Simulation Based Robotics Training to Test Skill Acquisition and Retention [4B

Abstract

INTRODUCTION: Simulation-based training may be important to teach and maintain robotic operative skills. The objective of this study is to investigate the learning curve among novice learners and to determine how fast simulation skills decay over time. METHODS: 31 medical students were trained with the daVinci Skills Simulator® in 4 exercises thought to simulate skills necessary in gynecologic robotic surgery. Each exercise was completed until proficient (an overall score of at least 91%) or a maximum of 10 times each. Participants were then randomized into 4 groups and returned for a follow-up session after a 1-, 3-, 5-, or 7-week interval to re-achieve competency and/or complete the same 4 exercises a maximum of 10 times each. RESULTS: Main outcomes measured were total simulation time (TST) to achieve proficiency or complete a task 10 times at baseline and follow-up sessions. Participants were divided into two groups: those able (high performers; n=13) and those unable (low performers; n=18) to reach proficiency of 91% within 10 trials at baseline testing. TST improved for all participants over the study period, however low performers had the greatest reduction in TST in camera targeting (P=.03) and match-board (P=.03) tasks. Participants in the 5-week interval group showed the greatest improvement in TST. CONCLUSION: Learners who start with lower skills at baseline may benefit the most from robotic simulation to improve operative skills. Skills obtained by robotic simulation were best maintained up to a 5-week period. Simulation training may be necessary to maintain robotics proficiency over time.