title: "See one, do one, teach one": inadequacies of current methods to train surgeons in hernia repair.
abstract: BACKGROUND
  Residency/fellowship training in hernia repair is still too widely characterized by the "see one, do one, teach one" model. The goal of this study was to perform a needs assessment focused on surgical training to guide the creation of a curriculum by SAGES intended to improve the care of hernia patients.
  
  
  METHODS
  Using mixed methods (interviews and online survey), the SAGES hernia task force (HTF) conducted a study asking subjects about their perceived deficits in resident training to care for hernia patients, preferred training topics about hernias, ideal learning modalities, and education development.
  
  
  RESULTS
  Participants included 18 of 24 HTF members, 27 chief residents and fellows, and 31 surgical residents. HTF members agreed that residency exposes trainees to a wide spectrum of hernia repairs by a variety of surgeons. They cited outdated materials, techniques, and paucity of feedback. Additionally, they identified the "see one, do one, teach one" method of training as prevalent and clearly inadequate. The topics least addressed were system-based approach to hernia care (46 %) and patient outcomes (62 %). Training topics residents considered well covered during residency were: preoperative and intraoperative decision-making (90 %), complications (94 %), and technical approach for repairs (98 %). Instructional methods used in residency include assisted/supervised surgery (96 %), Web-based learning (24 %), and simulation (30 %). Residents' preferred learning methods included simulation (82 %), Web-based training (61 %), hands-on laboratory (54 %), and videos (47 %), in addition to supervised surgery. Trainees reported their most desired training topics as basic techniques for inguinal and ventral hernia repairs (41 %) versus advanced technical training (68 %), which mirrored those reported by attending surgeons, 36 % and 71 %, respectively.
  
  
  CONCLUSIONS
  There was a consensus among HTF members and surgical trainees that a comprehensive, dynamic, and flexible educational program employing various media to address contemporary key deficits in the care of hernia patients would be welcomed by surgeons.
authors.affiliation: Department of General Surgery, Anne Arundel Medical Center, 2000 Medical Parkway, Suite 600, Annapolis, MD, 21401, USA. hzahiri@aahs.org.
authors.forename: H Reza
authors.initials: HR
authors.lastname: Zahiri
authors.affiliation: Department of General Surgery, Anne Arundel Medical Center, 2000 Medical Parkway, Suite 600, Annapolis, MD, 21401, USA. apark@aahs.org.
authors.forename: Adrian E
authors.initials: AE
authors.lastname: Park
authors.affiliation: Department of Surgery, University of Wisconsin School of Medicine, Madison, WI, USA.
authors.forename: Carla M
authors.initials: CM
authors.lastname: Pugh
authors.affiliation: Department of Surgery, McGill University School of Medicine, Montreal, Canada.
authors.forename: Melina
authors.initials: M
authors.lastname: Vassiliou
authors.affiliation: Department of Surgery, University of Tennessee School of Medicine, Memphis, TN, USA.
authors.forename: Guy
authors.initials: G
authors.lastname: Voeller
mesh_terms: D003479:Curriculum; D059685:Herniorrhaphy / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D007407:Interviews as Topic; D020380:Needs Assessment; D011795:Surveys and Questionnaires; D013663:Teaching / Q000379:methods*; D014481:United States
keywords: Clinical trials; Education; Hernia; Outcomes; Quality control; Residency