Name of the activity: Courses of Microsurgery

Country/NMO: Czech Republic (IFMSA-CZ)

Program: Teaching Medical Skills

 

Contact information: [email protected]

Type of the activity: Education

 

General description:

The Course of Microsurgery is a very intensive project with an individual approach. Thanks to the duration of the course we are able to provide the students with adequate care and give them a unique experience which would be for most of them accessible only after studies. We allow students the access to instruments, materials, and procedures which are for them otherwise unavailable. We hope that the Course of Microsurgery will help students with the start of their surgical carriers and that hospitals will also benefit due to more experienced peers.

Focus area:

Surgical Skills

Problem statement:

There is not a single medical student who has not heard about microsurgery. We usually learn the theory, however, we rarely have the opportunity to actually try it by ourselves. This was the reason for establishing the “Course of Microsurgery” project, open for all the students interested in the topic. Our course is very intensive and individual – each lasts 3 days (during weekends). Students start with small chicken vessels and finishes the course with making an anastomosis of the femoral artery on a living rat. So far we have trained about 50 medical students, but much more applied.

Target groups and beneficiaries:

Our target are medical students of all the medical faculties in the Czech Republic, with a preference for fourth to sixth year students with a serious interest in microsurgery or surgery in general.
The direct benefit will be that for the medical students. Learning extra skills will add value to their CVs, and will help them in the competitive field that is medicine. Having practical skills will be a plus when applying for a job.
Training students will ultimately make them more experienced, and therefore it will benefit patients, in a long run. They will subsequently receive better care from young doctors that had been previously educated in microsurgery techniques via our program.
Another group of beneficiaries would be hospitals and surgical departments in which these young doctors will be employed. Having finished our course, they will be better prepared, and already skilled.
The last, but not least, there will also undoubtedly be a benefit for the senior doctors at the plastic, vascular or neurosurgery or other departments, since they will be able to spend their limited time more effectively, rather than spending it on teaching basic microsurgical techniques.

Objectives and indicators of success:

Our objective is to allow other medical students to work with instruments, which are otherwise inaccessible. For this, we have obtained sponsors who provide us with all the necessary equipment such as microscopes, microsurgery forceps, needle holders or suture materials.
We want to provide sufficient opportunities to try dissection, creating a vascular anastomosis, and other techniques that are nowaday common in microsurgery. For this we collaborate with the department of Plastic Surgery which allows us to operate on living laboratory rats.
The main goal is to allow the students to perform an operation on their own without the assistance of any tutor.
Lastly, we want the students to find their passion for surgery, increase their enthusiasm, and show them that medicine and surgery can be fun.

Summary:
– to teach students who are interested in microsurgery and surgery general basics of microsurgery techniques
– allow medical students to work with instruments, which are usually inaccessible
– to let the students perform an operation on a living rat on their own without the assistance of any tutor
– to expand the curriculum
– to have fun and to boost their enthusiasm in surgery and medicine in general
– we would like to continue our work and our raise the number of trained students to 60 per year
– every single student will be able to make an anastomosis on a vessel

Methodology:

Our courses take place in a special laboratory equipped with microscopes and other special instruments that are needed. There is also a room where the lab rats excluded for this purpose are held.
The whole course last 3 full days (usually during weekends).
The whole process of carrying out a single course of microsurgery starts by discussing a possible date for at least 2 lectors (training 5 students). We then put up a link for students to sign up. Necessary requirement for signing up is a motivational letter and previous experience in surgery. Based on those we choose 5 students which we think will benefit from the course the most.
On the day of the course, lectors arrive in advance and prepare the working stations in the laboratory. Each station consists of a microscope, suture material, gloves, chicken leg/chicken wing/rat, microsurgery scissors, microsurgery needle holder, microsurgery forceps, clamps and saline solution.
The first lecture starts with a short presentation about the basics of microsurgery, schedule, and skills that will be taught throughout the course. We give each student a special textbook to study during the whole weekend, providing all the needed information for microsurgery skills. Students then try basic work with instruments on latex gloves and chicken wings. The second day is dedicated to vascular anastomoses. Students prepare veins and then arteries on chicken legs, cut them and then try to make a functional end-to-end anastomosis.
The last day is the highlight of our course. We give one sedated rat to each student and each one of them should perform surgery consisting of making end-to-end anastomosis on a femoral artery. In the best case scenario the rat survives a is treated as any other rat after an experiment.

Plans for evaluation:

Before the course we ask students what are their expectations, skills, and if they have any previous experience in microsurgery.
We usually conduct a survey at the end of the course. The students have a place to express what they liked or disliked and submit it. Subsequently, we collect the feedback forms which we then interpret and discuss amongst the lectors. We are talking with the tutors even in between the courses. We share ideas on how to improve the project, share results of the survey and they even take a part in selecting the most suitable students for the course according to their motivational letter.
We also have a Facebook group where students are able to leave comments, ask questions, and obtain information on the course.