Assessment of Feedback Mechanisms in Robotic Surgery Curriculum in Obstetrics and Gynecology Residency

Abstract

Study Objective Overcoming the learning curve in robotic surgery requires appreciable effort. A structured curriculum in robotic gynecologic surgery was established for residents at an academic teaching hospital. This study aimed to explore resident experience with robotic surgery and training and to elicit resident preferences for feedback within the curriculum. Design A survey assessing demographics, surgical preparation methods, robotic surgical experience and comfort, and feedback preferences was distributed electronically to current obstetrics and gynecology (OB/GYN) residents. Responses were analyzed with descriptive statistics. Setting This study was conducted in the OB/GYN residency at Northwestern University in Chicago, IL. Patients or Participants The survey was sent to the 47 current OB/GYN residents in the academic year 2019-2020. A total of 29 responses were elicited. Interventions N/A Measurements and Main Results Eighteen residents (18/29; 62%) reported console experience in at least one robotic surgery. Most (26/29; 90%) stated that prior to operating on the robotic console they felt uncomfortable or very uncomfortable. Prior to console experience, residents primarily used online videos (62%), VR simulation (48%) or observation of live surgery (48%) as preparation. Of note, 7 (24%) residents reported no preparation prior to robotic surgery; these were PGY1 or PGY2 residents who also reported no prior console experience. After console experience, ongoing preparation techniques remained similar, although more residents reported in engaging in pre-operative preparation. All reported that they do receive feedback on surgical skills, but perception of usefulness, timeliness, and structure varied. Feedback was reported as useful and timely, but not well-structured. Most residents (28/29, 97%) indicated that they would prefer real-time feedback immediately after console experience. Conclusion OB/GYN residents report that they are not comfortable with robotic surgery training. Current practices for preparation include self-directed activities, but they do not begin until after surgical console experience. This study demonstrates that early initiation of structured learning with feedback is necessary.