title: Construct validation of the key components of Fundamental Skills of Robotic Surgery (FSRS) curriculum--a multi-institution prospective study.
abstract: BACKGROUND
  Recent incorporation of simulation in surgical training necessitates developing validated platforms for training and assessment. A tool should fulfill the fundamental criteria of validation.
  
  
  OBJECTIVE
  To report the ability of a simulation-based robotic training curriculum-Fundamental Skills of Robotic Surgery (FSRS)-to assess and distinguish between different performance levels of operator experience (construct validity).
  
  
  METHODS
  This is a prospective multicenter observational study. Participants were classified as novice (0 robotic cases performed) and experts (>150 robotic cases performed). All participants were required to complete 4 key tasks in a previously validated FSRS curriculum: ball placement, coordinated tool control, fourth arm control, and needle handling and exchange. Using the metrics available in the simulator software, the performances of each group were compared to evaluate construct validation.
  
  
  RESULTS
  A convenience cohort of 61 surgeons participated. Novice group (n = 49) consisted of 41 fellows/residents/medical students and 8 trained open/laparoscopic surgeons, whereas expert group consisted of 12 surgeons. The novice group had no previous robotic console experience, whereas the expert group had >150 prior robotic cases experience. An overall significant difference was observed in favor of the expert group in 4 skill sets (p < 0.05). Time to complete all 4 tasks was significantly shorter in the expert group (p < 0.001). The expert group displayed significantly lesser tool collision (p = 0.002) and reduced tissue damage (p < 0.001). In performing most tasks, the expert group's camera (p < 0.001) and clutch usage (p < 0.001) was significantly greater when compared with the novice group.
  
  
  CONCLUSIONS
  The components of the FSRS curriculum showed construct validity. This validation would help in effectively implementing this curriculum for robot-assisted surgical training.
authors.affiliation: Roswell Park Cancer Institute, Buffalo, New York; Department of Urology, MRC Centre for Transplantation, Guy's Hospital, Kings College, London, United Kingdom.
authors.forename: Syed J
authors.initials: SJ
authors.lastname: Raza
authors.affiliation: Churchill Hospital, Oxford, United Kingdom; Department of Urology, MRC Centre for Transplantation, Guy's Hospital, Kings College, London, United Kingdom.
authors.forename: Saied
authors.initials: S
authors.lastname: Froghi
authors.affiliation: Roswell Park Cancer Institute, Buffalo, New York; Department of Urology, MRC Centre for Transplantation, Guy's Hospital, Kings College, London, United Kingdom.
authors.forename: Ashirwad
authors.initials: A
authors.lastname: Chowriappa
authors.affiliation: Department of Urology, MRC Centre for Transplantation, Guy's Hospital, Kings College, London, United Kingdom.
authors.forename: Kamran
authors.initials: K
authors.lastname: Ahmed
authors.affiliation: Roswell Park Cancer Institute, Buffalo, New York; Department of Urology, MRC Centre for Transplantation, Guy's Hospital, Kings College, London, United Kingdom.
authors.forename: Erinn
authors.initials: E
authors.lastname: Field
authors.affiliation: Roswell Park Cancer Institute, Buffalo, New York; Department of Urology, MRC Centre for Transplantation, Guy's Hospital, Kings College, London, United Kingdom.
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Stegemann
authors.affiliation: Roswell Park Cancer Institute, Buffalo, New York; Department of Urology, MRC Centre for Transplantation, Guy's Hospital, Kings College, London, United Kingdom.
authors.forename: Shabnam
authors.initials: S
authors.lastname: Rehman
authors.affiliation: Roswell Park Cancer Institute, Buffalo, New York; Department of Urology, MRC Centre for Transplantation, Guy's Hospital, Kings College, London, United Kingdom.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Sharif
authors.affiliation: Roswell Park Cancer Institute, Buffalo, New York; Department of Urology, MRC Centre for Transplantation, Guy's Hospital, Kings College, London, United Kingdom.
authors.forename: Yi
authors.initials: Y
authors.lastname: Shi
authors.affiliation: Roswell Park Cancer Institute, Buffalo, New York; Department of Urology, MRC Centre for Transplantation, Guy's Hospital, Kings College, London, United Kingdom.
authors.forename: Gregory E
authors.initials: GE
authors.lastname: Wilding
authors.affiliation: Department of Urology, MRC Centre for Transplantation, Guy's Hospital, Kings College, London, United Kingdom; University at Buffalo, Buffalo, New York.
authors.forename: Thenkurussi
authors.initials: T
authors.lastname: Kesavadas
authors.affiliation: Department of Urology, MRC Centre for Transplantation, Guy's Hospital, Kings College, London, United Kingdom; Cleveland Clinic Foundation, Cleveland, Ohio.
authors.forename: Jihad
authors.initials: J
authors.lastname: Kaouk
authors.affiliation: Roswell Park Cancer Institute, Buffalo, New York; Department of Urology, MRC Centre for Transplantation, Guy's Hospital, Kings College, London, United Kingdom. Electronic address: khurshid.guru@roswellpark.org.
authors.forename: Khurshid A
authors.initials: KA
authors.lastname: Guru
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003479:Curriculum; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D065287:Robotic Surgical Procedures / Q000193:education*; D012449:Safety
keywords: FSRS; Medical Knowledge; Practice-Based Learning and Improvement; Systems-Based Practice; curriculum; robot-assisted surgical training; simulation; validity