TITLE:
Surgical Flap and Graft Reconstruction Workshop for Dermatology Residents
AUTHORS:
Brandon Goodwin, Richard Wagner
KEYWORDS:
“Dermatology”, Grafts”, “Flaps, “Surgical Skills Workshop”, “Resident Education”
JOURNAL NAME:
Journal of Cosmetics, Dermatological Sciences and Applications,
Vol.5 No.2,
June
9,
2015
ABSTRACT: Background: Traditional models for
teaching surgical principles focus primarily on the apprenticeship theory;
however there has been a trend in surgical education to certifying competency
in a simulation environment prior to working with patients. Many surgical
models emphasize learning the technical and manual dexterity skills necessary
to be a surgeon, yet few focus on obtaining the theoretical and abstract skills
needed for planning complex cutaneous surgical repairs with flaps and grafts.
We developed and evaluated a novel surgical flaps and grafts workshop for
residents through the Department of Dermatology. Methods: Participants received
a 60 minute PowerPoint lecture focusing on the basic principles of cutaneous
repair with flaps and grafts, with examples and explanation of each of the four
main types of flaps and grafts. The participants then received nine photocopies
of Mohs micrographic surgery defects with instructions to design three repairs,
focusing on functional and aesthetic outcome. Hypothetical and actual repair
designs were then discussed in an open forum format. Anonymous surveys
administered to 11 dermatology residents assessed their knowledge level,
confidence level, and likelihood of using flaps and grafts pre- and
post-workshop using Likert scales. Overall experience was also assessed. A
paired sample Wilcoxon Signed Rank Test was used for analysis, since the data
was non-parametrically distributed. Results: There was a statistically
significant increase in confidence performing flaps post workshop (p = 0.0469).
There was also an increase in knowledge of flaps and grafts, confidence in
planning flaps and grafts, and confidence in performing grafts post workshop,
but these findings did not reach statistical significance. The workshop had no
effect on expected future use of flaps and grafts. Conclusions: The surgical
workshop is a novel simulation teaching tool for learning basic principles and
design of flaps and grafts in cutaneous surgery.