title: Robotic surgical skills: acquisition, maintenance, and degradation.
abstract: OBJECTIVE
  The degradation in robotic skills that occurs during periods of robotic surgical inactivity in newly trained surgeons was measured. The role of animate training in robotic skill was also assessed.
  
  
  METHODS
  Robotically naive resident and attending surgeons underwent training with the da Vinci robot on needle passage (DN), rocking ring transfer peg board (RPB), and running suture pod tasks (SP). Errors were established to convert actual time to adjusted time. Participants were deemed "proficient" once their adjusted times were within 80% of those set by experienced surgeons through repeated trials. Participants did not use the robot except for repeating the tasks once at 4, 8, and 12 weeks (tests). Participants then underwent animate training and completed a final test within 7 days.
  
  
  RESULTS
  Twenty-five attending and 29 resident surgeons enrolled; 3 withdrew. There were significant increases in time to complete each of the tasks, and in errors, by 4 weeks (Adjusted times: DN: 122.9 +/- 2.2 to 204.2 +/- 11.7, t = 6.9, P < .001; RPB: 262.4 +/- 2.5 to 364.7 +/- 8.0, t = 12.4, P < .001; SP: 91.4 +/- 1.4 to 169.9 +/- 6.8, t = 11.3, P < .001). Times decreased following animate training, but not to levels observed after proficiency training for the RPB and SP modules.
  
  
  CONCLUSIONS
  Robotic surgical skills degrade significantly within 4 weeks of inactivity in newly trained surgeons. Animate training may provide different skills than those acquired in the dry lab.
authors.affiliation: Department of Obstetrics and Gynecology, Akron General Medical Center, Akron, OH 44302, USA. ejenison@agmc.org
authors.forename: Eric L
authors.initials: EL
authors.lastname: Jenison
authors.forename: Karen M
authors.initials: KM
authors.lastname: Gil
authors.forename: Thomas S
authors.initials: TS
authors.lastname: Lendvay
authors.forename: Michael S
authors.initials: MS
authors.lastname: Guy
mesh_terms: D000328:Adult; D002983:Clinical Competence; D005260:Female; D013502:General Surgery / Q000193:education*; D006176:Gynecology / Q000193:education*; D006801:Humans; D059032:Learning Curve; D008297:Male; D009774:Obstetrics / Q000193:education*; D012371:Robotics; D013536:Suture Techniques / Q000193:education; D013647:Task Performance and Analysis; D013997:Time Factors