As robotic surgery has increased in popularity and adoption, so has the recognition that training for robotic surgeons is critical. Also critical is ensuring that when these surgeons perform their first case on live patients they will have been exposed to and trained for all aspects of the system.
In Europe, ERUS (the European Robotic Urology Section of the EAU) has been designing and developing a structured training program and curriculum to help surgeons who wish to engage in performing a robot-assisted radical prostatectomy (RARP).
The program is divided into six clear sections. Starting and finishing with evaluation protocols, participants go through online modules and observations, simulation training aligned with wet and dry labs, as well as modular console training and training on the full procedural steps.
When implemented, the program took approximately 12 weeks for participants to complete, including one week dedicated to simulation training and dry and wet lab tasks. After the intensive week of hands-on training was completed, the fellows returned to their institutions carrying out specific parts of the procedure and mastering them before moving onto other steps and finally a complete procedure. Their final procedure was assessed by their mentors as well video recorded for review by independent assessors.
In total, of the ten students who took part in the study 3 were residents, 5 were fellows and 2 were staff members. Based on the final assessment, two of the residents were not deemed sufficiently proficient to carry out a RARP independently but the remaining eight (80%) of the participants were deemed proficient including three (30%) who achieved being considered able to complete complex cases.
Throughout the 12-week program, the participant’s skills were measured on a regular basis and over time showed significant improvement. The graphs below illustrate how the skills improved over the duration of the fellowship in two of the more complex exercises.
Given the importance of simulation to this curriculum, Mimic has been pleased to work with the EAU and ERUS to offer exposure to a short simulation curriculum during the a number of EAU congress in 2014 and 2015. At seven various educational events between September 2014 and December 2015 Mimic was able to offer 11 days of robotic simulation initiation. 107 participants were able to sit down at the simulator and complete and average of 8 exercises each. The initial courses focused only on console skills, with later courses including laparoscopic skills for bed side assistants.
All exercises were completed and the average pass rate was 28%, though it ranged from 60% to 0% depending on the student.