Michael L Williford, MD1, Paula D Strassle, MSPH2, Meredith C Duke, MD, MBA1. 1University of North Carolina at Chapel Hill Department of Surgery, 2University of North Carolina at Chapel Hill Department of Epidemiology
Introduction: The primary aim of this study was to determine how three types of simulation impacted resident comfort level with various aspects of robotic surgery. As robotic surgery increases in prevalence, it is necessary for residents to become facile with this technology during training.
Methods and Procedures: Surgery residents at a single institution were surveyed in September 2017. They were asked to answer demographic questions and rate their comfort level (0=not comfortable, 10=very comfortable) with aspects of robotic surgery. Paired t-tests and Wilcoxon tests were used to assess whether there were changes in comfort level before and after labs, and Chi-square goodness of fit tests were used to assess whether dry lab (using inanimate objects), wet lab (using a porcine model), or simulator modules were thought to be most helpful in obtaining specific robotic skills.
Results: The survey response rate was 73% (n=32). Ninety-one percent of residents felt that robotic surgery is not intuitive. Prior to simulation, 94% of residents felt inadequately prepared to safely operate on the robotic console. Following simulation, 100% felt better prepared and more confident to participate in robotic surgery.
Among residents that participated in a dry lab (n=25), on average residents reported a 3.8 point increase in comfort docking the robot (p<0.0001) and a 2.9 point increase in comfort being bedside assistant after the lab (p<0.0001). Among those who participated in a wet lab (n=20), on average a 2.3 point increase was seen in comfort docking the robot (p=0.0003), a 1.7 point increase was seen in comfort being bedside assistant (p=0.003), and a 2.2 point increase was seen in comfort operating on the console after the lab (p<0.0001). No significant difference in console comfort was seen across PGY level, and no differences in skill improvement were seen across gender.
While residents did not report a preference for simulation type in learning how to adjust the camera (p=0.15) or handle robotic instruments (p=0.61), they reported that simulator modules were most helpful for learning electrocautery (p=0.009) and that the wet lab was most helpful for learning both suturing (p=0.002) and stapling (p=0.002).
Conclusions: In order to be functional at the bedside and safely operate on the console, residents should have the ability to practice skills in a simulated environment. All 3 types of simulation studied had a positive impact on resident comfort and skill acquisition. Therefore, simulation should be considered an integral part of resident education.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 86536
Program Number: P798
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster