training program.

Conclusions: We developed a microsurgical skills training program to be performed at home, which can be easily reproduced. It allows residents to improve manual coordination skills and is regarded as a feasible adjunct for ongoing training for surgical residents.

Keywords: COVID; Microsurgery; Neurosurgery; Pandemic; Simulation; Training.

Figure 1

Assembly of cell phone support using a shoe box. (A) In the back surface of the box, the cell phone contour is drawn. Inside, 4 tabs are drawn (dotted lines). (B) A cut is made along the dotted lines, the rectangle disposed, and the tabs inverted to the interior of the box. (C) The cell phone is placed with the screen upward. (D) The lateral surfaces of the box are cut and the support system is ready to use.

Figure 2

Participant training at home.

Figure 3

Grid coloring exercise.

Figure 4

Unraveling of the gauze.

Figure 5

Suturing and tying on the gauze.

Figure 6

Associating colors.

Figure 7

Tower of Hanoi exercise.