Background: Microsurgery lab training is one of the best ways to learn and improve microsurgical skills. We explored factors that facilitate positive and efficient development of microsurgical skills during plastic surgery training.

Objective: To identify the factors that are associated with improved microsurgical learning and find out the methods that help to increase efficiency in the microsurgery training program.

Materials and Methods: An open questionnaire examining factors potentially associated with microsurgical learning was
administered and six factors were identified. A satisfaction survey about the microsurgery training program was given to students. Using findings from these tools, a reorganization of the microsurgical training program was implemented. Six months later, the survey was administered again and the results were compared with the initial assessment. Student lab participation rates and laboratory costs were measured.

Results: Six months following program reorganization, student satisfaction significantly increased in 5 of 6 parameters; duration for assessment (p = 0.019), frequency for assessment (p<0.001), clarity of tools and topics (p = 0.045), knowledge gained (p<0.001), and validity and reliability of the assessor (p = 0.001). Overall trainee satisfaction improved from 2.40 to 3.00 (p = 0.028). The
average microsurgical skill of students increased from 1.77 to 2.35 (p = 0.001). Microsurgery lab participation increased from 46 (July to December 2018) to 105 (January to June 2019). The new training protocol reduced the average cost per microsurgery lab session from more than 4,500 baht (145 USD) to 1,468.34 baht (46.4 USD).

Conclusion: Five factors associated with an improved microsurgical learning experience were identified and used to guide program reorganization. Six months later, we measured increased rates of lab participation, improved student satisfaction and reduced program costs.

Keywords: Microsurgery training, Microsurgery lab, Microsurgical skills, Microsurgery, Plastic surgery training