MP19-11: Virtual classroom proficiency based progression for robotic surgery training (VROBOT): a prospective, cross-over, effectiveness study

Alexander Ng*, Arjun Nathan, Sonam Patel, Maria Georgi, London, United Kingdom, Monty Fricker, Newcastle, United Kingdom, Kien Hang, London, United Kingdom, William Mullins, Cambridge, United Kingdom, Aqua Asif, Leicester, United Kingdom, Alexander Light, Nader Francis, John Kelly, Justin Collins, Ashwin Sridhar, London, United Kingdom

Introduction: Robotic surgery is an established yet evolving surgical technique that requires specialist training. To date, training has lacked evidence-based standardisation. To address this, the Fundamentals of Robotic Surgery (FRS) curriculum has been established, to incorporate proficiency-based modules to certify the skills of novice robotic surgeons. However, the curriculum is self-directed and non-interactive. We aim to determine the effectiveness of interactive, supplemental virtual classroom training (VCT) in concordance with the FRS for robotic skills training.

Methods: 11 robotic surgical novices trainees were randomly allocated to two training groups. Both cohorts completed a one-week robotic skills induction. In week two, Group A undertook training under the FRS curriculum and VCT; Group B only received access to the FRS curriculum. In week three, the groups received the alternate intervention.

The primary outcome was objective performance score, quantified using the R-OSAT scoring system. This was collected post-intervention at time point 1 (end of week two) and time point 2 (end of week three).

Results: 11 participants completed the training curriculum, all were included in analyses. Both cohorts demonstrated significantly improved proficiency upon completion of the training programme. Participants attained higher mean proficiency scores with both the PBP-based FRS curriculum and VCT programme, compared to the FRS curriculum alone. At timepoint 1, Group A achieved a statistically significant greater mean proficiency score compared to Group B (44.80 vs 35.33 points, p=0.006). At timepoint 2, there was no significant difference in mean proficiency score in Group A from timepoint 1. In contrast, Group B showed significant improvement in mean proficiency by 9.67 points from timepoint 1 (95% CI 5.18-14.15, p=0.003) once they had received VCT.

Conclusions: VCT is an effective training adjunct to the FRS curriculum for the learning of basic robotic skills. With the steep learning curve in robotic surgery training, VCT offers interactive learning and can increase training effectiveness and accessibility.

Source of Funding: N/A