Surgical trainee experience and opinion of robotic surgery in surgical training and vision for the future: a snapshot study of pan-specialty surgical trainees

Abstract

Background: Robotic surgery is well established across multiple surgical specialities in the United Kingdom (UK) and Republic of Ireland (ROI). We aimed to elucidate current surgical trainee experience of and attitudes to robotic surgery in a surgical training programme across the UK and ROI to determine the future role of robotic surgery in international surgical training programmes. Methods: A pan-specialty trainee cross-sectional study was performed on behalf of the Association of Surgeons in Training (ASiT) using mixed-methodology. Round 1: a digital questionnaire was disseminated to all ASiT members. Round 2: 'live-polling' was performed prior to and following the Robotic Surgery plenary session convened at the ASiT 2020 International Conference (Birmingham). Data analysis was performed using a combination of quantitative and qualitative methods. Results: Three hundred and four responses were analysed (n = 244 digital questionnaire, n = 60 live-polling). Overall, 73.8% (n = 180) of trainees would value greater access to robotic surgery training. 73.4% (n = 179) believed that robotic surgery was important for the future of their desired specialty and 77.2% (n = 156) believed it should be incorporated into formal surgical training. Qualitative analysis identified that trainees believe that robotic training should have a formal role in surgical training. Perceived disadvantages of robotic surgery experience in surgical training included expense and the current impact of consultant robotic learning curves on training. Conclusion: Current surgical trainees desire greater access to robotic surgery in surgical training. Robotic surgery is developing an increasing role in current surgical practice and it is important that it is introduced in a timely, evidence-based fashion to surgical trainees at an appropriate stage of training.

Virtual classroom proficiency-based progression for robotic surgery training (VROBOT): a randomised, prospective, cross-over, effectiveness study

“…Robot-assisted surgery has gained momentum at an unprecedented pace, creating training challenges for novice surgical trainees. A recent pan-specialty trainee, cross-sectional study demonstrated that less than 12% of current surgical trainees reported having access to robotic surgery training opportunities [ 32 ]. To date, there have been numerous barriers identified for surgical trainees in accessing on-site practical robotic skills opportunities, particularly in relation to minimally invasive techniques.…”

Future of Surgery: Technology Enhanced Surgical Training: Report of the FOS:TEST Commission

“…23 The British Association of Urological Surgeons' national registry results from 2016 to 2019 outlined that over 86% of radical prostatectomies in the UK were performed robotically, 24 and yet less than 30% of surgical trainees are gaining access to the required literacy and skill to deliver robotic surgery in their future consultant practice. 25,26 With the ability to record operations, and the development of laparoscopic and robotic technology, there is vast potential in our ability to better understand and measure how we train -if trainees are afforded access to these opportunities. In future, if done correctly, it is predicted that this may result in competence benchmarks or 'credentialing'.…”

“…Less than 30% of surgical trainees are gaining access to the required literacy and skill to deliver robotic surgery in their future consultant practice. 25,26 Having considered the evidence, the conclusions of the FOS:TEST Commission regarding trainee exposure to operating and how technology can enhance this are as follows.…”

Assessment of students' satisfaction with virtual robotic surgery training

“…The results of a recent survey showed that although the robotic surgery training is considered important for the medical students [ 15 ], the majority of them did not had access to robotic surgery training in their hospital [ 16 ]. Trainees and residents still enter clinical robotic surgery practice without the necessary robotic skills and without having previous formal training on robotic surgery platform [ 6 , 15 ].…”

“…Skills acquisition is now related to the possibility to provide as early as possible robotic experience [ 5 , 17 ] within a relevant formal curriculum on robotic surgery training and to deliver appropriate documentation of the training quality and participants achievements [ 6 , [15] , [16] , [17] ]. One of the main conclusion drawn from studies is that training on simulators in isolation from traditional teaching methods contributes to the skills training of the surgeon, however the best time and place to use these skills comes only with experience [ 1 ].…”