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Urology. 2017 Oct 17. pii: S0090-4295(17)31056-7. doi: 10.1016/j.urology.2017.09.023. [Epub ahead of print]

A Randomized Comparison of Two Robotic Virtual Reality Simulators and Evaluation of Trainees' Skills Transfer to a Simulated Robotic Urethrovesical Anastomosis Task.

Author information

1
Department of Surgery, Division of Urology, McMaster University, Hamilton, Ontario, Canada. Electronic address: reamja@mcmaster.ca.
2
Department of Surgery, Division of Urology, McMaster University, Hamilton, Ontario, Canada.
3
Simply Simulators, London, Ontario, Canada.

Abstract

OBJECTIVE:

To determine, via a randomized comparison study, whether robotic simulator-acquired skills transfer to performance of a urethrovesical anastomosis (UVA) on a 3D-printed bladder model using the da Vinci Robot.

MATERIALS AND METHODS:

Medical students, surgical residents, and fellows were recruited and divided into two groups: G1 (junior trainees) and G2 (senior trainees). Participants were randomized to identical simulator training curricula on the dV-Trainer (dV-T) or da Vinci Surgical Skills Simulator (dVSSS). Participants then completed a UVA task on a 3D-printed bladder model using the da Vinci robot. Three blinded expert robotic surgeons rated videotaped performances of the UVA task using the GEARS (overall procedure) and RACE (specific to UVA) validated assessment tools.

RESULTS:

Thirty-nine participants (G1=23/G2=16) completed the study. Participants in G2 had significantly more simulation and surgical experience compared to G1 (p<0.05). UVA scores of the dVSSS group were higher compared to dV-T (GEARS: p=0.09; RACE: p=0.01). In the G1 cohort, dVSSS scores were significantly higher than dV-T (GEARS: p=0.01; RACE: p<0.01). In the G2 cohort, scores were statistically similar (GEARS: p=0.32; RACE: p=0.91).

CONCLUSIONS:

Compared to the dV-T, the dVSSS training led to superior GEARS and RACE scores for performance of the UVA task in junior trainees, but not in senior trainees. The dVSSS can be used to improve surgical skills acquisition in less experienced trainees in a safe and effective manner.

KEYWORDS:

Medical education; Robotic surgical procedures; Simulation training; Urologic surgical procedures; Urology

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