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

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.

Serious gaming in internal medicine education: do we know best or do we know last?

The use of digital tools is indispensable in our daily lives. The medical world keeps up with this progress by implementing digital tools to facilitate and improve patient care, such as eConsults and self-care apps. Serious games are also becoming increasingly popular in healthcare education, particularly in surgical residency training and nursing education. However, gaming and digitisation of education have not been widely integrated in internal medicine residency education yet. Therefore, these programs are not yet modernised to meet the demands of the 21th century physician. In this article, we will explicate our view on digitisation of the internal medical education programme with special attention to serious gaming. We will discuss pros and cons of digitisation, describe challenges of development and implementation of games, and offer some examples of digital educational tools for practical use.

Creation of a universal language for surgical procedures using the step-by-step framework.

BACKGROUND: Learning of surgical procedures is traditionally based on a master-apprentice model. Segmenting procedures into steps is commonly used to achieve an efficient manner of learning. Existing methods of segmenting procedures into steps, however, are procedure-specific and not standardized, hampering their application across different specialties and thus worldwide uptake. The aim of this study was to establish consensus on the step-by-step framework for standardizing the segmentation of surgical procedures into steps. METHODS: An international expert panel consisting of general, gastrointestinal and oncological surgeons was approached to establish consensus on the preciseness, novelty, usefulness and applicability of the proposed step-by-step framework through a Delphi technique. All statements were rated on a five-point Likert scale. A statement was accepted when the lower confidence limit was 3·00 or more. Qualitative comments were requested when a score of 3 or less was given. RESULTS: In round one, 20 of 49 experts participated. Eighteen of 19 statements were accepted; the 'novelty' statement needed further exploration (mean 3·05, 95 per cent c.i. 2·45 to 3·65). Based on the qualitative comments of round one, five clarifying statements were formulated for more specific statements in round two. Twenty-two experts participated and accepted all statements. CONCLUSION: The international expert panel consisting of general, gastrointestinal and oncological surgeons supported the preciseness, usefulness and applicability of the step-by-step framework. This framework creates a universal language by standardizing the segmentation of surgical procedures into step-by-step descriptions based on anatomical structures, and may facilitate education, communication and assessment.