{"id":"https://openalex.org/W7223039745","doi":"https://doi.org/10.1097/gox.0000000000008149","title":"Microsurgical Training and Skill Acquisition: A Systematic Review and Meta-analysis","display_name":"Microsurgical Training and Skill Acquisition: A Systematic Review and Meta-analysis","publication_year":2026,"publication_date":"2026-10-01","ids":{"openalex":"https://openalex.org/W7223039745","doi":"https://doi.org/10.1097/gox.0000000000008149","pmid":"https://pubmed.ncbi.nlm.nih.gov/42903278","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/13680914"},"language":"en","primary_location":{"id":"doi:10.1097/gox.0000000000008149","doi":"https://doi.org/10.1097/gox.0000000000008149","is_oa":true,"landing_page_url":"https://doi.org/10.1097/gox.0000000000008149","pdf_url":null,"source":{"id":"https://openalex.org/S2754281505","display_name":"Plastic & Reconstructive Surgery Global Open","issn_l":"2169-7574","issn":["2169-7574"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-d","jufo-1","ki-jl-1","norway-1","oarl","poland-70","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310318547","host_organization_name":"Wolters Kluwer","host_organization_lineage":["https://openalex.org/P4310318547"],"host_organization_lineage_names":["Wolters Kluwer"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Plastic and Reconstructive Surgery - Global Open","raw_type":"journal-article"},"volume":null,"type":"review","is_traditional":true,"indexed_in":["crossref","doaj","pubmed"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://doi.org/10.1097/gox.0000000000008149","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5159103534","display_name":"Abigail E. Elliott","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I26999989","display_name":"University of the Free State","ror":"https://ror.org/009xwd568","country_code":"ZA","type":"education","lineage":["https://openalex.org/I26999989"]}],"countries":["ZA"],"is_corresponding":true,"raw_author_name":"Abigail E. Elliott","raw_affiliation_strings":["Department of Plastic and Reconstructive Surgery, University of the Free State, Bloemfontein, South Africa"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Plastic and Reconstructive Surgery, University of the Free State, Bloemfontein, South Africa","institution_ids":["https://openalex.org/I26999989"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5159119012","display_name":"Travis M. Page","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I26999989","display_name":"University of the Free State","ror":"https://ror.org/009xwd568","country_code":"ZA","type":"education","lineage":["https://openalex.org/I26999989"]}],"countries":["ZA"],"is_corresponding":false,"raw_author_name":"Travis M. Page","raw_affiliation_strings":["Department of Plastic and Reconstructive Surgery, University of the Free State, Bloemfontein, South Africa"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Plastic and Reconstructive Surgery, University of the Free State, Bloemfontein, South Africa","institution_ids":["https://openalex.org/I26999989"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5059325367","display_name":"Corn\u00e9 P.G. Nel","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I26999989","display_name":"University of the Free State","ror":"https://ror.org/009xwd568","country_code":"ZA","type":"education","lineage":["https://openalex.org/I26999989"]},{"id":"https://openalex.org/I4210106096","display_name":"St Martha's Regional Hospital","ror":"https://ror.org/01mhbkr88","country_code":"CA","type":"healthcare","lineage":["https://openalex.org/I2802394193","https://openalex.org/I4210106096"]}],"countries":["CA","ZA"],"is_corresponding":false,"raw_author_name":"Corn\u00e9 P.G. Nel","raw_affiliation_strings":["Department of Plastic Surgery, Faculty of Health Sciences, University of the Free State, South Africa","Private Practice, St Martha\u2019s Regional Hospital Nova Scotia, Antigonish, Nova Scotia, Canada"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Plastic Surgery, Faculty of Health Sciences, University of the Free State, South Africa","institution_ids":["https://openalex.org/I26999989"]},{"raw_affiliation_string":"Private Practice, St Martha\u2019s Regional Hospital Nova Scotia, Antigonish, Nova Scotia, Canada","institution_ids":["https://openalex.org/I4210106096"]}]}],"institutions":[],"countries_distinct_count":2,"institutions_distinct_count":2,"corresponding_author_ids":["https://openalex.org/A5159103534"],"corresponding_institution_ids":["https://openalex.org/I26999989"],"apc_list":{"value":2195,"currency":"USD","value_usd":2195},"apc_paid":{"value":2195,"currency":"USD","value_usd":2195},"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.65243424,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"14","issue":"10","first_page":"e8149","last_page":"e8149"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10916","display_name":"Surgical Simulation and Training","score":0.9990000128746033,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10916","display_name":"Surgical Simulation and Training","score":0.9990000128746033,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11984","display_name":"Anatomy and Medical Technology","score":0.00039999998989515007,"subfield":{"id":"https://openalex.org/subfields/2204","display_name":"Biomedical Engineering"},"field":{"id":"https://openalex.org/fields/22","display_name":"Engineering"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}},{"id":"https://openalex.org/T11238","display_name":"Simulation-Based Education in Healthcare","score":0.00019999999494757503,"subfield":{"id":"https://openalex.org/subfields/3304","display_name":"Education"},"field":{"id":"https://openalex.org/fields/33","display_name":"Social Sciences"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/microsurgical-training","display_name":"microsurgical training","score":0.9620000123977661},{"id":"https://openalex.org/keywords/surgical-simulation-model","display_name":"surgical simulation model","score":0.8579999804496765},{"id":"https://openalex.org/keywords/simulation-fidelity","display_name":"simulation fidelity","score":0.7049999833106995},{"id":"https://openalex.org/keywords/animal-models","display_name":"animal models","score":0.7739999890327454},{"id":"https://openalex.org/keywords/synthetic-models","display_name":"synthetic models","score":0.7549999952316284},{"id":"https://openalex.org/keywords/microsurgical-instruments","display_name":"microsurgical instruments","score":0.7419999837875366},{"id":"https://openalex.org/keywords/surgical-training","display_name":"surgical training","score":0.4300000071525574}],"concepts":[{"id":"https://openalex.org/C2779343474","wikidata":"https://www.wikidata.org/wiki/Q3109175","display_name":"Context (archaeology)","level":2,"score":0.6621999740600586},{"id":"https://openalex.org/C2781437307","wikidata":"https://www.wikidata.org/wiki/Q977628","display_name":"Microsurgery","level":2,"score":0.5546000003814697},{"id":"https://openalex.org/C2776459999","wikidata":"https://www.wikidata.org/wiki/Q2119376","display_name":"Fidelity","level":2,"score":0.5541999936103821},{"id":"https://openalex.org/C2777211547","wikidata":"https://www.wikidata.org/wiki/Q17141490","display_name":"Training (meteorology)","level":2,"score":0.4471000134944916},{"id":"https://openalex.org/C132758656","wikidata":"https://www.wikidata.org/wiki/Q5307365","display_name":"Dreyfus model of skill acquisition","level":2,"score":0.44339999556541443},{"id":"https://openalex.org/C3020580240","wikidata":"https://www.wikidata.org/wiki/Q663272","display_name":"Expert opinion","level":2,"score":0.40389999747276306},{"id":"https://openalex.org/C3020594445","wikidata":"https://www.wikidata.org/wiki/Q1550460","display_name":"Initial training","level":2,"score":0.3864000141620636},{"id":"https://openalex.org/C19527891","wikidata":"https://www.wikidata.org/wiki/Q1120908","display_name":"Medical physics","level":1,"score":0.3734999895095825},{"id":"https://openalex.org/C41008148","wikidata":"https://www.wikidata.org/wiki/Q21198","display_name":"Computer science","level":0,"score":0.3702999949455261},{"id":"https://openalex.org/C204323151","wikidata":"https://www.wikidata.org/wiki/Q905424","display_name":"Range (aeronautics)","level":2,"score":0.3395000100135803},{"id":"https://openalex.org/C3018608816","wikidata":"https://www.wikidata.org/wiki/Q195818","display_name":"Surgical simulation","level":2,"score":0.3075000047683716},{"id":"https://openalex.org/C509550671","wikidata":"https://www.wikidata.org/wiki/Q126945","display_name":"Medical education","level":1,"score":0.2831000089645386},{"id":"https://openalex.org/C192209626","wikidata":"https://www.wikidata.org/wiki/Q190909","display_name":"Focus (optics)","level":2,"score":0.25189998745918274}],"mesh":[],"locations_count":4,"locations":[{"id":"doi:10.1097/gox.0000000000008149","doi":"https://doi.org/10.1097/gox.0000000000008149","is_oa":true,"landing_page_url":"https://doi.org/10.1097/gox.0000000000008149","pdf_url":null,"source":{"id":"https://openalex.org/S2754281505","display_name":"Plastic & Reconstructive Surgery Global Open","issn_l":"2169-7574","issn":["2169-7574"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-d","jufo-1","ki-jl-1","norway-1","oarl","poland-70","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310318547","host_organization_name":"Wolters Kluwer","host_organization_lineage":["https://openalex.org/P4310318547"],"host_organization_lineage_names":["Wolters Kluwer"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Plastic and Reconstructive Surgery - Global Open","raw_type":"journal-article"},{"id":"pmh:oai:pubmedcentral.nih.gov:13680914","doi":null,"is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13680914/","pdf_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13680914/pdf/gox-14-e8149.pdf","source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Plast Reconstr Surg Glob Open","raw_type":"Text"},{"id":"pmid:42903278","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/42903278","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Plastic and reconstructive surgery. Global open","raw_type":"Journal Article"},{"id":"pmh:oai:doaj.org/article:aa584d36099e424ea9fd00d690b0e96e","doi":null,"is_oa":false,"landing_page_url":"https://doaj.org/article/aa584d36099e424ea9fd00d690b0e96e","pdf_url":null,"source":{"id":"https://openalex.org/S4306401280","display_name":"DOAJ (DOAJ: Directory of Open Access Journals)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Plastic and Reconstructive Surgery, Global Open, Vol 14, Iss 10, p e8149 (2026)","raw_type":"article"}],"best_oa_location":{"id":"doi:10.1097/gox.0000000000008149","doi":"https://doi.org/10.1097/gox.0000000000008149","is_oa":true,"landing_page_url":"https://doi.org/10.1097/gox.0000000000008149","pdf_url":null,"source":{"id":"https://openalex.org/S2754281505","display_name":"Plastic & Reconstructive Surgery Global Open","issn_l":"2169-7574","issn":["2169-7574"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-d","jufo-1","ki-jl-1","norway-1","oarl","poland-70","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310318547","host_organization_name":"Wolters Kluwer","host_organization_lineage":["https://openalex.org/P4310318547"],"host_organization_lineage_names":["Wolters Kluwer"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Plastic and Reconstructive Surgery - Global Open","raw_type":"journal-article"},"sustainable_development_goals":[{"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3","score":0.8048999905586243},{"display_name":"Quality education","id":"https://metadata.un.org/sdg/4","score":0.5385000109672546}],"study_designs":[{"display_name":"Systematic Review","id":"https://openalex.org/study-designs/systematic-review"},{"display_name":"Meta-Analysis","id":"https://openalex.org/study-designs/meta-analysis"}],"awards":[],"funders":[],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7223039745.pdf","grobid_xml":"https://content.openalex.org/works/W7223039745.grobid-xml"},"referenced_works_count":27,"referenced_works":["https://openalex.org/W1486941842","https://openalex.org/W2008095224","https://openalex.org/W2018141681","https://openalex.org/W2048271068","https://openalex.org/W2083076590","https://openalex.org/W2122543714","https://openalex.org/W2170892587","https://openalex.org/W2313718695","https://openalex.org/W2526021703","https://openalex.org/W2604220329","https://openalex.org/W2737429398","https://openalex.org/W2740541054","https://openalex.org/W2887327672","https://openalex.org/W2972803910","https://openalex.org/W3017384512","https://openalex.org/W3028183218","https://openalex.org/W3081236209","https://openalex.org/W3118615836","https://openalex.org/W3130639277","https://openalex.org/W3202302220","https://openalex.org/W3208068097","https://openalex.org/W4284898216","https://openalex.org/W4312116102","https://openalex.org/W4378802681","https://openalex.org/W4385799855","https://openalex.org/W4401026693","https://openalex.org/W7128444375"],"related_works":["https://openalex.org/W3137859102","https://openalex.org/W2002868424","https://openalex.org/W7128444375","https://openalex.org/W4401026693","https://openalex.org/W2972803910","https://openalex.org/W4392161805","https://openalex.org/W3130639277","https://openalex.org/W2740541054","https://openalex.org/W2108939061","https://openalex.org/W1965715194"],"abstract_inverted_index":{"Background:":[0],"Simulation":[1],"in":[2,13,139,145],"the":[3,14,22,28,38,41,46,68,96,107,120,127,149,162,181,192],"context":[4],"of":[5,19,32,40,95,109,119,151,153,183,202],"microsurgical":[6,33,98,110,115,129,146,154,171,196],"training":[7,29,130,134],"has":[8],"been":[9],"explored":[10],"and":[11,30,80,85,141,185,189],"examined":[12],"literature":[15],"with":[16,103,113,135],"a":[17,57,82,104,167],"difference":[18],"opinion":[20],"regarding":[21],"optimal":[23,128],"model":[24,60,168,205],"to":[25,63,88,125,169,194],"use":[26],"for":[27],"acquisition":[31,108],"skills.":[34],"In":[35,65],"some":[36],"reports,":[37],"fidelity":[39,76],"live":[42],"animal":[43],"models":[44,77,100,137,188],"offers":[45],"opportunity":[47],"learn":[48],"surgical":[49,89],"as":[50,52],"well":[51],"surgical-scenario":[53],"contextualized":[54],"skills":[55,69,111,147,172,197],"that":[56,70],"less":[58,175],"realistic":[59],"is":[61,199,206],"unable":[62],"offer.":[64],"other":[66],"publications,":[67],"can":[71],"be":[72,174],"taught":[73],"on":[74,106],"lower":[75],"are":[78],"equivalent":[79],"offer":[81],"more":[83],"viable":[84],"feasible":[86],"approach":[87],"training.":[90],"Methods:":[91],"A":[92,117],"systematic":[93],"review":[94],"available":[97,200],"simulation":[99,136,204],"was":[101,122,158],"performed":[102,124],"focus":[105],"measured":[112],"validated":[114],"instruments.":[116],"meta-analysis":[118],"subgroups":[121],"then":[123],"identify":[126],"tool.":[131],"Results:":[132],"All":[133],"resulted":[138],"large":[140],"statistically":[142],"significant":[143],"improvements":[144],"across":[148,161],"range":[150,182],"groupings":[152],"simulations.":[155],"This":[156],"effect":[157],"consistently":[159],"identified":[160],"different":[163],"groups.":[164],"Conclusions:":[165],"Choosing":[166],"train":[170],"may":[173],"important":[176],"than":[177],"initially":[178],"thought.":[179],"Across":[180],"living":[184],"nonliving":[186],"biological":[187],"synthetic":[190],"models,":[191],"potential":[193],"improve":[195],"significantly":[198],"regardless":[201],"which":[203],"chosen.":[207]},"counts_by_year":[],"updated_date":"2026-11-06T12:05:46.655746","created_date":"2026-10-21T00:00:00"}
