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You have accessJournal of UrologySurgical Technology & Simulation: Training & Skills Assessment II1 Apr 2016

MP20-09 ROBOTIC SURGICAL SKILL ACQUISITION IN TRAINEES: A RANDOMIZED COMPARISON OF THE TWO ROBOTIC TRAINERS AND TRAINEES’ SKILLS TRANSFER TO A 3-D PRINTED SIMULATED SURGICAL TASK IN THE OPERATING ROOM

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    INTRODUCTION AND OBJECTIVES

    Technical ability is essential to surgical competency. With competency-based education on the horizon, there is a growing need for more objective evaluation methods for teaching surgical skills. Two virtual reality robotic surgical simulators are currently available, both of which emulate the da Vinci Surgical Robotic system. We developed a rigorous training curriculum using the dV-Trainer and the da Vinci Surgical Skills Simulator (dVSSS), which both utilize the same software and objective metrics. We aimed to determine whether skills acquired on these two simulators transfer to performing an urethrovesical anastomosis (UVA) on a high fidelity 3-D printed bladder model in the operating room using the da Vinci robot.

    METHODS

    Medical students (MS) and junior residents (JR) (year 1-3) were recruited at our university through program directors via email. Participants were randomized to conduct their simulator training sessions on either the dV-Trainer or dVSSS. All participants completed the identical curriculum: “Thread the ring”, “Knot the ring”, and “Tubes”. Each participant did warm-up exercises and performed each task three times. They then watched a video of a live UVA and subsequently performed in on the high fidelity model. Pre- and post-training survey were collected. Scores from the simulators (out of 100) were obtained from the software and three robotic surgeon at our centre independently evaluated videos and final end product of the UVA in accordance to previously validated scoring systems (GEARS (/25) and RACE (/25)). All analysts and evaluators were blinded.

    RESULTS

    A total of 26 participants (11 MS and 15 JR) were recruited and equally randomized to the dV-Trainer and dVSSS. Mean age was 25.5 and 53.8% were females. The average “Tubes” score for the dV-Trainer and dVSSS were 10/100 and 48.5/100 respectively. Scores of MS and JR were similar (p=0.36). GEARS scores of participants who initially used the dVSSS compared to the dV-Trainer were significantly higher (21/25 vs. 17.2/25, p=0.04). Similarly, RACE scores of participants who used the dVSSS were also significantly higher compared to the dV-Trainer (23.2/25 vs. 17.8/25, p=0.02). Scores of MS and JR were similar for GEARS (p=0.50) and RACE score (p=0.57). Intraclass correlation coefficient for the GEARS and RACE scoring were 72.6 and 89.3 respectively.

    CONCLUSIONS

    The dVSSS trainer lead to superior scores in performing UVA in the OR for both MS and JR compared to the dV-Trainer. The dVSSS can be used to improve teaching in surgical trainees in a safe and effective manner.

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