Τίτλος:
Proving the effectiveness of the fundamentals of robotic surgery (FRS) skills curriculum: A single-blinded, multispecialty, multi-institutional randomized control trial
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
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.
Συγγραφείς:
Satava, R.M.
Stefanidis, D.
Levy, J.S.
Smith, R.
Martin, J.R.
Monfared, S.
Timsina, L.R.
Darzi, A.W.
Moglia, A.
Brand, T.C.
Dorin, R.P.
Dumon, K.R.
Francone, T.D.
Georgiou, E.
Goh, A.C.
Marcet, J.E.
Martino, M.A.
Sudan, R.
Vale, J.
Gallagher, A.G.
Περιοδικό:
Annals of Surgery
Εκδότης:
Lippincott Williams and Wilkins
Λέξεις-κλειδιά:
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
DOI:
10.1097/SLA.0000000000003220
