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Giant spigelian hernia in an elderly woman: a case report.

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Structured hernia surgery training program for general practitioners in Rwanda - feasibility and evaluation.

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Updated: Jan 17, 2026

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Competency Assessment in Training in African Countries.

Jacob A Akoh1

  • 1Nuffield Health Plymouth Hospital, Plymouth, United Kingdom.

Journal of Abdominal Wall Surgery : JAWS
|September 15, 2025
PubMed
Summary

Competency-based surgical training camps significantly improved surgeon skills in inguinal hernia repair within days. This approach offers a faster way to build surgical capacity in Africa compared to traditional methods.

Keywords:
capacity buildingcompetency assessmentfeedbackindex proceduresmesh repair inguinal herniatraining

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Area of Science:

  • Surgical Education
  • Global Surgery
  • Medical Training Assessment

Background:

  • Traditional surgical training in Africa relies on apprenticeship and logbooks, with less rigorous objective competency assessment.
  • Current training models may not efficiently build surgical manpower for essential procedures like hernia repair.

Purpose of the Study:

  • To evaluate the effectiveness of a short, competency-based surgical training camp for open mesh repair of inguinal hernias.
  • To compare trainee self-assessment with trainer assessment of surgical competency.

Main Methods:

  • An 8-day structured, competency-based training program was conducted in Uganda and Nigeria.
  • Daily feedback sessions and final performance assessments using established criteria were employed.
  • Data were summarized using descriptive statistics and analyzed statistically.

Main Results:

  • A statistically significant improvement (p < 0.0004) was observed in six key parameters of hernia surgery knowledge and skill.
  • Post-training, 5 trainees could independently repair small hernias, and 8 required minimal supervision.
  • Competency in scrotal hernia repair varied, with 1 trainee independent and 11 requiring occasional help.

Conclusions:

  • Proficient surgical competency can be achieved in junior surgeons within a few days using focused training and feedback.
  • Competency-based assessment in index procedures is crucial for effective surgical training in Africa.
  • Adopting competency-based training can accelerate surgical manpower development.