Surg Endosc. 2025 Nov 3. doi: 10.1007/s00464-025-12321-z. Online ahead of print.
ABSTRACT
BACKGROUND: Robotic surgery demands specialized training to ensure proficiency and patient safety. Deliberate practice using Virtual Reality (VR) robotic simulation platforms provides a safe method for skill acquisition. The first part of our Initial curriculum (IC) consisted of 33 VR drills on the SimNow Simulator, which was refined in 2021 to 19 VR drills using a Simulation-Based Mastery Learning (SBML) approach. This study evaluates the feasibility and effectiveness of our refined curriculum (RC).
METHODS: A total of 87 general surgery residents were included. IC was completed by 41 residents, while 46 residents completed the RC. Metrics such as console time, pre- and post-test VR drill scores, and inanimate drill performance were assessed. Statistical analyses included independent or paired t-tests and Mann-Whitney U, or Wilcoxon Signed Rank tests for non-parametric data.
RESULTS: In the IC, 83% of participants achieved mastery versus 100% in the RC. Mean console training time was significantly reduced from 7 h 6 m (95% CI: 6.20-7.92) in the IC to 5 h 42 m (95% CI: 4.74-6.10) in the RC (p = 0.005), demonstrating enhanced efficiency. For VR drills, the IC median score improved from 62 (126-28) to 353 (366-317) (p < 0.001), with a median time reduction of 847 s (1169-565) (p < 0.001). In the RC, the median test score improved from 65.5 (138.75-37.75) to 344.5 (365.5-291.25) (p < 0.001), with a median time reduction of 999 s (1449.5-548.25) (p < 0.001). Inanimate drill times also improved: the IC median time decreased from 928.5 s (1066-853.5) to 741.5 s (859-613.5) (p < 0.001), while the RC median time decreased from 909.5 s (1037.7-744.7) to 464.5 s (518-413.7) (p < 0.001).
CONCLUSION: Reducing VR drills from 33 to 19 content-aligned drills with new proficiency benchmarks maintained effectiveness while significantly decreasing VR console training time. These findings support the feasibility of implementing this streamlined robotic training curriculum in general surgery residency programs without compromising skill acquisition.
PMID:41184674 | DOI:10.1007/s00464-025-12321-z
