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Hernia
Published in: Hernia 4/2020

01-08-2020 | Original Article

Validation and educational impact study of the NANEP high-fidelity simulation model for open preperitoneal mesh repair of umbilical hernia

Authors: U. Friedrich, J. Backhaus, C. T. Zipper, S. König, S. Mavroveli, A. Wiegering, S. Olbrecht, F. Puppe, U. A. Dietz

Published in: Hernia | Issue 4/2020

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Abstract

Objective

The aim of the study was to develop, validate and analyze the educational impact of a high-fidelity simulation model for open preperitoneal mesh repair of an umbilical hernia.

Summary of background data

The number of surgical simulators available for training residents is limited. Primary for ethical reasons and secondary for the emerging pay-per-quality policies, practicing-on simulators rather than patients is considered gold standard. Validated full-procedural surgical models will become more and more important in training residents. Such models may assure that evidence-based standards regarding technical aspects of the procedures become integral part of the curriculum. Furthermore, they can be employed as a quality control of residents’ skills (Fonseca et al. in J Surg Educ 70:129–137, 2013).

Methods

In a repeated measures design, medical students, residents in their last year of training and attending surgeons performed an open preperitoneal mesh repair on the NANEP model [NANEP stands for the German acronym Nabelhernien-Netzimplatation-Präperitonal (English: Umbilical hernia mesh implantation preperitoneal)]. Subjects were categorized as “Beginners” (internship students) or “Experts” (residents and surgeons). Content validity was analyzed by criteria of subject-matter-experts. Blinded raters assessed surgical skills by means of the Competency Assessment Tool (CAT) using the online platform “CATLIVE”. Differential validity was measured by group differences. Proficiency gain was analyzed by monitoring the learning curve (Gallagher et al. in Ann Surg 241:364–372, 2005). Post-operative examination of the simulators shed light on criterion validity.

Results

The NANEP model-proofed content and construct-valid significant Bonferroni-corrected differences were found between beginners and experts (p < 0.05). Beginners showed a significant learning increase from the first to the second surgery (p < 0.05). Post-operative examination data confirmed criterion validity.

Conclusion

The NANEP model is an inexpensive, simple and efficient simulation model. It has highly realistic features, it has been shown to be of high-fidelity, full-procedural and benchtop-model. The NANEP model meets the main needs of surgical educational courses at the beginning of residency.
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Metadata
Title
Validation and educational impact study of the NANEP high-fidelity simulation model for open preperitoneal mesh repair of umbilical hernia
Authors
U. Friedrich
J. Backhaus
C. T. Zipper
S. König
S. Mavroveli
A. Wiegering
S. Olbrecht
F. Puppe
U. A. Dietz
Publication date
01-08-2020
Publisher
Springer Paris
Published in
Hernia / Issue 4/2020
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI
https://doi.org/10.1007/s10029-019-02004-9

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