INSTRUCTION AND FEEDBACK METHOD FOR LAPAROSCOPIC HERNIA REPAIR USING SELF-MADE MANUAL WITH SELF-ASSESSMENT SHEET

Abstract Aim We use the self-made manual to understand procedures easily, and the self-assessment sheet to improve trainees' skills efficiently. We investigated the effect of this method for trainees in laparoscopic inguinal hernia repair. Material and Methods In the original manual, surgical procedures and how to make surgical fields are explained using intraoperative photos, in order to clarify the purpose of the procedures in each scene of surgery. We also made the self-assessment sheet that sets goals according to the manual, and evaluates the trainee's attainment objectively. Trainees score the assessment sheet after every surgery. Trainers evaluate their sheets and give feedback on their skills with a radar chart. Results By using the same manual, trainees and trainers could share the same terms and thoughts easily during surgery. The self-assessment sheet made trainees effective to understand their weak points and improve their skills. At the beginning of the training, the much-experienced trainee got a higher score. As trainees experienced surgeries, they became getting higher scores. There was a significant correlation between a high score and a short operation time. A radar chart helped efficiently to understand trainees' weak points. Conclusions Using the self-made manual and the self-assessment sheet together was useful for both the trainer and the trainees to evaluate their attainment objectively. Scores and graphs helped trainees assess their skills efficiently.