Objectives: to present a simple pedagogical experience based in a step by step development of specific surgical skills, measured by video assistance.

Material and Methods: the study was carried out with 25 plastic surgery residents with no previous experience in aesthetic rhinoplasty. The teaching learning method was divided in three main steps:1)Anatomical disections of the nose in fresh cadavers, in order to get the knowledge of the different nasal structures. 2)Specific surgical maneuvers performed in "open nose" fresh cadavers, in order to achieve and develop hand sensations: dorsum resection and lateral osteotomies. 3)Measurement of the same specific maneuvers during the first real rhinoplasty, performed by each resident assisted by a staff surgeon. The following pedagogical parameters were evaluated: knowledeges, attitudes and specific skills. Thru an observable video assisted behavioral scale, residents performances in accuracy and number of atempts were considered as very good, good, acceptable and non acceptable. The whole training program took 40 hours in 2 weeks. Results: this first group was compared with a other population of 25 residents who did not participate in this study. The first group obtained 75% very good and 15% good. The control group obtained 5% very good, 30 % good, 50 % acceptable and 15 % non acceptable. Conclusions: cost benefit ratio analysis in medical education suggests this training as an economic issue to be considered.
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