PD58-01 AN OBJECTIVE ASSESSMENT OF SURGICAL TECHNICAL SKILL DECAY DURING THE MANDATED COVID-19 SURGICAL SHUTDOWN

Abstract

You have accessJournal of UrologySurgical Technology & Simulation: Training & Skills Assessment (PD58)1 Sep 2021PD58-01 AN OBJECTIVE ASSESSMENT OF SURGICAL TECHNICAL SKILL DECAY DURING THE MANDATED COVID-19 SURGICAL SHUTDOWN Daniel I. Sanford, Balint Der, Ryan Hakim, Runzhuo Ma, Erik Vanstrum, Jessica H. Nguyen, and Andrew J. Hung Daniel I. SanfordDaniel I. Sanford More articles by this author , Balint DerBalint Der More articles by this author , Ryan HakimRyan Hakim More articles by this author , Runzhuo MaRunzhuo Ma More articles by this author , Erik VanstrumErik Vanstrum More articles by this author , Jessica H. NguyenJessica H. Nguyen More articles by this author , and Andrew J. HungAndrew J. Hung More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002092.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: In March 2020, elective surgical procedures in the US were postponed due to the COVID-19 pandemic. The potential degradation of surgical skills during this hiatus has not yet been studied. Our previous work demonstrated that suturing performance is associated with urinary continence recovery after robotic prostatectomy. Herein, we use objective virtual reality (VR) simulation metrics to evaluate suturing technical skill degradation during the COVID-19 shutdown. METHODS: Surgeons completed a robotic VR suturing sponge exercise immediately prior to and after a mandated six-week surgical hiatus that ran from March 20, 2020 to May 5, 2020 at our institution. VR simulator metrics were collected including completion time, economy of motion, instrument collisions, needle drops, and missed targets. Comparisons of parameters before/after the shutdown were performed with either paired Student’s t test or Wilcoxon-matched signed rank test. RESULTS: 22 urologic surgeons completed VR sessions pre- and post- COVID-19 shutdown. Surgeons were classified a priori as novice (<10 cases, n=6), training (10-300 cases, n=7), or expert (>300 cases, n=9) surgeons. Among all participants, weekly robotic surgery caseload decreased from median (IQR) 2.75 (0.5-6.0) pre-COVID to 0.75 (0-1.5) during the shutdown (p<0.001). Overall, we saw an increase in exercise completion time (p<0.001) and missed targets (p=0.004) as well as worse economy of motion (p=0.002) after the shutdown (Figure 1a, 2a, 3a). Our expert cohort had a significant increase in instrument collisions events (p=0.022) and missed targets (p=0.022) (Figure 3b) with significantly fewer needle drops (p=0.025). Our training surgeons had an increase in exercise completion time (p=0.020) and worse economy of motion (p=0.026) while our novice surgeons only showed worse economy of motion (p=0.037) (Figure 1c, 2c, 2d, respectively). CONCLUSIONS: In just six weeks, we saw degradations in measures of efficiency and accuracy for our overall cohort. The observed degradation of technical skill warrants investigation of impacts on clinical outcomes as well as development of methods of retaining surgical skills during common periods of inactivity (sabbatical, maternity/paternity leave). Source of Funding: National Institutes of Biomedical Imaging and Bioengineering of the National Institutes of Health under Award K23EB026493 © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e1016-e1016 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Daniel I. Sanford More articles by this author Balint Der More articles by this author Ryan Hakim More articles by this author Runzhuo Ma More articles by this author Erik Vanstrum More articles by this author Jessica H. Nguyen More articles by this author Andrew J. Hung More articles by this author Expand All Advertisement PDF downloadLoading ...