The training
hernia
INFILTRATION
The training consisted of two modules; one theoretical and one practical with supervised, hands-on surgery. The theoretical module lasted one day and was delivered by interactive, PowerPoint supported presentations developed by The Ghana Hernia Society. The content included anatomy of the groin, step-by-step explanation of local anaesthetic infiltration and the Lichtenstein method of inguinal hernia repair.During the practical module, each trainee observed, assisted and performed a number of inguinal hernia repairs with mesh. Trainees first assisted the trainer in at least one operation, followed by the trainee being the principal surgeon assisted by the trainer and then trainees assisting each other. Paired trainees were allowed to observe operations being performed by the other trainee when their counterpart was being assisted by a trainer. All training operations were done with at least one consultant surgeon present in theatre. To ensure patient safety, surgeon trainers took over operations if they thought the case was too difficult for the trainee. These cases are included in this study as training procedures but not as assessment procedures before qualification.The performance of each trainee was assessed after each surgery. The assessment was verbal and also delivered in a structured, written form based on the American College of Surgeon’s Groin Hernia Operative Performance Rating System [