How Surgical Robotics Transform the Development of Expertise in Modern Operating Rooms

Abstract

Current models of the clinical surgical process, and as a result, surgical education, present robot-assisted surgery (RAS) 1 as a simple sequential step in the evolution of surgical treatment from laparoscopy. In an ongoing research program on robot-assisted surgery this paper presents data from the first, ethnographic, research phase demonstrating that the requisite skills for success in the robot-assisted environment are altered from those expected within the laparoscopic domain, and as a result, the training paths and noviceto-expert progression trajectories are noticeably dissimilar. BACKGROUND AND BASIC MOTIVATIONS Existing work in adaptive and complex systems has demonstrated the value of studying a system at a point of change and observing how the system adapts around the change as a means to understand how that system functions (Woods and Dekker, 2000). In this case, the rapid introduction of surgical robotics into the operating room provides an ideal setting for the exploration of the surgical process, the nature of surgical expertise and processes of technological change in general.