General surgery training and robotics: Are residents improving their skills?
BACKGROUND
While robotic-assisted operations have become more prevalent, many general surgery residencies do not have a formal robotic training curriculum. We sought to ascertain how well current general surgery training permits acquisition of robotic skills by comparing robotic simulation performance across various training levels.


STUDY DESIGN
Thirty-six participants were categorized by level of surgical training: eight medical students (MS), ten junior residents (JR), ten mid-level residents (MLR), and eight senior residents (SR). Participants performed three simulation tasks on the da Vinci (®) Skills Simulator (MatchBoard, EnergyDissection, SutureSponge). Each task's scores (0-100) and cumulative scores (0-300) were compared between groups.


RESULTS
There were no differences in sex, hand dominance, video gaming history, or prior robotic experience between groups; however, SR was the oldest (p < 0.001). The median overall scores did not differ: 188 (84-201) for MS, 183 (91-234) for JR, 197 (153-218) for MLR, and 205 (169-229) for SR (p = 0.14). The median SutureSponge score was highest for SR (61, range 39-81) compared to MS (43, range 26-61), JR (43, range 11-72), and MLR (55, range 36-68) (p = 0.039). However, there were no significant differences in MatchBoard (p = 0.27) or EnergyDissection (p = 0.99) scores between groups. There was a positive correlation between SutureSponge score and number of laparoscopic cases logged (p = 0.005, r(2) = 0.21), but this correlation did not exist for the MatchBoard or EnergyDissection tasks. Lastly, there was no correlation between total lifetime hours of video gaming and overall score (p = 0.89, R(2) = 0.0006).


CONCLUSIONS
Robotic skillsets acquired during general surgery residency show minimal improvement during the course of training, although laparoscopic experience is correlated with advanced robotic task performance. Changes in residency curricula or pursuit of fellowship training may be warranted for surgeons seeking proficiency.
['Finnerty|Brendan M|BM|', 'Afaneh|Cheguevara|C|', 'Aronova|Anna|A|', 'Fahey|Thomas J|TJ|', 'Zarnegar|Rasa|R|']
D000328:Adult D002983:Clinical Competence D015331:Cohort Studies D003198:Computer Simulation D003479:Curriculum D004501:Education, Medical D005260:Female D013502:General Surgery D006801:Humans D007396:Internship and Residency D010535:Laparoscopy D008297:Male D010820:Physicians D011446:Prospective Studies D065287:Robotic Surgical Procedures D000066908:Simulation Training D013337:Students, Medical D013647:Task Performance and Analysis D055815:Young Adult
General surgery training Robotic education Robotic surgery Virtual reality robotic simulation