title: Paediatric laparoscopic hernia repair: Ex vivo skills in the reduced training era.
abstract: BACKGROUND
  Changes to surgical working hours have resulted in shorter training times and fewer learning opportunities. Tools that develop surgical skills ex-vivo are of particular interest in this era. Laparoscopic skills are regarded as essential by many for modern paediatric surgery practice. Several generic skills models have been reported and validated. However, there is limited evidence regarding the role of procedure specific models. Here, a laparoscopic paediatric hernia repair model is trialled with surgical trainees and their competence compared with consultant colleagues.
  
  
  METHODS
  An ex-vivo paediatric inguinal hernia repair model was devised. Surgical trainees from 5 specialist centres were recruited and performed multiple standardised repairs.
  
  
  RESULTS
  23 trainees performed 192 repairs. Experts performed 10 repairs for comparison. Trainees were timed performing the repair and their accuracy measured. With repeated attempts trainee's timings and accuracy improved until by the 10 th repair they were no different from benchmark consultant scores.
  
  
  CONCLUSIONS
  A simple, procedure specific ex-vivo training model has been evaluated for laparoscopic hernia training in paediatric surgery. The results suggest improvements in competence with repetition. Trainee and benchmark consultant scores are no different by the 10 th trainee attempt. We conclude that this model may have a valuable role in the training and assessment of future paediatric surgeons.
authors.affiliation: Department of Paediatric Surgery, Kings College Hospital, Denmark Hill, London, SE5 9RS, United Kingdom.
authors.forename: Chris
authors.initials: C
authors.lastname: Parsons
authors.forename: Joanna
authors.initials: J
authors.lastname: Manson
authors.forename: Ramesh
authors.initials: R
authors.lastname: Nataraja
authors.forename: Niall
authors.initials: N
authors.lastname: Jones
authors.forename: Joe
authors.initials: J
authors.lastname: Curry
authors.forename: Niyi
authors.initials: N
authors.lastname: Ade-Ajayi
mesh_terms: D002648:Child; D002983:Clinical Competence; D004502:Education, Medical, Continuing / Q000639:trends*; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000193:education* / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000193:education* / Q000379:methods; D008131:London; D017145:Models, Educational; D010372:Pediatrics / Q000193:education*; D011446:Prospective Studies