Acquisition of Basic Microsurgical Skills Using Low Cost Readily Available Models: The Orange Model.

BACKGROUND Attainment of basic microsurgical skills in neurosurgery presents a departmental challenge worldwide. Models for teaching are either not readily available or expensive, and are incompatible with a resident's busy schedule, requiring lengthy and proper setup. OBJECTIVE Presenting a model and a set of measurable tasks, based upon a fruit (orange) which is cheap, easy to setup instantly when desired and can be used for training of basic microsurgical skills. METHODS Basic microsurgical skills were identified necessitating hand-eye coordination working with the microscope. The goal was to dissect an orange segment, while preserving adjacent segments. Assessment was based on the number of side tears and task completion duration. Task was repeated in sequential manner (N=10), for validation purposes, for 3 operators at different seniority levels. RESULTS An improvement in number of side tears (mean of 12.66+-9.01 in the 1st trial vs 4+-4.35 in the 10th trial, p<0.01), as well as duration of time required for task completion (mean initial duration of 28:16+-19:00 minutes to a duration of 16:33+-10:50 minutes in the last attempt ,p<0.01)was observed. Daily practice scores and time gradually improved, and seniority level of operators was correlated with scoring between individuals. CONCLUSION The orange model is an easily accessible, cheap model enables the acquisition of basic micro-neurosurgical skills. In this work, we validated and defined reproducible tasks that can be scored and tracked, correlated with operator's proficiency and experience. This model can be incorporated into a resident's workflow environment and provides a platform for attainment of elementary microsurgical skills for neurosurgical residents.