Introduction: It is recognized that simulation can be used to aid the training of surgeons. Many courses give participants a certificate of completion rather than one of competence or proficiency. The aim of this presentation is to discuss the development and implementation of a proficiency based microsurgical course.

Methods: A five day course which uses prosthetic and non vital models to train participants in microsurgical techniques has been developed. Hand motion analysis, global rating scales and quality of final anastomosis assessments were used to objectively score participants throughout the course. Ten candidates were recruited to participate and their scores demonstrating progression were plotted. Inclusion criteria were candidates studying for a second degree in dentistry to pursue a career in OMFS with no previous formal training in microsurgery. The Friedmann analysis was used to statistically demonstrate whether there was a change in performance throughout the course and a p < 0.05 was deemed significant. Previous data collected from experienced microsurgeons was used to compare the participants’ final performance and hence level of proficiency. This data was compared using the Mann Whitney U test and a p < 0.05 was deemed significant.

Results: The participants performed significantly less well when compared to the experienced group at the start of the course. During the course the participants demonstrated a significant improvement. Performance of participants on the last day was equivalent to that of experienced surgeons.

Conclusion: A proficiency based course has been developed where objective assessments can be used to document progression of novice surgeons. Such a course has demonstrated that novice surgeons can be trained to an equivalent standard of experienced surgeons in a simulated environment.

Key words: microsurgery; simulation; training; assessment; dexterity analysis