Microsurgical skill decay in novices one year after training: a longitudinal follow-up study

Introduction Interruptions to clinical practice are common. Skill decay is known to occur during breaks in various surgical specialties. We aim to identify the extent of skill decay following a one-year break after completion of a dedicated microsurgical training course. Research question How significantly do microsurgical skills decay one year after training? Materials and methods We recruited 25 medical students who completed an 8-hour microsurgical training course one year earlier. Microsurgical skills were measured using a standardized test task (12 simple interrupted 8-0 sutures on a 6 mm silicone tube). Each participant completed the task prior to the microsurgical course, post-training, one-year after the course and an additional re-attempt. Performances were analysed based on speed, error counts, accuracy and a qualitative rating. Results Comparing the one-year test with the post-training test, we found that significant decay had occurred. Median task time increased from 28.5 to 34.1 min (p < 0.001), total errors increased from 42 to 56 (p < 0.001), and the qualitative score fell from 9 to 7 (p < 0.001). At the immediate re-test, speed recovered to post-training level. Discussion and conclusion We found that a one-year interruption in microsurgical training resulted in microsurgical skill decay, reflected by decreased speed and increased error counts. Upon an immediate re-test, speed returned to the post-training level, whereas quality and error counts did not fully recover. These findings indicate that even after long interruptions, microsurgical speed can be rapidly regained to levels comparable to those achieved before the break.