Sunday, October 3, 2010
18078

Incorporation of a Standardized Fresh Tissue Dissection Curriculum Into Plastic Surgery Education: An Old Solution to a New Problem

Joseph Nicholas Carey, MD1, Justin Kane, MD2, Christopher A. Campbell, MD1, Morad Askari, MD2, Dung Nguyen, MD, Mark Urata, MD, DDS3, Randy Sherman, MD4, and Wesley Schooler, MD2. (1) Plastic Surgery, University of Southern California, 1510 San Pablo Street, Suite 415, Los Angeles, CA 90033, (2) Plastic & Reconstructive Surgery, University of Southern California, 1510 San Pablo St, Suite 415, Los Angeles, CA 90033, (3) Plastic Surgery, Childrens Hospital Los Angeles, Mailstop # 96, 4650 Sunset Boulevard, Los Angeles, CA 90027, (4) Plastic Surgery, Cedars Sinai Medical Group, 8635 W 3rd 770W, Los ANgeles, CA 90048

PURPOSE: In an age of surgical education where work hours have been limited, and “practicing on patients” has become less tolerated, we are continuously searching for alternative methods of giving residents surgical experience while protecting our patients from novice errors. In plastic surgical simulation, fresh cadaveric tissue dissection remains the standard to which any simulation could be compared. We postulated that incorporating a required curriculum of fresh tissue dissections with emphasis on surgical technique and simulation would improve resident education, confidence, and ultimately quality of surgical performance.

METHODS: We designed a quarterly curriculum of required dissections divided into Craniofacial, Reconstruction, Hand, and Aesthetic sections. Fresh cadavers were obtained through coordination between the Pathology and Surgical Departments. Dissections were designed to emphasize surgical technique and anatomical concepts. Evaluation data were reported by participants on a confidence scale of 1-5, before and after dissection.

RESULT: A curriculum of fresh tissue dissections was created and implemented over a 3 year period. A total of 42 full dissection days occurred, and a total of 115 different procedures were reported. Dissection participants included, Residents (n=24), Staff (n=14), International Visitors (n=36), Medical Students (n=26). Data were gathered for n=9 residents, regarding confidence pre and post dissection. For n=115 dissections, resident predissection confidence was 1.8±0.98 and post dissection was 4.4±0.92.

CONCLUSION: Our results demonstrate that providing and requiring anatomic fresh tissue dissection and surgical simulation significantly improved resident confidence with plastic surgery operations. We believe that including and requiring fresh tissue dissection in plastic surgery training will provide an answer to improving surgical training in a decreased work hour environment. Additional evaluation is needed to establish evidence that patient outcomes and surgical quality can be improved with the addition of surgical simulation in plastic surgery education.

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