@article{3104083,
    title = "Proving the effectiveness of the fundamentals of robotic surgery (FRS) skills curriculum: A single-blinded, multispecialty, multi-institutional randomized control trial",
    author = "Satava, R.M. and Stefanidis, D. and Levy, J.S. and Smith, R. and Martin, J.R. and Monfared, S. and Timsina, L.R. and Darzi, A.W. and Moglia, A. and Brand, T.C. and Dorin, R.P. and Dumon, K.R. and Francone, T.D. and Georgiou, E. and Goh, A.C. and Marcet, J.E. and Martino, M.A. and Sudan, R. and Vale, J. and Gallagher, A.G.",
    journal = "Annals of Surgery",
    year = "2020",
    volume = "272",
    number = "2",
    pages = "384-392",
    publisher = "Lippincott Williams and Wilkins",
    issn = "0003-4932, 1528-1140",
    doi = "10.1097/SLA.0000000000003220",
    keywords = "adult;  article;  bird;  checklist;  comparative effectiveness;  controlled study;  curriculum;  dissection;  education;  female;  human;  human experiment;  human tissue;  interrater reliability;  male;  multicenter study;  nonhuman;  outcome assessment;  parallel design;  psychomotor performance;  randomized controlled trial;  resident;  robot assisted surgery;  simulation;  single blind procedure;  analysis of variance;  clinical competence;  clinical trial;  computer simulation;  curriculum;  education;  procedures;  risk assessment;  robot assisted surgery;  simulation training;  surgery;  treatment outcome, Analysis of Variance;  Clinical Competence;  Computer Simulation;  Curriculum;  Female;  Humans;  Male;  Risk Assessment;  Robotic Surgical Procedures;  Simulation Training;  Single-Blind Method;  Specialties, Surgical;  Treatment Outcome",
    abstract = "Objective: To demonstrate the noninferiority of the fundamentals of robotic surgery (FRS) skills curriculum over current training paradigms and identify an ideal training platform. Summary Background Data: There is currently no validated, uniformly accepted curriculum for training in robotic surgery skills. Methods: Single-blinded parallel-group randomized trial at 12 international American College of Surgeons (ACS) Accredited Education Institutes (AEI). Thirty-three robotic surgery experts and 123 inexperienced surgical trainees were enrolled between April 2015 and November 2016. Benchmarks (proficiency levels) on the 7 FRS Dome tasks were established based on expert performance. Participants were then randomly assigned to 4 training groups: Dome (n ¼ 29), dV-Trainer (n ¼ 30), and DVSS (n ¼ 32) that trained to benchmarks and control (n ¼ 32) that trained using locally available robotic skills curricula. The primary outcome was participant performance after training based on task errors and duration on 5 basic robotic tasks (knot tying, continuous suturing, cutting, dissection, and vessel coagulation) using an avian tissue model (transfer-test). Secondary outcomes included cognitive test scores, GEARS ratings, and robot familiarity checklist scores. Results: All groups demonstrated significant performance improvement after skills training (P < 0.01). Participating residents and fellows performed tasks faster (DOME and DVSS groups) and with fewer errors than controls (DOME group; P < 0.01). Inter-rater reliability was high for the checklist scores (0.82-0.97) but moderate for GEARS ratings (0.40-0.67). Conclusions: We provide evidence of effectiveness for the FRS curriculum by demonstrating better performance of those trained following FRS compared with controls on a transfer test. We therefore argue for its implementation across training programs before surgeons apply these skills clinically. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved."
}