Identifying curriculum content for a cross-specialty robotic-assisted surgery training program: a Delphi study

Hertz, Peter; Houlind, Kim Christian; Jepsen, Jan V.; Bundgaard, Lars; Jensen, Pernille Tine; Friis, Mikkel Lønborg; Konge, Lars; Bjerrum, Flemming

doi:10.1007/s00464-021-08821-3

Cited by 9 publications

(7 citation statements)

References 40 publications

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Section: Discussionmentioning

confidence: 99%

“…Zattoni F. et al5 observed that the assistant surgeon committed the most errors during an emergency simulation and highlighted the necessity to include this member in the training procedures for robotic surgery. Hertz P. et al,18 in their study of robotic surgery training programs, state that assistant surgeons should be given basic training in robotic surgery before participating in these surgeries, particularly due to their rotation within surgical teams.Concerning the surgical instrument technician and the nurse, it was observed that although essential members of the robotic surgery team, their actions did not interfere in the outcome of the emergency uncoupling of the robotic system. They were therefore considered as non-critical elements in these situations, especially when the teamwork is effective and adequately coordinated.In the present study, from the first to second simulation, the GI group showed improvement in their technical and non-technical skills, and in the time spent to decouple the robotic system from the patient.…”

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confidence: 99%

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Training in the protocol for robotic undocking for life emergency support (RULES) improves team communication, coordination and reduces the time required to decouple the robotic system from the patient

Almeida¹,

Campos²,

Castro³

et al. 2022

Robotics Computer Surgery

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Introduction Robotic surgery has expanded on it's surgical application and it is also noted an increase in surgical procedures complexity. Occurrence of emergency situations that require conversion of the minimally invasive access route to open access routes is uncommon. The urgent undocking of the robotic platform is a complex and neglected process in robotic surgery training. Objective To establish specific actions and comands for a safe emergency robotic undocking in a simulation environment. Method Two surgical teams, interventional group (IG) and control group (CG), were submitted to a simulation environment in which there was a need for emergency undocking of the robotic system. The intervention group underwent training with the robotic undocking for life emergency support (RULES) protocol. Result Undocking time of the robotic platform from the IG was reduced by 66% and the CG by only 20%. After RULES protocol training, during the second simulation, the IG acquired more critical actions necessary for emergency undocking and developed more non‐technical skills. Conclusion The RULES protocol proved to be effective, promoting an improvement in technical and non‐technical skills of all surgical team menbers, resulting in more effective actions that resut in a coordinated and faster robotic undocking. It is also concluded that the surgeon and bed side surgeon are the key elements for the efficient robotic system undocking in emergency situations.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Training in the protocol for robotic undocking for life emergency support (RULES) improves team communication, coordination and reduces the time required to decouple the robotic system from the patient

Almeida¹,

Campos²,

Castro³

et al. 2022

Robotics Computer Surgery

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“…4,[28][29][30][31][32] Robotic-assisted surgery surgeons report that essential skills for team members include troubleshooting and handling errors, knowledge of and the handling of robotic instruments, effective communication, and understanding the roles of other team members. 33 Our preliminary observations of data collected during 65 RAS procedures across 4 hospitals 34 demonstrated challenges associated with docking the robot, 35 managing the surgical environment, 36 and teamwork (communication and coordination). Operational concerns were expressed among OR staff leaders about implementing an "efficiency-focused" intervention given the high rates of staff turnover, burnout, and low morale as a result of the COVID-19 pandemic.…”

mentioning

confidence: 92%

“…The introduction of robots into the operating room (OR) in particular has introduced a range of new challenges that teams need to account for including (1) a greater need to negotiate the physical environment, (2) adoption of team communication to manage various tasks and technologies, and (3) management of the robotic system to optimize efficiency and workflow 4,28–32 . Robotic-assisted surgery surgeons report that essential skills for team members include troubleshooting and handling errors, knowledge of and the handling of robotic instruments, effective communication, and understanding the roles of other team members 33 . Our preliminary observations of data collected during 65 RAS procedures across 4 hospitals 34 demonstrated challenges associated with docking the robot, 35 managing the surgical environment, 36 and teamwork (communication and coordination).…”

mentioning

confidence: 99%

A Novel Approach for Engagement in Team Training in High-Technology Surgery: The Robotic-Assisted Surgery Olympics

Cohen¹,

Anger

Kanji³

et al. 2022

J Patient Saf

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Introduction:There is ongoing interest in the development of technical and nontechnical skills in healthcare to improve safety and efficiency; however, barriers to developing and delivering related training programs make them difficult to implement. Unique approaches to training such as "serious games" may offer ways to motivate teams, reinforce skill acquisition, and promote teamwork. Given increased challenges to teamwork in robotic-assisted surgery (RAS), researchers aimed to develop the "RAS Olympics," a game-based educational competition to improve skills needed to successfully perform RAS.Methods: This pilot study was conducted at an academic medical center in Southern California. Robotic-assisted surgery staff were invited to participate in the "RAS Olympics" to develop their skills and identify opportunities to improve processes. Impact of the activity was assessed using surveys and debriefs.Results: Sixteen operating room team members participated and reacted favorably toward the RAS-Olympics (average score, 4.5/5). They enjoyed the activity, would recommend all staff participate, felt that it was relevant to their work, and believed that they practiced and learned new techniques that would improve their practice. Confidence in skills remained unchanged. Participants preferred the RAS Olympics to traditional training because it provided an interactive learning environment. Conclusions:The successful implementation of the RAS Olympics provided insight into new opportunities to engage surgical staff members while also training technical and nontechnical skills. Furthermore, this shared experience allowed surgical staff members to gain a greater appreciation for their teammates and an understanding of the current challenges and methods to improve teamwork and communication while promoting safety and efficiency in RAS.

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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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Identifying curriculum content for a cross-specialty robotic-assisted surgery training program: a Delphi study

Abstract: This study is part of a Ph.D. project funded by the University of Southern Denmark (Faculty scholarship for Peter Hertz). The funder did not influence the protocol development or had access to the data.

Cited by 9 publications

References 40 publications

Training in the protocol for robotic undocking for life emergency support (RULES) improves team communication, coordination and reduces the time required to decouple the robotic system from the patient

Training in the protocol for robotic undocking for life emergency support (RULES) improves team communication, coordination and reduces the time required to decouple the robotic system from the patient

A Novel Approach for Engagement in Team Training in High-Technology Surgery: The Robotic-Assisted Surgery Olympics

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

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