P143 INSTRUCTION AND FEEDBACK METHOD FOR LAPAROSCOPIC HERNIA REPAIR USING SELF-MADE MANUAL WITH SELF-ASSESSMENT SHEET

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.

124 The Microsurgical Learning Curve: Can We Make the First Steps Faster and Safer; A Cadaveric Study with A Novel Principle of Learning

Aim Learning anew surgical technique can be a daunting experience for both the teacher and learner. Raising free flaps is a complex process, and our aim is to find out whether using Hi-fidelity simulation on cadavers can make the learning faster and safer. Method We used fresh frozen cadavers according to our local protocols. In the first stage of the study, we used 4 upper limbs in the first instance using different dye techniques. We use these in an international course and obtain feedback from the trainees. Results To a novel learner, we found that using a bright green dye was the important factor in making the first steps of learning easier and faster. This is perhaps due to the confounding information when raising the flap. We found that it made understanding the concept of free flap raising much faster when clarified with colour. It also made anticipating the steps easier when identifying the perforators. To an experienced trainee/consultant: We found teaching the concept of perforators easier, the ease of finding the perforators would raise confidence of the novel trainees. They will be able to conceptualize the principles of flap raising much faster. They believed it would also make them quicker at anticipating steps of the procedure. Conclusions Learning is an incredible process that we still have to better control and understand. Using simple tricks such as colour changes can make initial learning faster, which means cheaper and safer