# Basic microsurgical skills can be taught to novices with video material only - a prospective multicenter laboratory study

## TL;DR

This study shows that video-based training is just as effective as hands-on tutoring for teaching basic microsuturing skills to novices.

## Contribution

The study demonstrates that video-only instruction is non-inferior to hands-on tutoring for microsurgical skill acquisition.

## Key findings

- Video-based instruction produced non-inferior results to hands-on tutoring in suturing speed, quality, and error count.
- No significant differences were found between microscope and exoscope users in skill development.
- A short video-instruction program led to significant improvement in microsuturing skills.

## Abstract

The increasing use of educational video materials has provided an alternative to traditional apprenticeship-models in surgical education. We aim to evaluate if video materials are as effective as hands-on tutoring in teaching basic microsuturing skills. Additionally, we want to see if the magnification device (microscope vs. exoscope) affects learning outcomes.

Is video-based instruction an effective alternative to hands-on tutoring in teaching basic microsuturing skills to novices?

We designed an 8-h training program with videos to teach basic microsuturing skills to novices. Thirty medical students from two large medical universities in Europe (Helsinki and Prague) were randomised to receive either video instructions only (n = 20) or hands-on tutoring and video instruction (n = 10). Participants were further assigned to using either an exoscope (n = 15) or a microscope (n = 15) in their training. We assessed skill acquisition using a standardized microsuturing test task. All tasks were recorded and scored based task speed, quality of the suturing and the number of errors.

All groups demonstrated significant improvement in suturing speed, qualitative assessment, and fewer errors. Video instructions only produced non-inferior results to hands-on tutoring in the improvement in speed, error count and quality of sutures. No significant differences were found when comparing microscope and exoscope users.

Video-based instruction and hands-on tutoring seem equally effective in teaching basic microsuturing to surgical novices, irrespective of the magnification device used. Video-materials can be utilized in microsurgical laboratory training of novices as a more resource-efficient teaching method compared to hands-on tutoring.

•Video-based instruction of microsuturing is non-inferior compared to hands-on tutoring.•A short video-instruction program resulted in significant improvement in microsuturing.•Introduction of 3D exoscopes to microsurgical training does not hinder skill development.

Video-based instruction of microsuturing is non-inferior compared to hands-on tutoring.

A short video-instruction program resulted in significant improvement in microsuturing.

Introduction of 3D exoscopes to microsurgical training does not hinder skill development.