title: Fundamental skills of robotic surgery: a multi-institutional randomized controlled trial for validation of a simulation-based curriculum.
abstract: OBJECTIVE
  To develop and establish effectiveness of simulation-based robotic curriculum--fundamental skills of robotic surgery (FSRS).
  
  
  METHODS
  FSRS curriculum was developed and incorporated into a virtual reality simulator, Robotic Surgical Simulator (RoSS). Fifty-three participants were randomized into an experimental group (EG) or control group (CG). The EG was asked to complete the FSRS and 1 final test on the da Vinci Surgical System (dVSS). The dVSS test consisted of 3 tasks: ball placement, suture pass, and fourth arm manipulation. The CG was directly tested on the dVSS then offered the chance to complete the FSRS and re-tested on the dVSS as a crossover (CO) group.
  
  
  RESULTS
  Sixty-five percent of participants had never formally trained using laparoscopic surgery. Ball placement: the EG demonstrated shorter time (142 vs 164 seconds, P = .134) and more precise (1.5 vs 2.5 drops, P = .014). The CO took less time (P <.001) with greater precision (P <.001). Instruments were rarely lost from the field. Suture pass: the EG demonstrated better camera utilization (4.3 vs 3.0, P = .078). Less instrument loss occurred (0.5 vs 1.1, P = .026). Proper camera usage significantly improved (P = .009). Fourth arm manipulation: the EG took less time (132 vs 157 seconds, P = .302). Meanwhile, loss of instruments was less frequent (0.2 vs 0.8, P = .076). Precision in the CO improved significantly (P = .042) and camera control and safe instrument manipulation showed improvement (1.5 vs 3.5, 0.2 vs 0.9, respectively).
  
  
  CONCLUSIONS
  FSRS curriculum is a valid, feasible, and structured curriculum that demonstrates its effectiveness by significant improvements in basic robotic surgery skills.
authors.affiliation: Roswell Park Cancer Institute, Buffalo, NY 14263, USA.
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Stegemann
authors.forename: Kamran
authors.initials: K
authors.lastname: Ahmed
authors.forename: Johar R
authors.initials: JR
authors.lastname: Syed
authors.forename: Shabnam
authors.initials: S
authors.lastname: Rehman
authors.forename: Khurshid
authors.initials: K
authors.lastname: Ghani
authors.forename: Ricardo
authors.initials: R
authors.lastname: Autorino
authors.forename: Mohamed
authors.initials: M
authors.lastname: Sharif
authors.forename: Amrith
authors.initials: A
authors.lastname: Rao
authors.forename: Yi
authors.initials: Y
authors.lastname: Shi
authors.forename: Gregory E
authors.initials: GE
authors.lastname: Wilding
authors.forename: James M
authors.initials: JM
authors.lastname: Hassett
authors.forename: Ashirwad
authors.initials: A
authors.lastname: Chowriappa
authors.forename: Thenkurussi
authors.initials: T
authors.lastname: Kesavadas
authors.forename: James O
authors.initials: JO
authors.lastname: Peabody
authors.forename: Mani
authors.initials: M
authors.lastname: Menon
authors.forename: Jihad
authors.initials: J
authors.lastname: Kaouk
authors.forename: Khurshid Ahad
authors.initials: KA
authors.lastname: Guru
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003198:Computer Simulation; D003479:Curriculum; D004521:Educational Measurement; D006801:Humans; D012371:Robotics / Q000193:education*; D013520:Urologic Surgical Procedures / Q000193:education*