How to integrate robotic training in surgical residency? An example of a 2-week robotic rotation.

Abstract

General surgery residents should be proficiently trained in robotic surgery. However, there is currently no standardized robotic training curriculum. We aimed to evaluate two approaches to a robotic curriculum and how implementing a virtual reality (VR) simulation curriculum improves trainee robotic performance. From 2019 to 2022, two models of a robotic training curriculum were examined: an in-unit rotation (IUR) and a 2-week curriculum (2WR). The VR curriculum was completed using the da Vinci® Skill Simulator. The curriculum used a pre/post-test design. Residents completed a pre-test that consisted of 4 VR exercises (graded 0-100%) and 3 inanimate box trainer exercises (graded using modified Objective Structured Assessment of Technical Skills). Then, residents completed a VR curriculum of 23 modules. Following the curriculum, residents were given a post-test with the same pre-test exercises. Time necessary to complete the curriculum and compliance were recorded. Of the 11 residents who participated in the IUR, 4 completed the VR curriculum. Comparatively, 100% (n = 23) of residents in the 2WR completed the curriculum. Average time to complete the VR curriculum was 3.8h. After completion of the 2WR curriculum, resident performance improved from pre-test to post-test: VR test scores increased (160% vs 223%, p < 0.001), OSATS scores increased (15.0 vs 21.0, p < 0.001), and time to complete inanimate exercises decreased (1083 vs 756s, p = 0.001). Residents who mastered all modules had higher post-test VR scores (241% vs 214%, p = 0.024). General surgery residents demonstrated improved compliance with the 2WR. The VR curriculum improved resident robotic performance in both virtual and inanimate domains.