Team Training (Training at Own Facility) versus Individual Surgeon’s Training (Training at Trainer’s Facility) When Implementing a New Surgical Technique: Example from the ONSTEP Inguinal Hernia Repair

Background. When implementing a new surgical technique, the best method for didactic learning has not been settled. There are basically two scenarios: the trainee goes to the teacher’s clinic and learns the new technique hands-on, or the teacher goes to the trainee’s clinic and performs the teaching there. Methods. An informal literature review was conducted to provide a basis for discussing pros and cons. We also wanted to discuss how many surgeons can be trained in a day and the importance of the demand for a new surgical procedure to ensure a high adoption rate and finally to apply these issues on a discussion of barriers for adoption of the new ONSTEP technique for inguinal hernia repair after initial training. Results and Conclusions. The optimal training method would include moving the teacher to the trainee’s department to obtain team-training effects simultaneous with surgical technical training of the trainee surgeon. The training should also include a theoretical presentation and discussion along with the practical training. Importantly, the training visit should probably be followed by a scheduled visit to clear misunderstandings and fine-tune the technique after an initial self-learning period. 1. Introduction Over the years, numerous new surgical techniques have been implemented [1], but there is no overall consensus of how to facilitate this process. Typically, the trainee surgeon will visit another department and watch a procedure or he/she will see it in videos either at international meetings or on the Internet. Thereafter, a sort of trial and error phase will follow in the surgeon’s own department until the technique is running smoothly. This scenario may not be optimal, since a formalized training program would probably result in better learning and thereby better patient outcome. Traditionally, learning has been defined as a process with creation of new skills and knowledge at an individual level. Over the recent years, this approach has been questioned. Research has shown that high-standard learning should be seen as a social process, where the interaction between individuals creates new learning [2]. Human learning should therefore be seen as a social interaction between the individual and his environment [2]. The success rate when implementing a new surgical technique may be measured by the percentage of the trainee surgeons who will perform the new procedure when they are not in the training situation anymore. Thus, when spending resources on instruction and training, a high adoption rate would be optimal. The training setup