TY - JOUR
TI - Proving the effectiveness of the fundamentals of robotic surgery (FRS) skills curriculum: A single-blinded, multispecialty, multi-institutional randomized control trial
AU - Satava, R.M.
AU - Stefanidis, D.
AU - Levy, J.S.
AU - Smith, R.
AU - Martin, J.R.
AU - Monfared, S.
AU - Timsina, L.R.
AU - Darzi, A.W.
AU - Moglia, A.
AU - Brand, T.C.
AU - Dorin, R.P.
AU - Dumon, K.R.
AU - Francone, T.D.
AU - Georgiou, E.
AU - Goh, A.C.
AU - Marcet, J.E.
AU - Martino, M.A.
AU - Sudan, R.
AU - Vale, J.
AU - Gallagher, A.G.
JO - Annals of Surgery
PY - 2020
VL - 272
TODO - 2
SP - 384-392
PB - Lippincott Williams and Wilkins
SN - 0003-4932, 1528-1140
TODO - 10.1097/SLA.0000000000003220
TODO - 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
TODO - 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.
ER -