Validation of Open Inguinal Hernia Repair Simulation Model A Randomised Controlled Educational Trial

Khatib M, Hald N, Brenton H, Sarker S, Standfield N, Ziprin P, Kneebone R, Bello F

Imperial College London

Validation of Open Inguinal Hernia Repair Simulation Model A Randomised Controlled Educational Trial

Khatib M, Hald N, Brenton H, Sarker S, Standfield N, Ziprin P, Kneebone R, Bello F

Imperial College London

Association for Surgical Education

Surgical Education Week

24th April 2013

Introduction• Surgical simulation brought to the forefront of

surgical training– Technological advances– Importance of surgical safety– Limitation in surgical trainee exposure

• EWTD• Duty hour restrictions

• Abundance of laparoscopic/ endovascular simulators

• Development of Hernia Repair Open Surgical Simulation (HeROSS) model

Recruitment

Clinical Years Medical students invited to participate

Volunteers screened

Exclusion criteria implemented

Block Randomisation

Pre-intervention MCQ

Intervention Group

Group 4:

Control Group

Group 1:

Interactive Simulation

Group 2:

Non-interactive Simulation

Group 3:

Video Tutorial

Assessment

1. Post-intervention MCQ

2. Viva

Method

Performing or assisting in an open inguinal hernia repair

Previous bachelor degree in anatomy

Anatomy demonstrator

Method• Three separate one hour learning sessions

• Scenario given to candidates

• All in one week

• Assessment one day after final learning session

Method• Interactive Simulation

Method• Video Tutorial

Method• Control Group

– Internet access– Quick access to all surgical procedure

textbooks and mini-textbooks available in Imperial College Library

– Anatomy handouts from commonly used anatomy textbooks and atlases

Results

Results• 54 students completed study

• Group 1 n=15• Group 2 n=15• Group 3 n=12• Group 4 n=14

Results

 

Group Mean Standard Deviation

Pre Intervention MCQ

(%)

1 43.33 13.282 38.92 9.933 38.33 9.374 39.57 9.27

Total 40.14 10.58

Score Improvement in MCQ

(%)

1 30.15 13.682 36.08 12.483 31.74 12.874 7.41 9.56

Total 26.4 16.41

Assessment Score(%)

1 76.92 9.92 65.38 2.723 59.67 8.864 42.93 9.54

Total 61.63 14.88

Results – Comparison Between Groups

Conclusions• Statistically significant Improvement in

anatomical and procedural knowledge from using the interactive simulation model

• Vital role of simulation as an adjunct in modern surgical training

• Open surgical procedural knowledge a pre-requisite to laparoscopic surgery

• Envisage online virtual theatre with ability to do multiple core index procedures

Future Research• Recruitment of surgical trainees

ongoing• Addition of recorded assessment on

hernia model

Thank you