A Standardized Robotic Training Curriculum in a General Surgery Program

Abstract

Background and objectives: The general surgery residency at the University of Illinois College of Medicine at Peoria has a long tradition of integrating robotic surgery into training since 2002. The purpose of this paper is to investigate our curriculum and evaluation system, which was designed to achieve a standardized format for education in general robotic surgery.

Methods: The curriculum consists of two phases: phase 1 (PGY 1-2): Complete 4 robotic surgery training modules; read two assigned robotic surgery articles; and practice simulation modules on the robot. phase 2 (PGY 3-5): Refresh training modules, score >90% on the simulator modules every 6 months; bedside assist minimum of 4 robotic procedures; and act as console surgeon for a minimum of 10 procedures with 2 separate attending surgeons. The required simulator modules were specially selected to incorporate all of the skills categories documented in the simulator. The faculty evaluate the resident's operative performance using the Global Evaluative Assessment of Robotic Skills validated rubric.

Results: Since the curriculum was instituted in June 2017, 73 evaluations from 8 surgeons have been collected. We examined data from 6 residents who had at least 5 Global Evaluative Assessment of Robotic Skills assessments completed. Correlation coefficient scores showed a positive correlation ranging from 0.476 to 0.862 for average skills and 0.334 to 0.866 for overall performance scores.

Discussion: The preliminary results suggest an improvement of resident robotic surgical skills through tailored education. This curriculum is designed to enhance robotic general surgery education that could potentially produce general surgeons able to operate robotically without needing a robotic/MIS (Minimally Invasive Surgery) fellowship.

Keywords: Curriculum; General surgery; Resident education; Robotic surgery; Robotic surgical training.

Figure 1.

The various simulations that one can complete and the respective skills each simulation exercises. For the curriculum, Energy Dissection level 2, Ring Walk level 3, and Suture sponge level 3 were chosen. Thus, all skills were included and evaluated.

Figure 2.

Global Evaluative Assessment of Robotic Skills validated rubric, created in 2012 by Aghazadeh et al.

Figure 3.

Graph showing improvement of residents' average skills rating over the time span of cases completed during phase 2.

Figure 4.

Graph showing improvement in the residents' Global Evaluative Assessment of Robotic Skills overall performance score over the time span of the cases completed in phase 2.