Britta J Han1, William Sherrill2, Michael M Awad3. 1. Division of Minimally Invasive Surgery Clinical Research Fellow/Resident Physician, Department of Surgery, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8109, Saint Louis, MO, 63110, USA. bhan@wustl.edu. 2. Department of Surgery, Atrium Health General & Complex Abdominal Surgery, Carolinas Medical Center, Saint Louis, MO, USA. 3. Division of Minimally Invasive Surgery Clinical Research Fellow/Resident Physician, Department of Surgery, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8109, Saint Louis, MO, 63110, USA.
Abstract
BACKGROUND: General surgery has the fastest growing robotic operative volume in the United States, but most robotic curricula are focused on basic psychomotor skills. There are limited curricula focused on advanced robotic technical and related non-technical skills. We describe a novel pilot curriculum for robotic hiatal hernia repair developed for senior surgical residents to provide training and standardized assessment of higher-order robotic technical and leadership skills. METHODS: Twelve senior residents, post-graduate year (PGY) 4 & 5, participated in a robotic hiatal hernia repair skills curriculum. Residents completed a pre- and post-survey on confidence and ability ratings on a 5-point Likert-type Scale, and a knowledge assessment. An informal faculty-led didactic was provided prior to the simulation. Residents were scored on two validated assessment tools: Ottawa Surgical Competency Operating Room Evaluation (O-SCORE) and Global Ratings Scale of Operative Performance (GRS) by faculty proctors. RESULTS: Confidence in ability to independently complete a robotic hiatal hernia case increased from mean of 2.6 ± 0.8 to 3.3 ± 0.6 (p = 0.0007). Following the simulation, residents reported increased overall confidence and ability to operate independently with mean scores of 3.3 ± 0.8 and 3.8 ± 0.9, respectively. Mean O-SCORE and GRS scores were 3.6 (range 2 - 4) and 25.4 (range 12 - 31), respectively. Number of prior live robotic cases was strongly positively correlated to O-SCORE (R = 0.84, p = 0.0006) and GRS (R = 0.88, p = 0.0002). CONCLUSION: Our pilot study suggests live-operative robotic training is not sufficient alone for advanced robotic skill training. Simulations such as this can be used to (1) practice advanced robotic technical and relevant non-technical skills such as communication and operating room leadership in a low stake setting and (2) assess residents in a standardized environment to eventually evaluate robotic competency.
BACKGROUND: General surgery has the fastest growing robotic operative volume in the United States, but most robotic curricula are focused on basic psychomotor skills. There are limited curricula focused on advanced robotic technical and related non-technical skills. We describe a novel pilot curriculum for robotic hiatal hernia repair developed for senior surgical residents to provide training and standardized assessment of higher-order robotic technical and leadership skills. METHODS: Twelve senior residents, post-graduate year (PGY) 4 & 5, participated in a robotic hiatal hernia repair skills curriculum. Residents completed a pre- and post-survey on confidence and ability ratings on a 5-point Likert-type Scale, and a knowledge assessment. An informal faculty-led didactic was provided prior to the simulation. Residents were scored on two validated assessment tools: Ottawa Surgical Competency Operating Room Evaluation (O-SCORE) and Global Ratings Scale of Operative Performance (GRS) by faculty proctors. RESULTS: Confidence in ability to independently complete a robotic hiatal hernia case increased from mean of 2.6 ± 0.8 to 3.3 ± 0.6 (p = 0.0007). Following the simulation, residents reported increased overall confidence and ability to operate independently with mean scores of 3.3 ± 0.8 and 3.8 ± 0.9, respectively. Mean O-SCORE and GRS scores were 3.6 (range 2 - 4) and 25.4 (range 12 - 31), respectively. Number of prior live robotic cases was strongly positively correlated to O-SCORE (R = 0.84, p = 0.0006) and GRS (R = 0.88, p = 0.0002). CONCLUSION: Our pilot study suggests live-operative robotic training is not sufficient alone for advanced robotic skill training. Simulations such as this can be used to (1) practice advanced robotic technical and relevant non-technical skills such as communication and operating room leadership in a low stake setting and (2) assess residents in a standardized environment to eventually evaluate robotic competency.
Authors: Richard H Bell; Thomas W Biester; Arnold Tabuenca; Robert S Rhodes; Joseph B Cofer; L D Britt; Frank R Lewis Journal: Ann Surg Date: 2009-05 Impact factor: 12.969
Authors: Samer G Mattar; Adnan A Alseidi; Daniel B Jones; D Rohan Jeyarajah; Lee L Swanstrom; Ralph W Aye; Steven D Wexner; José M Martinez; Sharona B Ross; Michael M Awad; Morris E Franklin; Maurice E Arregui; Bruce D Schirmer; Rebecca M Minter Journal: Ann Surg Date: 2013-09 Impact factor: 12.969
Authors: Luise I M Pernar; Faith C Robertson; Ali Tavakkoli; Eric G Sheu; David C Brooks; Douglas S Smink Journal: Surg Endosc Date: 2017-04-14 Impact factor: 4.584