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Different Methods for Training Technicians

Dr. Martinick developed the Training Placer Board to address placement problems in hair transplantation. The board standardizes training, improves technique, and enhances efficiency. It offers structured lessons, practice, and feedback to improve staff morale and clinic outcomes, all while reducing clinic expenses through controlled training.

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Different Methods for Training Technicians

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  1. Different Methods for Training Technicians Jennifer Martinick, MBBS

  2. Disclosure Dr. Martinick developed this Training Placer Board and receives a royalty from sales.

  3. 2 Greatest Problems in Placement is Incorrect Technique • Forceps inserted TOO DEEPLY. Consequences; • Squashes & kills follicle • Follicle comes out again with forceps due to ‘imprint’ • Dislodges clotted blood; starts bleeding again • Over handling & death of follicle • INCORRECT/Rough grasp of follicle. Consequences; • ‘Dragged’/Jammed follicle is bent/twisted & doesn’t grow • The CLEAR LASERED HOLES & HARD texture of the TPB addresses these issues; it stops the forceps entering deeply & allows the teacher to see if the graft is bent in the recipient hole

  4. Bottleneck in HT is graft placing Commonly encountered problems: • Incorrect grasp of follicle with forceps • Not parting hair away that occludes the hole • Roughly jamming follicles into holes • Putting forceps too deeply into hole • Causing follicle compression & injury with more likelihood of it coming out again • Creating false passages, bleeding & popping

  5. Roughly Jammed MISTAKES!!!! Poor Forceps Application Upside Down Grafts bent in HT

  6. AIM: Develop a training medium to overcome placement problems Trainer Placer Board • Demonstrates how to implant effectively so as to eliminate inappropriate movements • Standardizes, simplifies and systematizes the training procedure • Increases the percentage of trainable applicants • Decreases time to competency and clinic expenses • Enhances dexterity, eye/ hand co-ordination, teaches a gentle 2- touch placement technique • Learn to differentiate between sagittal and coronal placement using either bent or straight forceps

  7. Training Setup

  8. The Board has 30 slits, 10 each of 2mm, 1.5mm, & 1mm Its hard texture discourages forceps’ deep penetration and encourages gentle feeding of the graft into the slits Its clear nature allows the trainer to check on placement & observe poorly placed grafts. Grafts preserved in 10% formalin are used. Staff like it because it’s impersonal, can talk & get feedback. There’s no bleeding & they don’t feel like they’re hurting the patient.

  9. Lesson One: Learn the required movement to implant a small graft into a large slit in 2-3 movements. This implantation is then repeated into the medium size slits and then the smallest slits. Lesson Two: Place 10 large grafts, 10 medium grafts and 10 small grafts systematically, gently and accurately into the appropriate slits within the shortest time frame. The technician is re-tested & times documented after every 10 hours of O.R. time. (See Video Coronal and Sagittal Placements)

  10. Good Technique Grab tip-to-tip Place 1mm into ‘scalp’ Gently grab ½ way & rock the rest in

  11. Results • After 40 hours, 3 groups emerge; Good prospect, possible, no prospect. • Our results to date show that 40-50% of applicants can be trained • There is an enhanced appreciation for quality & speed • Inappropriate movements & techniques are decreased • And there is increased gentleness in graft handling

  12. Lesson 3 Advanced Trainer Placer Board The Advanced Board has 66 sites. It focuses on constantly changing direction, relationship and orientation. The technician must change wrist angles, use differing forceps grasps, & body posture. This mimics a virtual procedure when 3 or 4 technicians may be planting. One hour training on this board is followed by a quantum leap in comprehension. An average placer takes less than 15 minutes to fill the sites; an outstanding one, less than 12 minutes (See Video)

  13. A Planned Training System of Placing • Minimizes time wasted on unsuitable trainees • In 40 hours selects those with average/above performance levels • Helps build a ‘bank’ of back-up trainees • Focuses on movements to enhance efficiency & effectiveness • Minimizes unproductive time of technician & surgeon • Reduces on-the-job frustration • Develops effective feedback routine • Enhances staff morale & confidence • Decreases staff frustration & burnout • Improves productivity & predictability of outcomes • Decreases turnaround time if staff leave • Creates a shorter procedure time • Uses less blades & other consumables • Decreases clinic expenses • Surgeon gains control of his clinic

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