Developing a Robotic General Surgery Training Curriculum: Identifying Key Elements Through a Delphi Process

Schmiederer, Ingrid S.; Torices-Dardon, Arturo; Ferrari-Light, Dana; Abboud, Elia Charbel; Villani, Vincenzo; Lau, James N.; Foglia, Christopher M.

doi:10.1016/j.jsurg.2021.08.006

Cited by 11 publications

(19 citation statements)

References 18 publications

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“…The use of an anonymous feedback technique to develop a survey to assess 3D printing has not been reported previously. The Delphi method has been used and validated in several fields, including healthcare [24,[39][40][41]. Given the role of user feedback, the output of the Delphi method is dependent on the selection of expert participants.…”

Section: Discussionmentioning

confidence: 99%

“…The Delphi method is a structured and anonymous process used to collect opinions on a specific topic. It has previously been used in healthcare for a variety of purposes ranging from developing a curriculum for general surgery robotic education to creating a guideline for clinical trial protocol content [23,24]. The Delphi process consists of the expert evaluation of a questionnaire with variable rounds of review and modification built upon feedback.…”

Section: Introductionmentioning

confidence: 99%

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Standardizing evaluation of patient-specific 3D printed models in surgical planning: development of a cross-disciplinary survey tool for physician and trainee feedback

Schlegel

Fields

et al. 2022

BMC Med Educ

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Background 3D printed models are becoming increasingly popular in healthcare as visual and tactile tools to enhance understanding of anatomy and pathology in medical trainee education, provide procedural simulation training, and guide surgical procedures. Patient-specific 3D models are currently being used preoperatively for trainee medical education in planning surgical approaches and intraoperatively to guide decision-making in several specialties. Our study group utilized a modified Delphi process to create a standardized assessment for trainees using patient-specific 3D models as a tool in medical education during pre-surgical planning. Methods A literature review was conducted to identify survey questions administered to clinicians in published surgical planning studies regarding the use of patient-specific 3D models. A core study team reviewed these questions, removed duplicates, categorized them, mapped them to overarching themes, and, where applicable, modified individual questions into a form generalizable across surgical specialties. The core study panel included a physician, physician-scientist, social scientist, engineer/medical student, and 3D printing lab manager. A modified Delphi process was then used to solicit feedback on the clarity and relevance of the individual questions from an expert panel consisting of 12 physicians from specialties including anesthesiology, emergency medicine, radiology, urology, otolaryngology, and obstetrics/gynecology. When the Radiological Society of North America (RSNA)/American College of Radiology (ACR) 3D Printing Registry Data Dictionary was released, additional survey questions were reviewed. A final cross-disciplinary survey of the utility of 3D printed models in surgical planning medical education was developed. Results The literature review identified 100 questions previously published in surveys assessing patient-specific 3D models for surgical planning. Following the review, generalization, and mapping of survey questions from these studies, a list of 24 questions was generated for review by the expert study team. Five additional questions were identified in the RSNA/ACR 3D Printing Registry Data Dictionary and included for review. A final questionnaire consisting of 20 questions was developed. Conclusions As 3D printed models become more common in medical education, the need for standardized assessment is increasingly essential. The standardized questionnaire developed in this study reflects the interests of a variety of stakeholders in patient-specific 3D models across disciplines.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Standardizing evaluation of patient-specific 3D printed models in surgical planning: development of a cross-disciplinary survey tool for physician and trainee feedback

Schlegel

Fields

et al. 2022

BMC Med Educ

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“…High-definition cameras and binocular imagery provide a 3D view and multiple control points, overcoming the limitations of laparoscopic or open approaches. 8,9 Benefits of RS include improved 3D visualization, enhanced freedom of movement, dexterity, precision, and reduced human error. 9 Surgeons experience increased physical comfort, less fatigue, and improved longevity.…”

Section: Robotic Surgerymentioning

confidence: 99%

Robotic surgery education in Australia and New Zealand: primetime for a curriculum

Harrison,

Munien,

Desai

2024

ANZ Journal of Surgery

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BackgroundGlobally, robotic surgery (RS) has witnessed remarkable growth, yet Australia and New Zealand (ANZ) lack dedicated RS training programs, creating a workforce gap. This narrative review synthesises international research to explore trends and challenges in robotic education.MethodsWe conducted a comprehensive literature review, searching PubMed, Google Scholar, and MEDLINE using keywords like ‘robotic surgery’, ‘surgical education’, ‘robotic surgery training’, and ‘robotic surgery curriculum’. We selected studies contributing to understanding current curricula, training tools, and issues in robotic education, utilising the international experience and how it might apply to the ANZ context.ResultsRS in ANZ has grown significantly over two decades, but formal curricula for trainees are absent. North America and Europe employ diverse training tools and curricula. Barriers include cost, access, time constraints, equipment complexity, changing training environments, and competition from emerging robotic surgical systems. Balancing the curriculum's demands with trainees' existing requirements is essential.ConclusionDeveloping a tailored RS curriculum within ANZ's surgical training is crucial for RS to become the primary surgical approach in the future. By working towards a national curriculum we can prepare skilled trainees in robotics to meet the rising demand. The most significant barrier is the lack of robotics in public hospital where trainees are based. This curriculum should encompass online teaching modules, bedside assistance, surgical simulation, dual console mentoring, and primary operator experience.

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“…New curricula must incorporate virtual reality and simulation training to achieve competency across basic skills prior to progressing to in vivo operating [1,2]. These curricula have previously enabled validation of simulation-based training in robotic surgery, with consensus opinion supporting this approach [3][4][5]. Despite the availability of multiple virtual reality simulators for robotic training [6], currently only the DaVinci Skills ® Simulator™ and the dV-Trainer ® have face, content, construct, concurrent and predictive validity [7] and Da Vinci technology currently dominates robotic education and training.…”

Section: Introductionmentioning

confidence: 99%

Transferability of robotic console skills by early robotic surgeons: a multi-platform crossover trial of simulation training

Larkins

Mohan

Gray³

et al. 2022

J Robotic Surg

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Robotic surgical training is undergoing a period of transition now that new robotic operating platforms are entering clinical practice. As this occurs, training will need to be adapted to include strategies to train across various consoles. These new consoles differ in multiple ways, with some new vendors using flat screen open source 3D enhanced vision with glasses and differences in design will require surgeons to learn new skills. This process has parallels with aviation credentialling across different aircraft described as type rating. This study was designed to test the hypothesis that technical robotic console operating skills are transferrable across different robotic operating platforms. Ten participants sequentially completed four Mimic®(Surgical Science) simulation exercises on two different robotic operating platforms (DaVinci®, Intuitive Surgical and HUGO™ RAS, Medtronic). Ethical approval and informed consent were obtained for this study. Groups were balanced for key demographics including previous robotic simulator experience. Data for simulation metrics and time to proficiency were collected for each attempt at the simulated exercise and analysed. Qualitative feedback on multi-platform learning was sought via unstructured interviews and a questionnaire. Participants were divided into two groups of 5. Group 1 completed the simulation exercises on console A first then repeated these exercises on console B. Group 2 completed the simulated exercises on console B first then repeated these exercises on console A. Group 1 candidates adapted quicker to the second console and Group 2 candidates reached proficiency faster on the first console. Participants were slower on the second attempt of the final exercise regardless of their allocated group. Quality and efficiency metrics and risk and safety metrics were equivalent across consoles. The data from this investigation suggests that console operating skills are transferrable across different platforms. Overall risk and safety metrics are within acceptable limits regardless of the order of progression of console indicating that training can safely occur across multiple consoles contemporaneously. This data has implications for the design of training and certification as new platforms progress to market and supports a proficiency-based approach.

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Developing a Robotic General Surgery Training Curriculum: Identifying Key Elements Through a Delphi Process

Cited by 11 publications

References 18 publications

Standardizing evaluation of patient-specific 3D printed models in surgical planning: development of a cross-disciplinary survey tool for physician and trainee feedback

Standardizing evaluation of patient-specific 3D printed models in surgical planning: development of a cross-disciplinary survey tool for physician and trainee feedback

Robotic surgery education in Australia and New Zealand: primetime for a curriculum

Transferability of robotic console skills by early robotic surgeons: a multi-platform crossover trial of simulation training

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