Development & Validation of a Scoring System for Robot-assisted Surgical Training – The Robotic Skills Assessment Scale

A. Chowriappa, S. Raza, A. Stegemann, K. Ahmed, Y. Shi, G. Wilding, J. Kaouk, J. Peabody, M. Menon, T. Kesavadas, K. Guru

Roswell Park Cancer Institute; Guy’s Hospital London; Henry Ford Hospital;

Background
Evaluation of technical skills is based on crucial surgical tenets that ultimately define a master surgeon. No scoring system exists to evaluate, validate and integrate virtual reality-based metrics into a scale to describe safe and crucial surgical skills / steps during Robot-assisted Surgery. This study aims to develop an assessment scale along with its construct validation.

Methods
Following an expert consensus (Delphi), critical safety determining procedural steps were identified and a hierarchical task decomposition of multiple parameters using a variety of metrics was used to develop the multi-metric scoring system. “The Robotic Skills Assessment Scale” (RSA-Scale) focuses on safety in operative field, critical error, economy, bimanual dexterity and time. All subjects performed key tasks (Table) on the Fundamental Skills of Robotic Surgery (FSRS) curriculum, which were recorded, and metrics were stored. Ten relevant metrics used during curriculum (FSRS) were utilized to assess technical skills. All tasks in the RSA-Scale were essential and contributed equally towards training and the final score. The RSA-Scale was further evaluated for construct validation and feasibility. The RSA-Scale was also implemented to assess development of critical surgical tenets. Spearman’ Correlation tests performed between tasks using the RSA Scores indicate no cross correlation. Wilcoxon Rank-Sum tests were performed between the two groups.

Results
The proposed RSA-Scale was evaluated on (n=15) non-robotic surgeons and (n=12) expert-robotic surgeons. The expert group demonstrated significantly better performance on all four tasks in comparison to the novice group.

Conclusion
The Robotic Skills Assessment Scale is a valid tool that could be incorporated in other virtual reality based surgical simulators to achieve standardized assessment of fundamental surgical tents during robot-assisted surgery.


Session: Poster Presentation

Program Number: ETP022

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