Learning inguinal hernia repair? A survey of current practice and of preferred methods of surgical residents

Abstract

Purpose During surgical residency, many learning methods are available to learn an inguinal hernia repair (IHR). This study aimed to investigate which learning methods are most commonly used and which are perceived as most important by surgical residents for open and endoscopic IHR. Methods European general surgery residents were invited to participate in a 9-item web-based survey that inquired which of the learning methods were used (checking one or more of 13 options) and what their perceived importance was on a 5-point Likert scale (1 = completely not important to 5 = very important). Results In total, 323 residents participated. The five most commonly used learning methods for open and endoscopic IHR were apprenticeship style learning in the operation room (OR) (98% and 96%, respectively), textbooks (67% and 49%, respectively), lectures (50% and 44%, respectively), video-demonstrations (53% and 66%, respectively) and journal articles (54% and 54%, respectively). The three most important learning methods for the open and endoscopic IHR were participation in the OR [5.00 (5.00–5.00) and 5.00 (5.00–5.00), respectively], video-demonstrations [4.00 (4.00–5.00) and 4.00 (4.00–5.00), respectively], and hands-on hernia courses [4.00 (4.00–5.00) and 4.00 (4.00–5.00), respectively]. Conclusion This study demonstrated a discrepancy between learning methods that are currently used by surgical residents to learn the open and endoscopic IHR and preferred learning methods. There is a need for more emphasis on practising before entering the OR. This would support surgical residents’ training by first observing, then practising and finally performing the surgery in the OR.

Laparoscopic hernioplasty in Mexico: results of a national survey

“…Nazari et al, reported from a survey in which surgery residents from 19 European countries participated, that 59.2% of them had no experience on LIHR. 12 Our study showed that one fourth of the participants finished the residency before 1990, and therefore, they were not trained when modern laparoscopic surgery began. One fifth of them, finished the residency within the five years previous of the survey, so they were trained fully in laparoscopic era.…”

Australian general surgical trainee experience with inguinal hernia surgery: a review of international training programmes and the learning curve

“…UK/Europe: No published data on the rates of LIHRs in the UK or Europe could be found. A survey published in Hernia in 2020 showed that only 52.9% of European surgical residents had experience with LIHRs during training 13 . Data from the rest of the world are lacking.…”

“…To achieve competency within training, a more efficient teaching syllabus needs to be developed beyond the apprenticeship model in the operating theatre. Video demonstration and hands on hernia courses have been reported to be perceived by trainees as the most important learning methods, 13 and additionally simulator‐based training and video analysis have been shown to be effective 21,26 . A standardized curriculum model along the lines of a ‘Hernia School’ involving anatomy, procedure steps, intraoperative decision making and simulation enhanced technical skills training is required.…”

RAWS4all project: validation of a new silicone model for robotic TAPP inguinal hernia repair

“…On the other side, there are real challenges for training and surgery proficiency such as working legislation, legal and ethical concerns, and lack of proctors and simulation opportunities [ 17 ]. The three most important learning methods for hernia repair are participation in the OR and video-demonstrations followed by hands-on hernia courses [ 25 ]. That highlights the importance of hands-on simulation and the need to be widely accessible to residents and surgeons meaning that models should be low-cost and with low logistics; valuable from an educational point-of-view; and suitable for procedure and skills assessment.…”