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One year after implementing Competency-Based Medical Education (CBME) at a Swiss hospital, improved feedback quality alongside increased resident stress were key results of our internal evaluation. These results led us to the research question of whether residents possess sufficient skills to receive feedback and respond appropriately. The aim of this study was to explore the feedback competence of residents in Switzerland and other European countries.

A qualitative, cross-sectional 12-item survey was conducted exploring key components of feedback dimensions and focusing on plastic surgery residents' perceived ability to integrate feedback into clinical practice. The survey was distributed to plastic surgery residents, divided into a Swiss and a European cohort, the latter comprising residents from six European countries other than Switzerland.

60 residents completed the survey (28 Swiss, 32 European). Primary barriers to effective feedback processing in both cohorts were two psychological factors: the truth trigger, defined as perceived unfairness, and the identity trigger, defined as threat to self-concept. Truth trigger challenges were more frequently reported by the European cohort (20/32, 62.5% vs. 14/28, 50%), whereas identity trigger reactions were more common among Swiss residents (12/28, 42.9% vs. 11/32, 34.4%). Across both cohorts, residents rated their ability to manage emotions when receiving feedback as fairly well to very well. They also reported similar ratings for evaluating their personal strengths and weaknesses.

While plastic surgery residents across Europe perceive themselves as competent in emotional regulation, our findings indicate persistent challenges in responding to feedback. Differences between the European and Swiss cohort may reflect variations in leadership and individual feedback competence among both supervisors and residents. Literature emphasizes the dependence of effective feedback on competence of both the giver and the receiver. Additionally, structured training to receive feedback seems essential for effective CBME implementation. Our results suggest that additional support is required to strengthen emotional intelligence as a core professional and leadership competence. Future research should further explore country-specific differences.

Structured microsurgical training requires objective and reproducible assessment. While most programs rely on intensive short courses (typically few consecutive days), iterated spaced longitudinal training may improve skill acquisition and retention. For this purpose, a 6-month microsurgical program using non-living animal models was developed. The aim of this study is to assess longitudinal participants’ performance during this 6-months course compared to the literature.

Based on the review of the literature, two complementary score assessments were selected in accordance with International Microsurgery Simulation Society (IMSS) standards: the Anastomosis Lapse Index (ALI), quantifying 10 technical errors associated with anastomotic failure, and the End-Product Intimal Assessment (EPIA), a 9-component score (0 to 100). From the third session onward, participants were invited to perform one end-to-end arterial anastomosis on chicken femoral arteries. After O’Brien patency test, the anastomoses were cross-sectioned and photographed under surgical microscope. All anastomoses were evaluated by blinded independent experts. Procedure time was analyzed as well as inter-rater reliability.

This ongoing prospective study will enroll 20 participants across two cohorts over two years from multiple specialties and varying experience levels (plastic, hand, and maxillofacial surgery residents, neurosurgery, one veterinary ophthalmologist, beginner to advanced levels). The program consists in twelve bimonthly 4-hour sessions over 6 months (48 hours total). At the time of submission, 10 participants were enrolled and completing the training program, and 3 independent experts are evaluating their performance according to the ALI and EPIA tool. Preliminary results will be presented at the congress.

A longitudinal iterative microsurgical training program using validated non-living chicken femoral artery models and dual end-product assessment is feasible and compliant with IMSS minimum standards. We hypothesize that our results will demonstrate progressive skill acquisition with reproducible expert and computerized evaluation and that this multidisciplinary, low to middle-cost framework may provide a scalable alternative to intensive short courses for microsurgical training across surgical specialties.

Entrustable Professional Activities (EPAs) are a central element of competency-based medical education. While EPAs are increasingly implemented in surgical training, no studies have examined strategies to promote their sustainable integration in plastic surgery. This study explores mechanisms underlying effective EPAs to define strategies enhancing long-term integration.

A qualitative study using semi-structured realist interviews was conducted with all seven residents in the Department of Plastic Surgery at a Swiss Hospital. Interviews included questions in three categories: mechanisms through which EPAs function, for whom they are effective, and in which contexts. Data were analysed using inductive coding.

A central mechanism enabling effective EPA use, as reported by residents, was the routine integration of EPAs into clinical practice. Regarding the category for whom EPAs function, residents reported that EPAs apply to trainees across all stages of training, although the function of EPAs differs by level of residency. EPAs were experienced as more effective when conducted by junior consultants compared to senior staff. Key contextual factors supporting effective EPA use were reported to be a supportive learning culture at all levels and trust between trainees and supervisors. EPAs were perceived to function best in clearly structured clinical activities such as in the operation room and during ambulatory interventions.

Our study provides a foundation for strategies to foster sustainable EPA implementation. Routine integration of EPAs appears to support their functioning by normalizing and legitimizing feedback. A strategy to reinforce this positive mechanism is embedding them into clinical workflows. Feedback from junior consultants seems to be more comfortable to receive, but it is the senior staff, that has a greater clinical expertise. These findings may indicate generational differences in feedback culture and the need to further develop the ability to provide individualized feedback. Residents’ feedback receiving skills should also be strengthened. Sustaining a learning culture and trust as key contextual factors may require the improvement of leadership skills at all levels. This suggests that plastic surgery training extends beyond EPAs to cover the full range of required competencies.

The Pygmalion effect describes how expectations influence behavior and outcomes. Within aesthetic surgery, plastic surgeons are continuously exposed to ideals of beauty and transformation, which may influence their own aesthetic practices and those of their intimate partners. The objective was to investigate the prevalence of self-directed and partner-directed aesthetic procedures among plastic surgeons and to explore whether these behaviors demonstrate patterns consistent with a Pygmalion-type mechanism.

A cross-sectional anonymous online survey was distributed to plastic surgeons in Germany, Austria, and Switzerland. Demographic data, personal history of aesthetic procedures, partner history of aesthetic procedures, and surgeon-performed partner treatments were collected. Descriptive statistics and exploratory chi-square testing were performed.

A total of 167 respondents were included. Minimally invasive self-directed aesthetic procedures were reported by 69% of respondents, and 26% reported prior aesthetic surgery. Fifty-three percent reported that their partner had undergone aesthetic procedures. Surgeons who had undergone aesthetic procedures themselves were significantly more likely to report personally performing aesthetic procedures on their partners (χ¹ = 5.76, p = 0.016).

Plastic surgeons demonstrate a high prevalence of self-directed and partner-directed aesthetic procedures. The observed association supports a behavioral pattern consistent with a Pygmalion-type effect, suggesting that internalized aesthetic ideals may influence both personal behavior and interpersonal decision-making.

Plastic surgery training lacks a systematic approach to leadership education, although leadership competencies are essential in clinical practice. This study aims to identify leadership competencies required by plastic surgery residents and to develop a competency-based leadership curriculum framework.

In a first step, qualitative interviews were conducted with all seven plastic surgery residents at a Swiss hospital, to identify relevant leadership competencies. Data were analyzed using a thematic analysis approach, combining deductive and inductive strategies. In a second step, the competencies identified in the interviews guided the literature-based development of a competency-based curriculum framework structured into modules with defined subtopics, learning objectives, and delivery formats.

Interview results indicated that systematic leadership training during residency was considered highly needed. Relevant leadership competencies included self-leadership, emotional intelligence, communication skills, positive leadership, and team leadership. Based on these competencies we developed a curriculum that consists of four modules with defined competency-based learning objectives categorized into skills, attitudes, and knowledge. Formats considered effective included group-based courses, simulation training, and self-directed learning.

This study presents a leadership curriculum framework tailored to the needs of Swiss plastic surgery residents and designed to align with the four-year specialist training program in Switzerland. Based on the existing literature, the leadership topics identified for this curriculum are likely to be relevant in other countries as well. A prerequisite for successful implementation is the awareness that systematic leadership training for residents is currently lacking and needed in plastic surgery. However, implementation remains challenging, as it requires the allocation of adequate resources including funding, protected training time and qualified faculty.

Writing high-quality case reports is essential for trainees to learn and communicate complex clinical decision-making and to share innovative reconstructive methods or challenging scenarios. We have developed the open digital educational platform 'PlastSurgeon.com' for sharing of cases worldwide. Our study aimed to identify parameters most appreciated by specialist plastic surgeons to win the case competition.

Our digital educational platform PlastSurgeon.com enable surgeons to submit step-by-step cases for publication, take surgical courses and share surgical knowledge world-wide with 125.000 yearly visitors.
A descriptive mixed-methods analysis was conducted on 51 plastic surgery case reports submitted to the Case Competition 2023–2025. Submissions were evaluated by an International expert panel of 23 blinded senior plastic surgeons. Cases were scored from 1-10 across six parameters: Photo quality, text quality, clinical solution, reproductibility, references/pearls/pitfalls, and overall presentation (scored double 2-20 points). Mean scores and standard deviations were calculated, and parameters scoring above 7.5 were examined qualitatively.

Winner cases consistently demonstrated high scores over 7.5 in the following: (1) High-resolution images with drawings, multiple angles, perioperative markings, and diagnostic imaging; (2) Flawless, concise, and well-structured text; (3) Clearly justified surgical decision-making, frequently integrating two or more established reconstructive techniques; (4) Detailed pre-, peri-, and postoperative considerations enabling step-by-step reproducibility; and (5) Comprehensive pearls and pitfalls supported by relevant literature. Strong overall presentation was most closely associated with superior text quality and multimodal visual explanation.

Specialist evaluation revealed that excellence in case reporting is driven by clarity, structure, visual detail, and well-reasoned operative strategies. Emphasizing these elements, particularly high-quality images, precise writing, and transparent surgical rationale, can greatly enhance educational value. Our educational platform PlastSurgeon is used globally for surgical preparing, decision making and sharing of cases. Integrating digital solutions and structured writing training in surgery residency may further improve knowledge sharing among future plastic surgeons.