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Feasibility of Learner-Led Model Building for Simulation-Based Training in Open Inguinal Hernia Repair: A Randomized

Rebecca Hisey1, Denesh Peramakumar2, Vanessa Wiseman3

  • 1Laboratory for Percutaneous Surgery, School of Computing, Queen's University, Kingston, Ontario, Canada.

Journal of Surgical Education
|July 13, 2026
PubMed
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Building inguinal hernia models is feasible for novice learners, enhancing their understanding of inguinal canal anatomy and improving surgical simulation performance. This low-cost method boosts confidence and technical skills in open inguinal hernia repairs (IHR).

Area of Science:

  • Medical Education
  • Surgical Simulation
  • Anatomy Education

Background:

  • Simulation-based training is crucial for surgical skills acquisition.
  • Novice learners require effective methods to understand complex anatomy like the inguinal canal for open inguinal hernia repairs (IHR).
  • Traditional didactic methods may not fully prepare learners for the practical aspects of IHR.

Purpose of the Study:

  • To assess the feasibility of novice learners constructing inguinal hernia models for IHR simulation.
  • To evaluate the impact of model building on learners' anatomical knowledge, confidence, and technical performance in simulated IHR.
  • To determine if learner-led model construction is a cost-effective training tool.

Main Methods:

  • A prospective randomized controlled trial involving 48 novice learners (second-year medical students).
Keywords:
anatomical understandinginguinal herniamodel buildingopen surgeryprocedural performancesimulation-based training

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  • Participants were assigned to either a lecture-only group (control) or a lecture plus learner-led model-building group (intervention).
  • Outcomes included self-reported confidence, anatomical accuracy of models, and technical performance during a simulated open IHR.

    • Main Results:

    • Learner-constructed models were anatomically accurate and suitable for training.
    • The model-building group showed significantly greater gains in understanding inguinal canal anatomy (p=0.004).
    • Intervention participants made fewer errors in external oblique aponeurosis exposure (p=0.03) and wound closure (p=0.05), and were more likely to complete hernia sac resection (p=0.04).

    Conclusions:

    • Learner-led construction of inguinal hernia models is a feasible and low-cost simulation-based training method for open IHR.
    • This approach enhances anatomical understanding and improves specific technical skills in simulated open IHR.
    • Minimal materials and instructional resources are required, making it an accessible training strategy.