James D Roy, MD, John D Hunter, MD, Seth Hill, BS, MS, Joseph E Stahl, BS, Paul F Rider, MD, William O Richards, MD. University of South Alabama
INTRODUCTION: The aim of this study is to examine if a robotic surgery simulation competition, incentivized by prizes, increases voluntary utilization of a robotic simulator. Virtual reality surgical simulation is a validated method for training residents and surgeons on robotic platforms. Additionally, robotic virtual reality simulation training has been shown to improve basic skillsets and lead to improved operative skills. A major hurdle to the use of simulation in resident training is voluntary utilization by trainees.
METHODS AND PROCEDURES: This is a single center, IRB exempt, retrospective cohort study performed from 12/19/17 until 6/21/18. Open access to the da Vinci Xi® surgeon console and Mimic Simulation® dV-Trainer® software was afforded to residents beginning on 12/19/17. A robotics competition was announced on 4/20/2018 and held on 6/21/18.
Prizes for winners of each PGY class and an overall winner were announced, but specific prizes were not revealed until after the competition concluded. A total of 19 residents met inclusion criteria. The competition included three simulated tasks. Technical skill outcomes for each of the three tasks were quantified with an overall score. Technical proficiency was measured by time to complete, economy of motion, instrument collisions, excessive instrument force, instruments out of view, and workspace range.
Overall simulator use was compared for all residents before and after announcement of the competition using the Wilcoxon Sum Rank tests. Correlation of simulator use with overall score and technical proficiency was analyzed using Spearman’s Rho. Comparison of specific technical proficiency measures between the top, middle and bottom scoring competition participants were analyzed using the Kruskal-Wallis tests. Statistical analyses were performed using IBM SPSS Statistics version 25.
RESULTS: Following announcement of the competition and prizes, voluntary robotic simulator use increased by 132% (p=0.008). There were 8 novel users following announcement of the competition. Total completed attempts correlated significantly with overall competition score (p<0.001). Total attempts in the study period also positively correlated with improved economy of motion (p=0.039), decreased time of excessive force (p=0.038), and decreased instrument collisions (p=0.013). Among our grouped skill categories, average time to complete exercises (p=0.023), average economy of motion (p=0.031), and number of instrument collisions (p=0.002) significantly varied between the top, middle, and bottom performing groups.
CONCLUSIONS: Competition along with prizes significantly increases voluntary use of robotic simulators among residents. Additionally, increased utilization of robotic simulators leads to improved technical performance among surgical trainees.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 95527
Program Number: P396
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster