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Micro-Surgery Training at Residence (mSTAR)

A project run in Guy’s and St Thomas’ NHS Foundation Trust

Related themes

  • Improving training programmes and pathways


Evidence shows that simulated training on low fidelity models* in microsurgery is an effective intervention that leads to acquisition of transferable skills and improved technical performance. The project is designed to provide a structured training programme at home, which will allow trainees to practice relevant skills with available resources. Several models of practice have been devised to support the learning; tablet, microscope and loupes. Practice is further enhanced through obtaining regular feedback from experts or clinical learning mentors.

Project objectives

  • Validate and provide a viable model of simulation training outside of a specialised environment to complement microsurgical training.
  • Affordability – to make the model affordable to trainees with an interest in microsurgery, and those beginning training.
  • Improve patient safety, and outcomes.


  • Statistically significant improvement demonstrated by home and lab-based training groups both between baseline and post-training performances.
  • Tablet training groups were quicker. Evidence supports time as an important parameter to demonstrate efficiency of movement thus level of skill.
  • Consistent improvement of skills in trainees using a tablet device compared to lab training, which displayed a wider level of skills attained. More of the trainees in the tablet-trained group were able to achieve competencies compared to the lab-trained group in the time period.
  • Produced video recordings for the training sessions, which can be uploaded and provided as evidence of training in the trainee’s portfolio.
  • Trainees able to develop and maintain skills without compromising patient care.


The case study in the related documents section below. provides a detailed overview of the project. Feel free to adapt this resource to suit your projects.
Your organisation may have its own materials and templates that you can use or you may find the NHS Improving Quality (NHS IQ) learning handbook useful too.

* There are three levels of fidelity simulators – low, medium and high.  Fidelity refers to how closely a simulation imitates reality. Low-fidelity simulations feel the least real to the learner and are largely based on problem solving activities that are computer based.  Low fidelity does not, however, mean low technology. Low simulation models can have high levels of advanced technology. 

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