Robot-assisted laparoscopic skills development: formal versus informal training.
BACKGROUND
The learning curve for robotic surgery is not completely defined, and ideal training components have not yet been identified. We attempted to determine whether skill development would be accelerated with formal, organized instruction in robotic surgical techniques versus informal practice alone.


METHODS
Forty-three medical students naive to robotic surgery were randomized into two groups and tested on three tasks using the robotic platform. Between the testing sessions, the students were given equally timed practice sessions. The formal training group participated in an organized, formal training session with instruction from an attending robotic surgeon, whereas the informal training group participated in an equally timed unstructured practice session with the robot. The results were compared based on technical score and time to completion of each task.


RESULTS
There was no difference between groups in prepractice testing for any task. In postpractice testing, there was no difference between groups for the ring transfer tasks. However, for the suture placement and knot-tying task, the technical score of the formal training group was significantly better than that of the informal training group (p < 0.001), yet time to completion was not different.


CONCLUSIONS
Although formal training may not be necessary for basic skills, formal instruction for more advanced skills, such as suture placement and knot tying, is important in developing skills needed for effective robotic surgery. These findings may be important in formulating potential skills labs or training courses for robotic surgery.
Benson
Aaron D
AD
Division of Urology, Center for Laparoscopy and Endourology, Southern Illinois University School of Medicine, Springfield, Illinois 62794-9665, USA.
Kramer
Brandan A
BA
Boehler
Margaret
M
Schwind
Cathy J
CJ
Schwartz
Bradley F
BF
D000328:Adult; D002983:Clinical Competence; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D012371:Robotics / Q000193:education* / Q000295:instrumentation*; D055815:Young Adult