title: Development and validation of a composite scoring system for robot-assisted surgical training--the Robotic Skills Assessment Score.
abstract: BACKGROUND
  A standardized scoring system does not exist in virtual reality-based assessment metrics to describe safe and crucial surgical skills in robot-assisted surgery. This study aims to develop an assessment score along with its construct validation.
  
  
  METHODS
  All subjects performed key tasks on previously validated Fundamental Skills of Robotic Surgery curriculum, which were recorded, and metrics were stored. After an expert consensus for the purpose of content validation (Delphi), critical safety determining procedural steps were identified from the Fundamental Skills of Robotic Surgery curriculum and a hierarchical task decomposition of multiple parameters using a variety of metrics was used to develop Robotic Skills Assessment Score (RSA-Score). Robotic Skills Assessment mainly focuses on safety in operative field, critical error, economy, bimanual dexterity, and time. Following, the RSA-Score was further evaluated for construct validation and feasibility. Spearman correlation tests performed between tasks using the RSA-Scores indicate no cross correlation. Wilcoxon rank sum tests were performed between the two groups.
  
  
  RESULTS
  The proposed RSA-Score was evaluated on non-robotic surgeons (n = 15) and on expert-robotic surgeons (n = 12). The expert group demonstrated significantly better performance on all four tasks in comparison to the novice group. Validation of the RSA-Score in this study was carried out on the Robotic Surgical Simulator.
  
  
  CONCLUSIONS
  The RSA-Score is a valid scoring system that could be incorporated in any virtual reality-based surgical simulator to achieve standardized assessment of fundamental surgical tents during robot-assisted surgery.
authors.affiliation: Roswell Park Cancer Institute, Buffalo, New York; University at Buffalo, Buffalo, New York.
authors.forename: Ashirwad J
authors.initials: AJ
authors.lastname: Chowriappa
authors.forename: Yi
authors.initials: Y
authors.lastname: Shi
authors.forename: Syed Johar
authors.initials: SJ
authors.lastname: Raza
authors.forename: Kamran
authors.initials: K
authors.lastname: Ahmed
authors.forename: Andrew
authors.initials: A
authors.lastname: Stegemann
authors.forename: Gregory
authors.initials: G
authors.lastname: Wilding
authors.forename: Jihad
authors.initials: J
authors.lastname: Kaouk
authors.forename: James O
authors.initials: JO
authors.lastname: Peabody
authors.forename: Mani
authors.initials: M
authors.lastname: Menon
authors.forename: James M
authors.initials: JM
authors.lastname: Hassett
authors.forename: Thenkurussi
authors.initials: T
authors.lastname: Kesavadas
authors.forename: Khurshid A
authors.initials: KA
authors.lastname: Guru
mesh_terms: D000328:Adult; D003162:Competency-Based Education / Q000379:methods / Q000592:standards; D003198:Computer Simulation / Q000592:standards; D004503:Education, Medical, Graduate / Q000379:methods* / Q000592:standards*; D004521:Educational Measurement / Q000379:methods* / Q000592:standards*; D005260:Female; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency / Q000379:methods / Q000592:standards; D008297:Male; D011446:Prospective Studies; D012371:Robotics / Q000193:education*; D014584:User-Computer Interface
keywords: Robotic skills assessment; Robotic training; Score; Scoring system; Surgical training