TEP and Lichtenstein anatomy: does simulation accelerate acquisition among interns?

Area of Science:

• Surgical Education
• Anatomical Simulation
• Hernia Repair

Background:

• Inguinal anatomy presents a significant learning challenge for surgeons.
• Mastery of open inguinal hernia (OIH) and totally extraperitoneal (TEP) anatomy is crucial for effective hernia repair.

Purpose of the Study:

• To evaluate the efficacy of low-fidelity simulation models in teaching OIH and TEP anatomy to general surgery interns.
• To assess the impact of a simulated hernia repair session on interns' anatomical knowledge and confidence.

Main Methods:

• General surgery interns (n=30) participated in a 3-hour session involving anatomy lectures and hands-on simulation of OIH and TEP hernia repairs.
• Low-fidelity models were constructed using accessible materials like cardboard, plastic bins, fabric, and yarn.
• Knowledge was assessed via pre- and post-tests including didactic questions and anatomical drawing tasks for TEP and OIH.

Main Results:

• Median post-test scores significantly improved to 47% from a median pre-test score of 13% (p < 0.001).
• The number of correctly drawn anatomical structures for TEP and OIH significantly increased post-session (p < 0.001).
• Participant-reported outcomes favored session enjoyability, perceived training value, and improved understanding of OIH and TEP anatomy.

Conclusions:

• Low-fidelity simulation models are a viable tool for teaching and assessing OIH and TEP anatomy.
• While beneficial for enhancing foundational knowledge, a single session does not confer expertise in hernia surgery.
• Simulation-based learning offers an engaging and effective method to improve surgical anatomy comprehension in novice trainees.