Facilitators and barriers to adopting robotic-assisted surgery: contextualizing the unified theory of acceptance and use of technology

Abstract

Robotic-assisted surgical techniques are not yet well established among surgeon practice groups beyond a few surgical subspecialties. To help identify the facilitators and barriers to their adoption, this belief-elicitation study contextualized and supplemented constructs of the unified theory of acceptance and use of technology (UTAUT) in robotic-assisted surgery. Semi-structured individual interviews were conducted with 21 surgeons comprising two groups: users and nonusers. The main facilitators to adoption were Perceived Usefulness and Facilitating Conditions among both users and nonusers, followed by Attitude Toward Using Technology among users and Extrinsic Motivation among nonusers. The three main barriers to adoption for both users and nonusers were Perceived Ease of Use and Complexity, Perceived Usefulness, and Perceived Behavioral Control. This study's findings can assist surgeons, hospital and medical school administrators, and other policy makers on the proper adoption of robotic-assisted surgery and can guide future research on the development of theories and framing of hypotheses.

Figure 1. Modified Unified Theory of Acceptance and Use of Technology (UTAUT) model contextualized for robotic surgery.

Figure 2. Number of comments (pro-robotic surgery versus contra-robotic surgery) per modified UTAUT subconstruct for users and nonusers.

Note: PU – Perceived Usefulness, EM – Extrinsic Motivation, POE – Personal Outcome Expectations, PEUC – Perceived Ease of Use/Complexity, SN – Subjective Norm, SF – Social Factor, I – Image, PBC – Perceived Behavioral Control, FC – Facilitating Conditions, ATU – Attitude Toward Using Technology, L – Leadership.