eP691 - Leveraging Robotic Colectomy Metrics to Evaluate Trainer Specialty and Trainee Autonomy

ePoster Presenter(s)

• 

  Laura DeCesare, MD

  Colorectal Surgery Fellow
  The Ohio State University
  The Ohio State University
  Columbus, OH, United States

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

Author(s)

• XC

  Xiaodong Chen, PhD, MS

  Research Associate Professor
  The Ohio State University
  Columbus, Ohio, United States

  Disclosure information not submitted.
• MA

  Madiha Aziz, MD

  Colorectal Surgery Fellow
  OSU
  The Ohio State University
  Columbus, OH, United States

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

  JC Chen, MD (they/them/theirs)

  Resident
  Ohio State University
  Ohio State University
  Columbus, OH, United States

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

  YouJin Cho, PhD (she/her/hers)

  Medical Student
  The Ohio State University College of Medicine
  The Ohio State University
  Columbus, OH, United States

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

  Samantha Toscano, BS

  Medical Student
  Ohio State University College of Medicine
  Columbus, OH, United States

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

  Matthew F. Kalady, MD, FACS, FASCRS

  Professor of Surgery
  The Ohio State University Wexner Medical Center
  Ohio State University
  Columbus, Ohio, United States

  Disclosure information not submitted.
• 

  Emily Huang, MD, MEd

  Assistant Professor of Surgery
  Ohio State University
  Columbus, Ohio, United States

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

Senior Author(s)

• 

  Syed Husain, MB.,BS.

  Associate Professor of Surgery-Clinical
  Ohio State University
  Ohio State University
  Columbus, OH, United States

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

Purpose/Background: Machine generated, objective robotic performance metrics have provided unprecedented insight into trainer and trainee interactions. These metrics have been verified to be reflective of the trainee-trainer interaction and to be closely related to the resident's Entrustable Professional Activities (EPAs). Prior studies have suggested that resident’s learning experience may be affected by faculty’s operative volume and expertise. We aimed to evaluate whether an attending’s specialty influences trainee autonomy. We hypothesized that Colon and Rectal Surgery trained faculty would provide more autonomy during performance of robotic colectomy compared to faculty without colorectal surgical training.Methods/Interventions: Robotic colon resections from 1/1/2017 to 7/1/2023 at our institution were analyzed. Automated objective performance metrics recorded with each case using a dual console robot were collected. To minimize confounders introduced by varying training levels, only cases involving senior residents (postgraduate year 4/5) were included; cases with fellows or junior residents were excluded. Robotic performance metrics analyzed were “percent in procedure (PIP)” (time resident was at the console), "percent follow time (PFT)" (time resident was actively controlling the robotic arms,) and "handoff count (HC)" (number of times the control of robotic arms was handed off between attending and resident). ANOVA was used to analyze our results.Results/Outcomes: A total of 44 cases performed by ten attendings, 6 colorectal and 4 non-colorectal, were included. Twenty-seven of the 44 cases (61%) were performed by colorectal surgeons, and 17/44 (39%) were performed by non-colorectal surgeons. A significant difference in the mean HC was observed between colorectal and non-colorectal surgeons (7.04 vs. 12.18, p=0.025) (Figure 1). However, there was no significant difference when comparing the residents’ PIP during cases with colorectal and non-colorectal attendings (87.87% vs. 82.27%, p=0.221). There was also no significant difference when comparing the residents’ mean PFT during cases with colorectal and non-colorectal attendings (43.10% vs. 45.89%, p=0.736) (Figure 2).Conclusion/

Discussion: Our findings highlight differences and similarities in trainee-trainer interactions between colorectal and non-colorectal surgeons during robotic colectomy procedures. While the percentage of active participation afforded to residents is similar between the two groups, colorectal surgeons were less likely to assume control of robotic arms with fewer interruptions during the case compared to non-colorectal surgeons. These findings may reflect increased autonomy during robotic colectomy procedures when the trainer has formal colorectal surgery training. Additionally, our findings suggest that objective performance metrics can serve as a valuable adjunct to the incorporation of EPAs in surgical training. Further investigation is needed to determine if our findings lead to an enhanced training experience for the trainees."Figure 1. Average Hand offs between Attending Surgeon and Resident

Figure 2. General Surgery Resident Times (%) with Colorectal and Non-colorectal Faculty.
"