title: Training program for fundamental surgical skill in robotic laparoscopic surgery.
abstract: BACKGROUND
  Although the use of robotic laparoscopic surgery has increased in popularity, training protocols for gaining proficiency in robotic surgical skills are not well established. The purpose of this study was to examine a fundamental training program that provides an effective approach to evaluate and improve robotic surgical skills performance using the da Vinci(™) Surgical System.
  
  
  METHODS
  Fifteen medical students without any robotic surgical experience were recruited. Participants went through a 4-day training program for developing fundamental robotic surgical skills and received a retention test 1 day after the completion of training. Data analysis included time to task completion, average speed, total distance traveled and movement curvature of the instrument tips, and muscle activities of the participants' forearms. Surgical performance was graded by the modified Objective Structured Assessment of Technical Skills for robotic laparoscopic surgery. Finally, participants evaluated their own performance after each session through questionnaires.
  
  
  RESULTS
  Significant training effects were shown for the time to task completion (p < 0.001), average speed (p < 0.01), and movement curvature (p < 0.05) for the test conditions. Significant learning effects were also found for EMG activation (p < 0.05). Participants reported more mastery, familiarity, and self-confidence and less difficulty in performing fundamental tasks with the surgical robot in both post-testing and retention sessions.
  
  
  CONCLUSIONS
  Our 4-day training program comprising of a series of training tasks from fundamental to surgical skill levels was effective in improving surgical skills. Further studies are required to verify these findings with a longer period of retention.
authors.affiliation: University of Nebraska Medical Center, College of Public Health; University of Nebraska Medical Center, Center for Advanced Surgical Technology.
authors.forename: Irene
authors.initials: I
authors.lastname: Suh
authors.forename: Mukul
authors.initials: M
authors.lastname: Mukherjee
authors.forename: Dmitry
authors.initials: D
authors.lastname: Oleynikov
authors.forename: Ka-Chun
authors.initials: KC
authors.lastname: Siu
mesh_terms: D000328:Adult; D001696:Biomechanical Phenomena; D002983:Clinical Competence; D003198:Computer Simulation; D004501:Education, Medical / Q000379:methods*; D004576:Electromyography / Q000379:methods; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000193:education* / Q000379:methods*; D008297:Male; D065287:Robotic Surgical Procedures / Q000193:education* / Q000379:methods*; D025321:Surgery, Computer-Assisted / Q000379:methods*; D013647:Task Performance and Analysis; D055815:Young Adult