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You have accessJournal of UrologySurgical Technology & Simulation: Training & Skills Assessment I (PD27)1 Apr 2019


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    Improvements in virtual reality (VR) technology have enabled the development of procedural simulation training which closely replicate surgical procedures. VR simulation training has been shown to be highly effective for robotic surgical training however to-date curricula are limited to generic basic skills training. This RCT aims to compare the transfer of learning following procedural VR or standard basic skills VR training.


    Initially 25 novice surgeons underwent basic robotic skills training, completing three FRS tasks. Participants were then block randomised to standard basic VR training or procedural VR training. All training was performed on the RobotiX Mentor (3D Systems (Airport City, Israel) VR robotic simulator. Standard basic skills training comprised further training following the FRS curriculum. The procedural simulation group underwent training on the guided bladder neck dissection and guided urethrovesical anastomosis tasks, parts of radical prostatectomy training module. Both groups completed a total of at least 5 hours of training. Following training both groups underwent transfer of skills assessment on fresh frozen cadavers using a Da Vinci Xi surgical robot in a simulated operating room environment. Their performances were compared to a control group of novice training without training. All performances were video recorded and were assessed blindly post hoc by a trained expert using GEARS.


    Baseline FRS scores were equal between the two groups (p=0.5). Subjects in both arms completed an average of 5.6 ± 0.3 hours of training. VR training (basic or procedural) resulted in a significantly higher GEARS score than no training, (mean GEARS score 11.3 ± 0.6 vs 8.8 ± 2.9 p=0.002). Procedural training resulted in significantly higher GEARS score than either basic training or control (p=0.03)(Figure 1).


    This study provides the first evidence supporting the use of procedural-based VR simulation for training robotic skills even in novice participants. It also provides further validity evidence to support the use of VR simulation and the effective transfer of learned skills.

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    Source of Funding:

    Vattikuti Foundation

    London, United Kingdom;

    Sapporo, Japan;

    London, United Kingdom