eP427 - Does Resident Participation in a Mandated and Supervised Robotic Skills Training Curriculum Result in Improvement in Self-perceived Proficiency?

ePoster Presenter(s)

• 

  Pavel Mazirka, MD

  Resident
  University of Florida
  University of Florida
  Gainesville, FL, United States

  All relevant financial disclosures have been managed and will be listed below.
  This individual has no financial relationships with ineligible companies.

Author(s)

• NL

  Nicholas Laconi, MD

  Resident
  University of Florida - Gainesville, FL
  Gainesville, Florida, United States

  Disclosure information not submitted.
• WW

  Whitman Wiggins, MD

  Resident
  University of Florida Department of Surgery
  Gainesville, Florida, United States

  Disclosure information not submitted.
• AC

  Analucia Cadavid, MD

  Resident
  University of Florida Department of Surgery
  Gainesville, Florida, United States

  Disclosure information not submitted.
• KE

  Kathleen R. Ehresmann, MD

  Resident
  University of Florida
  Gainesville, FL, United States

  All of the relevant financial relationships listed below have been mitigated.
  This individual has no financial relationships with ineligible companies.
• 

  Jeremy A. Balch, MD

  Resident
  University of Florida
  University of Florida
  Gainesville, FL, United States

  All of the relevant financial relationships listed below have been mitigated.
  This individual has no financial relationships with ineligible companies.
• KT

  Krista P. Terracina, MD

  Assistant Professor
  University of Florida
  Gainesville, Florida, United States

  Disclosure information not submitted.
• JN

  Johan Nordenstam, MD, PhD

  Associate Professor
  University of Florida
  Gainesville, Florida, United States

  Disclosure information not submitted.
• 

  Thomas E. Read, MD

  Professor and Chief, Division of Gastrointestinal Surgery
  University of Florida
  University of Florida College of Medicine
  Gainesville, FL, United States

  All relevant financial disclosures have been managed and will be listed below.
  This individual has no financial relationships with ineligible companies.
• MA

  Michael Awad, MD, PhD

  Professor, Surgery Division of General Surgery
  Washington University
  St. Louis, Missouri, United States

  Disclosure information not submitted.

Senior Author(s)

• LG

  Lindsey E. Goldstein, MD, FACS, FASCRS

  Chief, Surgical Service NF/SG Veterans Health System
  University of Florida
  Gainesville, Florida, United States

  Disclosure information not submitted.

Purpose/Background: Surgical trainees continue to experience increased training demands in the setting of work-hour restrictions. These limitations likely have a direct impact on exposure and familiarity with new surgical technologies, specifically, robot-assisted surgery. We designed a study to determine whether mandatory, supervised participation in a robotic surgery training curriculum would improve a trainee's self-perceived proficiency.Methods/Interventions: A study was conducted at the University of Florida, a quaternary academic institution, in which residents were immersed in a mandatory curriculum that included bedside training and robotic simulation in an intensive boot camp fashion. A total of 43 residents from General Surgery and Gynecology training during the 2019-2020 academic year were included. An anonymous survey was administered to each resident before and after participation to document changes in self-perceived proficiency in defined robotic surgical skills. A NASA Task Load Index (NASA-TLX) scale was included to capture workload. Statistical significance was determined using the Fischer’s exact or Mann-Whitney test.Results/Outcomes: Over 60% of all residents reported improvements in self-perceived proficiency in docking, instrument exchange, camera control and energy utilization. Residents with no prior robotic experience reported a significant improvement in the areas of docking (pre-curriculum mean: 1.1; post-curriculum mean: 2.4; p < 0.01), instrument exchange (pre-curriculum mean: 1.1; post-curriculum mean: 2.4; p < 0.01), camera control (pre-curriculum mean: 1.0; post-curriculum mean: 2.2; p < 0.01), energy (pre-curriculum mean: 1.0; post-curriculum mean: 2.0; p < 0.01) and emergency procedures (pre-curriculum mean: 1.0; post-curriculum mean: 1.4; p=0.01). Junior residents, defined as PGY 1-2 level or PA-C residents, documented similar improvements in self-perceived proficiency in the same domains. There was no reported improvement in proficiency in suturing skills, independent of training level or prior robotic experience. Despite improvement in self-perceived proficiency, this did not translate to a significant change in workload as measured by the NASA-TLX.Conclusion/

Discussion: This study demonstrated that resident participation in a robotic training boot camp can improve self-perceived proficiency in some surgical robotic skills, but this does not translate into an immediate improvement in perceived workload as measured by the NASA-TLX. Future aims could examine whether longitudinal robotic boot camp programs eventually lead to reduced perceived workload when skills are applied in real-time operating room cases."Figure 3

Self-perceived proficiencies (y-axis) for each task (x-axis) by residents with no previous robotic experience. Each level of proficiency was assigned a numeric value from 1 (Need further review/instruction) to 5 (Proficient in clinical settings independently).
Figure 4

Self-perceived proficiencies (y-axis) for each task (x-axis) by junior trainees (PGY 1-2, PA-C). Each level of proficiency was assigned a numeric value from 1 (Need further review/instruction) to 5 (Proficient in clinical settings independently).
Figure 5 & 6

NASA-TLX Scores (y-axis) with 0 as very low demand to 20 as very high demand (no one scored above 15), among Junior and Senior residents and the various demands (x-axis) of tasks.
Figure 1

Pre and post-test survey. Participants were asked to rate their self-perceived proficiency with the above tasks. Each level of proficiency was assigned a numeric value from 1 (Need further review/instruction) to 5 (Proficient in clinical settings independently) [06]."