Comparison of effective teaching methods to achieve skill acquisition using a robotic virtual reality simulator: Expert proctoring versus an educational video versus independent training

Abstract

Background: To compare the superiority of teaching methods for acquiring a proficient level of surgical skill in a robotic surgery-naïve individual using a robotic virtual reality simulator.

Methods: This study employed a prospective, randomized study design to assess student's learning curve. We divided 45 subjects into 3 groups: those with expert proctoring (group I), those who watched only an educational video (group II), and those with independent training (group III; n = 15 per group). The task used in this study was the Tube 2 and it imitates a vesicourethral anastomosis in robotic prostatectomy. The effects were analyzed by the time to end the task after overcoming the learning curve which is determined by several performance parameters.

Results: The number of task repetitions required to reach the learning curve plateau was 45, 42, and 37 repetitions in groups I, II, and III, which means that there was continuous improvement in performing the task after 40 repetitions only in groups I and II. The mean time for completing the task during the stabilization period was significantly different between group I and group III and group II and group III, which means that the independent training method was inferior to the other methods (group I vs. group II vs. group III: 187.38 vs. 187.07 vs. 253.47 seconds, P < .001).

Conclusions: This study's findings showed that an educational video can be as beneficial as expert proctoring, which implies that the development of a standardized educational video would be worthwhile.

Figure 1

Line plot showing the time to complete the task in the 3 groups for each trial.

Figure 2

Learning curves of the proctoring group (A), video only group (B), and independent group (C) depicted by the cumulative sum chart. LCL = lower cumulative limit, UCL = upper cumulative limit.

Figure 3

Comparisons of the mean time differences for completing the task among the 3 groups after overcoming learning curve. ^∗, ^∗∗: statistically significant (P < .05) between the 2 groups.