Background
Materials and methods
Curricular objective and targets
Target | Explanation |
---|---|
Surgical competency | |
Soft skills | Communication and feedback culture; rate of performed standardized communication |
Practical skills | Successful performed simulator training due to predetermined exercises; intraoperative overall workload evaluation by NASA Task Load Index; ability of bedside assistance independently (OSCORE and residents’ feedback questionnaire); rate of independent performed intraoperative procedural steps at the robotic console and their complexity |
Surgical progression | |
Practical skills | Difference between planned/preoperative specified intraoperative procedural steps and actual performed intraoperative procedural steps; relation to surgical experience level |
Organization | |
Participant motivation | Repetitive data analysis for involved personnel to enhance learning progression including feedback and NASA Task Load Index results |
Personnel scheduling | Successful implementation given by rate of scheduled and actual involved personnel to robotic procedures; achievement of targeted number of procedures |
Patient safety | Assurance of state-of-the art surgical performance by standardization of robotic procedures; intraoperative overall workload evaluation by NASA Task Load Index; patient outcome including operation parameters, morbidity and mortality |
Needs assessment, analysis of local resources and literature review
Creation of the robotic training concept RoCS and evaluation methods
Surgical approach | Experience level | Performed procedures (n) | Experience score count |
---|---|---|---|
Open | High | > 300 | 3 |
Moderate | 101–300 | 2 | |
Low | 20–100 | 1 | |
Minimal/none | < 20 | 0 | |
Laparoscopic | High | > 100 | 3 |
Moderate | 51–100 | 2 | |
Low | 20–50 | 1 | |
Minimal/none | < 20 | 0 | |
Robotic | High | > 50 | 3 |
Moderate | 31–50 | 2 | |
Low | 15–30 | 1 | |
Minimal/none | < 15 | 0 |
Participant and patient recruitment
Electronic data collection in collaboration with referring department, future analysis
Initialization of RoCS with simultaneous evaluation and feedback loop
Periodical concept and feedback analysis and consecutive adjustments
Results
Author | Journal, year | Personnel participation (General/visceral surgery) | Simulator training | Bedside assistance | Console training | Operations/Organ systems | Curricular phases/duration | Curricular connection to surgical experience level/Pgy1 | Evaluation method | |
---|---|---|---|---|---|---|---|---|---|---|
1 | Grannan et al. [31] | Surg Laparosc Endosc Percutan Tech, 2021 | Residents | Included | Included | Included | — | 1 | PGY 1 | Post-curriculum survey (resident opinion) |
2 | Mustafa et al. [32] | J Surg Educ, 2019 | Residents | — | — | Included | Hernia repairs | — | — | Retrospective case review |
3 | Moit et al. [33] | JSLS, 2019 | Residents | Included | Included | Included | — | 2 | Phase 1: PGY 1–2 Phase 2: PGY 3–5 | Global Evaluative Assessment of Robotic Skills for resident's operative performance |
4 | Krause, Bird [12] | J Robot Surg, 2019 | Residents, voluntarily | Included | Included | Included | — | 2 | Phase 1: PGY 1–2 Phase 2: PGY 3 + | Survey (residents’ individual opinion) including 6 questions |
5 | Ramirez Barriga et al. [34] | J Surg Educ, 2022 | Residents | Included | — | — | — | 2 week period | PGY 3 | Surveys, comparison to laparoscopic and open techniques, performed mentor sessions and exposure in the OR |
6 | Ann Surg Oncol, 2018 | Fellows | Included | — | Included | Pancreas resections | 5 steps | Included | Depending on the step; including fellow’s education portfolio, pre-/ post-test design, OSATS score, video library, feedback, review of operative performance, etc | |
7 | Gonzalez-Hernandez et al. [35] | J Robot Surg, 2018 | Residents | Included | Included | Included | Hernia repairs | — | Included | Comparison of surgical experience and patient outcomes with/without resident participation |
8 | Winder et al. [36] | J Robot Surg, 2016 | Residents | Included | Included | Included | CR2, biliary, foregut operations | 1 year period | — | Education time and self-reported progress, rate of bedside assistance and operating at the console |
9 | Arain et al. [37] | Surg Endosc, 2012 | Residents, interdisciplinary | Included | — | — | — | 2 month period | Included | Task scoring for time and errors using modified FLS metric |
10 | Formisano et al. [38] | Minerva Chir, 2019 | Attendings | — | Included | Included | Right hemi-colectomy | — | Included | Perioperative factors, pathological outcomes |
11 | Ebeling et al. [39] | Am J Surg, 2020 | Residents and fellows | — | — | Included | Inguinal hernia repairs | — | — | Patient and operation characteristics, residents’ technical competency (GEARS), Zwisch scores, number of robotic console cases (residents as primary surgeon) |
12 | Juza et al. [40] | J Robot Surg, 2014 | Residents and fellows | Included | Included | Included | Initially cholecystectomies | — | Novice robotic surgeons | Comparison to laparoscopic cholecystectomies |
13 | Aradaib et al. [16] | J Robot Surg, 2019 | Colorectal surgeons | Included | — | Included | CR2 | European Academy of Robotic Colorectal Surgery (EARCS) program | Robotic beginners | Multiple patient and perioperative characteristics, 30-day mortality, pathological outcome |
14 | Buchs et al. [14] | Surg Endosc, 2013 | —Interdisciplinary | Included | Included | Included | — | 2-day course | — | Retrospective review of the participants' surgical practice using online research and surveys |
15 | Rückbeil et al. [41] | Zentralbl Chir, 2022 | Residents | — | — | Included | CR2 | 100 consecutive operations | — | Patient and perioperative characteristics |
16 | Collins et al. [2] | J Robot Surg, 2021 | Residents, nurses, surgeons, medical students | — | Included | — | — | 3 stages | — | Pre- and post-Robotic Assistant Surgical Training (RAST) survey (25 questions), between-stages repeated-measures survey (11 questions); including baseline demographics, confidence level, fundamental knowledge, participant feedback, etc |
17 | Thomas et al. [4] | J Robot Surg, 2021 | Colorectal surgeons | Included | — | Included | CR2 | 1-year period | — | Comparison with prior surgical results of involved surgeons, patient and perioperative characteristics, pathological outcome |