Evaluation of long-term impact of education program Hernia Help - Hernia Repair for the Underserved (HRFU) in Brazil

Abstract

AIM: Hernia Help - Hernia Repair for the Underserved (HRFU) is a non-governmental organization (NGO) that has the following objectives: (1) to provide free hernia surgery to underserved populations, (2) to train local surgeons in a competency-based training program, and (3) to assist local authorities in creating self-sustaining hernia repair teams that can provide further care to the community. We aim to report a quality research of the training program of Hernia Help. Materials and Methods: Fifty-five surgeons who took the courses promoted by Hernia Help were contacted by email or telephone and invited to participate in the study. Those who accepted by signing their own and individual terms will answer a standardized questionnaire (10 closed questions) that evaluates the training course, as well as the incorporation of the technique taught in the participant's daily practice. Results: Hernia Help - HRFU trained 55 surgeons in Brazil, of which 33 responded to the contact and agreed to participate in the study; 16 did not return the contact; 2 refused to participate in the study; and 4 could not be reached for lack of means of contact. Of this group, all see Hernia Help as a good experience to them, and it has fulfilled the scope of teaching the modified Lichtenstein technique (MLT), and 88% adopted the technique in their daily practice. Of the group that adopted the MLT (29 participants), 6 (20.6%) admitted that they do not follow every step as it was taught. Additionally, 9 (31%) also reported that they have altered, to some degree, the technique when performing it in their daily practice. In addition, 4 (13.7%) admitted that they need another course. In contrast, 26 (89.6%) feel confident to teach the MLT, and 22 (75,8%) manifest the intent to participate as instructors in other occasions. Conclusion: Those results may indicate the need to develop new forms to help these students become proficient and perform the MTL following the steps. Besides, the study shows that Hernia Help - HRFU is a valuable initiative to educate surgeons - in developing countries - to build a sustainable inguinal hernia program in their communities.