On one of the threads last week I mentioned that training of techs is not that dissimilar to the training of surgical residents in a particular procedure. There is an observation period, a hands on under close supervision period, and the development of skills while being supervised by the doctor in charge as well as more experienced techs.

We brought on additional staff this year and what I show in the pictures is a brief synopsis of how we train folks.

Pickles provide 2 things that we use to test manual dexterity, and then to enhance skill. First we have techs dissect out the seeds under the microscope using hair instrumentation. Although hard at first, after about 30 minutes we can tell who has a knack and who will never really get this skill and shouldn't come on staff.

Next, the kind of hard pickle material just under the outer skin, can be cut to the size of singles or doubles. This rapidly develops cutters' skills and is readily transferable to patient tissue, in fact most of our cutters think that when they actually move on to real tissue, its easier. (I would rather they struggle on pickle tissue and think that the real tissue is easier.)

Finally, placement can be taught by placing the pickle "grafts" into slits on oranges or tangerines. I think its actually harder to see the slits in the fruit, as there is no bleeding or color change.

Thus, we can identify tech candidates with better potential skills, and train them on inexpensive, yet realistic material BEFORE having them work with real tissue....the finite resource of any patient(donor hair).

Then when they move on to cutting and placing, our senior cutters and I are intimately involved in constructive criticism as skills develop.

Lastly, since I place a good amount on each case, there is continual quality inspection and feedback.

Dr. Lindsey McLean VA