Long Term Followup of a Validated Robotic Surgery Training Program

Sam E Kirkendall, MD, Aimee K Gardner, PhD, Robert V Rege, MD. University of Texas Southwestern Medical Center

INTRODUCTION: A comprehensive, proficiency-based robotic training program was previously developed, validated, and integrated into the curriculum at our large teaching institution. The purpose of this study was to query past participants regarding the usefulness of the training for their practice in order to determine how to further improve and expand the curricula.

METHODS AND PROCEDURES: An anonymous 34-item online survey was developed and submitted to past participants of whom we had current contact information.

RESULTS: Forty-seven of the 101 (46.5%) previous trainees responded, consisting of graduates in General Surgery (N=28), Urology (N=13), Thoracic Surgery (N=5) and Neurosurgery (N=1). Eleven respondents are still in training.  Participants reported current practice setting as private practice (29.3%), academic institution (51.2%), or community hospital (19.5%). The majority of respondents (83%) reported the curriculum as their first robotic training experience. Only 10 reported undergoing any additional training since completing the course (including fellowships). Approximately one-third (38%) perform 0 robotic cases per year, whereas 19% perform 1-10/year, 27.6% perform 11-50/year, 6.3% perform 51-100, and 8% perform more than 100 robotic cases per year. When asked to rate the usefulness of each of the nine individual tasks to their current practice on a five-point scale, respondents rated clutch and camera movement (3.83), simple suture (3.78), and running suture (3.75) as the most useful modules. A majority (85%) was not familiar with any other robotic training curricula, but 49% were interested in pursuing additional robotic training.  Almost all respondents (97%) felt the training program should be continued for surgical trainees and 44% indicated that robotic training should be offered to ancillary staff members. Of those who were aware of credentialing requisites at their institution, 48% indicated that this training program was sufficient to meet those requirements. Suggestions for improvement included additional training in port placement and docking, integration with the backpack trainer, live tissue suturing/pig lab, additional suture practice including tying knots under tension, and more feedback.

CONCLUSIONS: This robotic training program is an important component in preparing trainees for independent practice that includes robotic surgery. These trainees did not frequently complete further training and completion of the program was often acceptable for credentialing at their current institutions, emphasizing the importance of a comprehensive initial program.  The program might be improved by integrating the backpack virtual reality training system into training, adding additional suturing with possible live tissue model, and providing more feedback.

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