Structure robotic surgery curricula as a stepwise progression in which training modalities complement rather than replace each other¶

Strategy · All strategies
Evidence · 6 claims (4 for, 2 mixed) · 2 studies (2 review), q3 · 0 of 2 report an effect size · 6 claims rest on one study

Description¶

The review recommends that training modalities be combined in a progressive curriculum rather than used in isolation, because each has inherent drawbacks. It states "one training modality should not replace the other due to their inherent drawbacks, but instead they should complement each other" and describes a sequence from theory and e-learning, through digital system training and dry lab with objective sensors and GEARS feedback, to wet lab, cadaver labs, and proctored procedures.

Design Implications¶

Context¶

Requirements¶

• Access to a progression of modalities: digital training platform, dry lab with force and motion sensors, and ex-vivo animal tissue or cadaver labs
• Validated benchmarks to determine when a trainee moves from digital training to dry lab

Constraints¶

• VR training and dry lab both lack haptic feedback, and master console availability is limited, requiring trainees to train outside regular working hours

Target Learners¶

• novice robotic surgeons
• surgical residents
• experienced surgeons learning robotic surgery

Target Learning Goals¶

• basic technical robotic surgery skills
• procedural skills
• tissue handling and manipulation

Claims¶

• All 29 comprehensive RAS curricula included simulation training, with VR simulation (n = 16), dry lab (n = 11), and wet lab/bio-tissue/cadaveric (n = 12) as the most common modalities. [+W]
• In 82% of studies on transferability, simulation performance was correlated with better operating room performance [+W]
• Surgical societies outlined RAS curricula featuring proficiency-based progression, modular intraoperative training, and objective assessment. [+W]
• A standardised RAS curriculum is feasible and beneficial, and surgical societies have outlined RAS curricula which could be implemented locally. [+W]
• The nature and volume of simulation training and mentorship varied widely across the 29 comprehensive RAS curricula. [~W]
• Objective assessment and non-technical skills training were not uniformly included across the 29 comprehensive RAS curricula. [~W]

Related Strategies¶

• Structured cross-platform training curriculum combining generalised exposure and platform-specific proficiency
• Tiered ECE implementation: virtual and case-based learning first, then simulated patient interaction, then supervised real patient contact
• Incorporate VR-based simulation training into spine surgery residency curricula as an adjunct to traditional methods
• Integrate AI-driven simulation into dental curricula as a complement to traditional training, attending to domain-specific effectiveness and the lack of long-term validated outcomes
• Develop universal objective assessment and feedback methods that go beyond time and motion to capture tissue handling and interaction forces
• Combine background theory, video demonstrations, and simulator training in an integrated endoscopy curriculum (GATE model)

Examples¶

-

Key Sources¶

• Rahimi A. Masie, Uluç Ezgi, Hardon Sem F., Bonjer H. Jaap, van der Peet Donald L., Daams Freek. (2024). Training in robotic-assisted surgery: a systematic review of training modalities and objective and subjective assessment methods. Surgical Endoscopy. https://doi.org/10.1007/s00464-024-10915-7