Advertisement

Developing a Robotic Surgery Curriculum: Selection of Virtual Reality Drills for Content Alignment

Published:December 01, 2022DOI:https://doi.org/10.1016/j.jss.2022.11.019

      Abstract

      Introduction

      Despite the importance of simulation-based training for robotic surgery, there is no consensus about its training curricula. Recently, a virtual reality (VR) platform (SimNow, Intuitive, Inc) was introduced with 33 VR drills but without evidence of their validity. As part of our creating a new robotic VR curriculum, we assessed the drills’ validity through content mapping and the alignment between learning goals and drill content.

      Methods

      Three robotically trained surgeons content-mapped all 33 drills for how well the drills incorporated 15 surgery skills and also rated the drills’ difficulty, usefulness, relevance, and uniqueness. Drills were added to the new curriculum based on consensus about ratings and historic learner data. The drills were grouped according to similar skill sets and arranged in order of complexity.

      Results

      The 33 drills were judged to have 12/15 surgery skills as primary goals and 13/15 as secondary goals. Twenty of the 33 drills were selected for inclusion in the new curriculum; these had 11/15 skills as primary goals and 11/15 as secondary goals. However, skills regarding energy sources, atraumatic handling, blunt dissection, fine dissection, and running suturing were poorly represented in the drills. Three previously validated inanimate drills were added to the curriculum to address lacking skill domains.

      Conclusions

      We identified 20 of the 33 SimNow drills as a foundation for a robotic surgery curriculum based on content-oriented evidence. We added 3 other drills to address identified gaps in drill content.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Surgical Research
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Sheetz K.H.
        • Claflin J.
        • Dimick J.B.
        Trends in the adoption of robotic surgery for common surgical procedures.
        JAMA Netw Open. 2020; 3: e1918911
        • Alemzadeh H.
        • Raman J.
        • Leveson N.
        • Kalbarczyk Z.
        • Iyer R.K.
        Adverse events in robotic surgery: a retrospective study of 14 years of FDA data.
        PLoS One. 2016; 11: e0151470
        • Fisher R.A.
        • Dasgupta P.
        • Mottrie A.
        • et al.
        An over-view of robot assisted surgery curricula and the status of their validation.
        Int J Surg. 2015; 13: 115-123
        • Satava R.M.
        • Stefanidis D.
        • Levy J.S.
        • et al.
        Proving the effectiveness of the fundamentals of robotic surgery (FRS) skills curriculum: a single-blinded, multispecialty, multi-institutional randomized control trial.
        Ann Surg. 2020; 272: 384-392
        • Vining C.C.
        • Skowron K.B.
        • Hogg M.E.
        Robotic gastrointestinal surgery: learning curve, educational programs and outcomes.
        Updates Surg. 2021; 73: 799-814
        • Arain N.A.
        • Dulan G.
        • Hogg D.C.
        • et al.
        Comprehensive proficiency-based inanimate training for robotic surgery: reliability, feasibility, and educational benefit.
        Surg Endosc. 2012; 26: 2740-2745
        • Dulan G.
        • Rege R.V.
        • Hogg D.C.
        • et al.
        Developing a comprehensive, proficiency-based training program for robotic surgery.
        Surgery. 2012; 152: 477-488
        • Ahmad S.B.
        • Rice M.
        • Chang C.
        • Zureikat A.H.
        • Zeh 3rd, H.J.
        • Hogg M.E.
        dV-Trainer vs. da Vinci Simulator: comparison of Virtual Reality Platforms for Robotic Surgery.
        J Surg Res. 2021; 267: 695-704
        • Martin J.A.
        • Regehr G.
        • Reznick R.
        • et al.
        Objective structured assessment of technical skill (OSATS) for surgical residents.
        Br J Surg. 1997; 84: 273-278
        • Hogg M.E.
        • Tam V.
        • Zenati M.
        • et al.
        Mastery-based virtual reality robotic simulation curriculum: the first step toward operative robotic proficiency.
        J Surg Educ. 2017; 74: 477-485
        • Rice M.K.
        • Hodges J.C.
        • Bellon J.
        • et al.
        Association of mentorship and a formal robotic proficiency skills curriculum with subsequent generations' learning curve and safety for robotic pancreaticoduodenectomy.
        JAMA Surg. 2020; 155: 607-615
        • Radi I.
        • Tellez J.C.
        • Alterio R.E.
        • et al.
        Feasibility, effectiveness and transferability of a novel mastery-based virtual reality robotic training platform for general surgery residents.
        Surg Endosc. 2022; 36: 7279-7287
        • American Psychological Association (APA)
        • American Educational Research Association., American Psychological Association., National council on measurement in education, & joint committee on standards for educational and psychological testing (U.S.)
        Standards for Educational and Psychological Testing.
        American Educational Research Association, 2014
        • Korndorffer Jr., J.R.
        • Kasten S.J.
        • Downing S.M.
        A call for the utilization of consensus standards in the surgical education literature.
        Am J Surg. 2010; 199: 99-104
        • Dulan G.
        • Rege R.V.
        • Hogg D.C.
        • Gilberg-Fisher K.K.
        • Tesfay S.T.
        • Scott D.J.
        Content and face validity of a comprehensive robotic skills training program for general surgery, urology, and gynecology.
        Am J Surg. 2012; 203: 535-539
        • Lyons C.
        • Goldfarb D.
        • Jones S.L.
        • et al.
        Which skills really matter? proving face, content, and construct validity for a commercial robotic simulator.
        Surg Endosc. 2013; 27: 2020-2030
      1. Fundamentals of robotic surgery.
        (Available at:)
        https://frsurgery.org/frs-curriculum/
        Date accessed: July 8, 2021
        • Gavazzi A.
        • Bahsoun A.N.
        • Van Haute W.
        • et al.
        Face, content and construct validity of a virtual reality simulator for robotic surgery (SEP Robot).
        Ann R Coll Surg Engl. 2011; 93: 152-156
        • Ramos P.
        • Montez J.
        • Tripp A.
        • Ng C.K.
        • Gill I.S.
        • Hung A.J.
        Face, content, construct and concurrent validity of dry laboratory exercises for robotic training using a global assessment tool.
        BJU Int. 2014; 113: 836-842