Literature DB >> 22538678

Comprehensive proficiency-based inanimate training for robotic surgery: reliability, feasibility, and educational benefit.

Nabeel A Arain1, Genevieve Dulan, Deborah C Hogg, Robert V Rege, Cathryn E Powers, Seifu T Tesfay, Linda S Hynan, Daniel J Scott.   

Abstract

BACKGROUND: We previously developed a comprehensive proficiency-based robotic training curriculum demonstrating construct, content, and face validity. This study aimed to assess reliability, feasibility, and educational benefit associated with curricular implementation.
METHODS: Over an 11-month period, 55 residents, fellows, and faculty (robotic novices) from general surgery, urology, and gynecology were enrolled in a 2-month curriculum: online didactics, half-day hands-on tutorial, and self-practice using nine inanimate exercises. Each trainee completed a questionnaire and performed a single proctored repetition of each task before (pretest) and after (post-test) training. Tasks were scored for time and errors using modified FLS metrics. For inter-rater reliability (IRR), three trainees were scored by two raters and analyzed using intraclass correlation coefficients (ICC). Data from eight experts were analyzed using ICC and Cronbach's α to determine test-retest reliability and internal consistency, respectively. Educational benefit was assessed by comparing baseline (pretest) and final (post-test) trainee performance; comparisons used Wilcoxon signed-rank test.
RESULTS: Of the 55 trainees that pretested, 53 (96 %) completed all curricular components in 9-17 h and reached proficiency after completing an average of 72 ± 28 repetitions over 5 ± 1 h. Trainees indicated minimal prior robotic experience and "poor comfort" with robotic skills at baseline (1.8 ± 0.9) compared to final testing (3.1 ± 0.8, p < 0.001). IRR data for the composite score revealed an ICC of 0.96 (p < 0.001). Test-retest reliability was 0.91 (p < 0.001) and internal consistency was 0.81. Performance improved significantly after training for all nine tasks and according to composite scores (548 ± 176 vs. 914 ± 81, p < 0.001), demonstrating educational benefit.
CONCLUSION: This curriculum is associated with high reliability measures, demonstrated feasibility for a large cohort of trainees, and yielded significant educational benefit. Further studies and adoption of this curriculum are encouraged.

Mesh:

Year:  2012        PMID: 22538678     DOI: 10.1007/s00464-012-2264-x

Source DB:  PubMed          Journal:  Surg Endosc        ISSN: 0930-2794            Impact factor:   4.584


  12 in total

1.  Fundamental principles of validation, and reliability: rigorous science for the assessment of surgical education and training.

Authors:  A G Gallagher; E M Ritter; R M Satava
Journal:  Surg Endosc       Date:  2003-09-19       Impact factor: 4.584

2.  Proving the value of simulation in laparoscopic surgery.

Authors:  Gerald M Fried; Liane S Feldman; Melina C Vassiliou; Shannon A Fraser; Donna Stanbridge; Gabriela Ghitulescu; Christopher G Andrew
Journal:  Ann Surg       Date:  2004-09       Impact factor: 12.969

3.  Global evaluative assessment of robotic skills: validation of a clinical assessment tool to measure robotic surgical skills.

Authors:  Alvin C Goh; David W Goldfarb; James C Sander; Brian J Miles; Brian J Dunkin
Journal:  J Urol       Date:  2011-11-17       Impact factor: 7.450

4.  Content and face validity of a comprehensive robotic skills training program for general surgery, urology, and gynecology.

Authors:  Genevieve Dulan; Robert V Rege; Deborah C Hogg; Kristine K Gilberg-Fisher; Seifu T Tesfay; Daniel J Scott
Journal:  Am J Surg       Date:  2012-02-09       Impact factor: 2.565

5.  The MISTELS program to measure technical skill in laparoscopic surgery : evidence for reliability.

Authors:  M C Vassiliou; G A Ghitulescu; L S Feldman; D Stanbridge; K Leffondré; H H Sigman; G M Fried
Journal:  Surg Endosc       Date:  2006-02-27       Impact factor: 4.584

Review 6.  Objective assessment of technical performance.

Authors:  Gerald M Fried; Liane S Feldman
Journal:  World J Surg       Date:  2008-02       Impact factor: 3.352

Review 7.  Training, credentialing, proctoring and medicolegal risks of robotic urological surgery: recommendations of the society of urologic robotic surgeons.

Authors:  Kevin C Zorn; Gagan Gautam; Arieh L Shalhav; Ralph V Clayman; Thomas E Ahlering; David M Albala; David I Lee; Chandru P Sundaram; Surena F Matin; Erik P Castle; Howard N Winfield; Matthew T Gettman; Benjamin R Lee; Raju Thomas; Vipul R Patel; Raymond J Leveillee; Carson Wong; Gopal H Badlani; Koon H Rha; Scott E Eggener; Peter Wiklund; Alex Mottrie; Fatih Atug; Ali R Kural; Jean V Joseph
Journal:  J Urol       Date:  2009-07-21       Impact factor: 7.450

Review 8.  Evolution of robot-assisted radical prostatectomy.

Authors:  M A Orvieto; V R Patel
Journal:  Scand J Surg       Date:  2009       Impact factor: 2.360

9.  Developing a comprehensive, proficiency-based training program for robotic surgery.

Authors:  Genevieve Dulan; Robert V Rege; Deborah C Hogg; Kristine M Gilberg-Fisher; Nabeel A Arain; Seifu T Tesfay; Daniel J Scott
Journal:  Surgery       Date:  2012-09       Impact factor: 3.982

Review 10.  Best practices for robotic surgery training and credentialing.

Authors:  Jason Y Lee; Phillip Mucksavage; Chandru P Sundaram; Elspeth M McDougall
Journal:  J Urol       Date:  2011-02-22       Impact factor: 7.450

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  14 in total

1.  Virtual reality robotic surgery simulation curriculum to teach robotic suturing: a randomized controlled trial.

Authors:  Daniel J Kiely; Walter H Gotlieb; Susie Lau; Xing Zeng; Vanessa Samouelian; Agnihotram V Ramanakumar; Helena Zakrzewski; Sonya Brin; Shannon A Fraser; Pira Korsieporn; Laura Drudi; Joshua Z Press
Journal:  J Robot Surg       Date:  2015-05-16

Review 2.  Simulation-based training in robot-assisted surgery: current evidence of value and potential trends for the future.

Authors:  Michael I Hanzly; Tareq Al-Tartir; Syed Johar Raza; Atif Khan; Mohammad Manan Durrani; Thomas Fiorica; Phillip Ginsberg; James L Mohler; Boris Kuvshinoff; Khurshid A Guru
Journal:  Curr Urol Rep       Date:  2015-06       Impact factor: 3.092

3.  European Association of Endoscopic Surgeons (EAES) consensus statement on the use of robotics in general surgery.

Authors:  Amir Szold; Roberto Bergamaschi; Ivo Broeders; Jenny Dankelman; Antonello Forgione; Thomas Langø; Andreas Melzer; Yoav Mintz; Salvador Morales-Conde; Michael Rhodes; Richard Satava; Chung-Ngai Tang; Ramon Vilallonga
Journal:  Surg Endosc       Date:  2014-11-08       Impact factor: 4.584

Review 4.  Learning tools and simulation in robotic surgery: state of the art.

Authors:  Nicolas C Buchs; François Pugin; Francesco Volonté; Philippe Morel
Journal:  World J Surg       Date:  2013-12       Impact factor: 3.352

5.  Proficiency training on a virtual reality robotic surgical skills curriculum.

Authors:  Justin Bric; Michael Connolly; Andrew Kastenmeier; Matthew Goldblatt; Jon C Gould
Journal:  Surg Endosc       Date:  2014-06-20       Impact factor: 4.584

6.  Time to consider integration of a formal robotic-assisted surgical training program into obstetrics/gynecology residency curricula.

Authors:  Monica Hagan Vetter; Marilly Palettas; Erinn Hade; Jeffrey Fowler; Ritu Salani
Journal:  J Robot Surg       Date:  2017-12-28

7.  Development of an affordable, immersive model for robotic vaginal cuff closure: a randomized trial.

Authors:  Federico Gheza; Lauren Pinkard; Arielle Grand; Gabriela Aguiluz-Cornejo; Alberto Mangano; Andras Ladanyi
Journal:  J Robot Surg       Date:  2022-03-30

8.  RoCS: Robotic Curriculum for young Surgeons.

Authors:  Jessica Stockheim; Aristotelis Perrakis; Bernhard A Sabel; Robert Waschipky; Roland S Croner
Journal:  J Robot Surg       Date:  2022-07-09

Review 9.  A review of robotic surgical training: establishing a curriculum and credentialing process in ophthalmology.

Authors:  Bonnie He; Marc D de Smet; Mohit Sodhi; Mahyar Etminan; David Maberley
Journal:  Eye (Lond)       Date:  2021-06-11       Impact factor: 4.456

10.  Learning curve of surgical novices using the single-port platform SymphonX: minimizing OR trauma to only one 15-mm incision.

Authors:  Rabi R Datta; Sebastian Schönhage; Thomas Dratsch; Justus Toader; Dolores T Müller; Roger Wahba; Robert Kleinert; Michael Thomas; Georg Dieplinger; Dirk L Stippel; Christiane J Bruns; Hans F Fuchs
Journal:  Surg Endosc       Date:  2020-09-23       Impact factor: 4.584

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