ETD

• Ansia
• Flow State
• Microchirurgia
• Psicologico
• Stress
• Training

Microsurgery is a technically demanding surgical discipline in which fine motor control, sustained attention and emotional regulation are essential for safe and precise performance. Because microsurgical training requires prolonged concentration on progressively complex tasks, it may represent not only a technical learning environment, but also a psychophysiological setting capable of modulating stress and promoting task absorption. This prospective single-arm pilot study investigated the effect of a basic microsurgery course on perceived stress, state anxiety and acute stress-related components in plastic surgery residents, while also exploring the occurrence of flow state at the end of the training.
Twenty-four residents enrolled in three editions of the basic microsurgery course organized by the Italian Society of Microsurgery were recruited, with 23 participants completing paired pre- and post-course assessments. Perceived stress, state anxiety and stress state were evaluated immediately before and after the course using the Perceived Stress Scale, the State-Trait Anxiety Inventory Y1 and the Short Stress State Questionnaire. The Flow State Scale was administered once, after completion of the training, in accordance with its retrospective nature. Statistical analysis was performed through paired comparisons, using parametric or non-parametric tests according to the distribution of pre- and post-course differences.
Participation in the course was associated with a significant reduction in perceived stress and state anxiety: PSS-10 scores decreased from 22-70 ± 6.37 to 21.00 ± 5.46, while STAI-Y1 scores decreased from 40.87 ± 9.27 to 36.22 ± 8.33; the SSSQ showed a coherent psychological pattern, with significant reductions in Distress and Worry and a concomitant increase in Engagement. Flow State Scale scores were high overall, with a mean total score of 4.12 ± 0.41 on a 1 to 5 Likert scale: the most represented dimensions were autotelic experience, concentration on the task at hand, transformation of time and clear goals, whereas action-awareness merging showed comparatively lower values, consistent with the basic level of the training and the still deliberate nature of microsurgical gesture in early learners.
These findings suggest that structured microsurgical training may be associated with a measurable remodulation of the participants’ psychological state, characterized by reduced negative emotional activation and cognitive worry, together with increased attentional engagement. Flow state may offer a plausible interpretative framework for this profile, although causality cannot be inferred from the present study design. Further research, ideally including physiological markers and clinical microsurgical setting, is warranted to clarify the relationship between stress, flow and microsurgical learning.