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Surgical coaching improves overall scores on robotic simulator compared to self-practice: a randomized controlled trial

Purpose: To assess whether surgical coaching on the robotic simulator improves overall simulation scores (OS). 

 

Background: Simulators have been instrumental in surgical training given the growing proportion of minimally invasive hysterectomies performed despite an overall decreasing surgical volume. However, the impact of surgical coaching on the robotic simulator has not been studied.

 

Methods: OBGYN trainees were stratified by post-graduate year (PGY) and randomized to either: self-practice (SP) or surgical coaching (SC). Participants completed four repetitions each in 1) camera targeting, 2) endowrist manipulation, 3) needle driving, and 4) energy switching. An additional 30 minutes of coaching time was allotted to each participant in the SC arm. OS and various performance metrics were collected.

 

Means scores were compared using Student’s t-test. Rates of improvement were determined by linear regression and compared using ANOVA. A p-value < 0.05 was considered statistically significant.

 

Results: There were 7 participants in the SP arm and 6 in SC arm. OS were not significantly different between arms across all exercises after the first repetition, but were significantly higher in the SC arm across all exercises after the fourth repetition. The SC arm had a faster rate of improvement with each repetition for camera targeting (27.8 (95% CI 14.5, 41.2), p< 0.001), endowrist manipulation (15.9 (95% CI 0.8, 31.0), p=0.04), and needle driving (21.3 (95% CI 8.2, 34.4), p=0.002).

 

Discussions: Coaching on the robotic simulator can accelerate the rate of improvement in surgical skills compared to SP. Training programs may consider integrating coaching to simulation curricula to improve surgical skills.

Topics: CREOG & APGO Annual Meeting, 2022, Resident, Faculty, Residency Director, Practice-Based Learning & Improvement, GME, CME, Simulation, Minimally Invasive Surgery,

General Information


Intended
Audience
Resident,Faculty,Residency Director,
Competencies
Addressed
Practice-Based Learning & Improvement,
Educational
Continuum
GME,CME,
Educational
Focus
Simulation,
Clinical Focus
Minimally Invasive Surgery,

Author Information

Jessica Jou, MD, MS, UCSD; Michelle Tang, MD; Michael McHale, MD

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