title: Pilot Validation Study of the European Association of Urology Robotic Training Curriculum.
abstract: BACKGROUND
  The development of structured and validated training curricula is one of the current priorities in robot-assisted urological surgery.
  
  
  OBJECTIVE
  To establish the feasibility, acceptability, face validity, and educational impact of a structured training curriculum for robot-assisted radical prostatectomy (RARP), and to assess improvements in performance and ability to perform RARP after completion of the curriculum.
  
  
  METHODS
  A 12-wk training curriculum was developed based on an expert panel discussion and used to train ten fellows from major European teaching institutions. The curriculum included: (1) e-learning, (2) 1 wk of structured simulation-based training (virtual reality synthetic, animal, and cadaveric platforms), and (3) supervised modular training for RARP.
  
  
  METHODS
  The feasibility, acceptability, face validity, and educational impact were assessed using quantitative surveys. Improvement in the technical skills of participants over the training period was evaluated using the inbuilt validated assessment metrics on the da Vinci surgical simulator (dVSS). A final RARP performed by fellows on completion of their training was assessed using the Global Evaluative Assessment of Robotic Skills (GEARS) score and generic and procedure-specific scoring criteria.
  
  
  CONCLUSIONS
  The median baseline experience of participants as console surgeon was 4 mo (interquartile range [IQR] 0-6.5 mo). All participants completed the curriculum and were involved in a median of 18 RARPs (IQR 14-36) during modular training. The overall score for dVSS tasks significantly increased over the training period (p<0.001-0.005). At the end of the curriculum, eight fellows (80%) were deemed able by their mentors to perform a RARP independently, safely, and effectively. At assessment of the final RARP, the participants achieved an average score ≥4 (scale 1-5) for all domains using the GEARS scale and an average score >10 (scale 4-16) for all procedural steps using a generic dedicated scoring tool. In performance comparison using this scoring tool, the experts significantly outperformed the fellows (mean score for all steps 13.6 vs 11).
  
  
  CONCLUSIONS
  The European robot-assisted urologic training curriculum is acceptable, valid, and effective for training in RARP.
  
  
  RESULTS
  This study shows that a 12-wk structured training program including simulation-based training and mentored training in the operating room allows surgeons with limited robotic experience to increase their robotic skills and their ability to perform the surgical steps of robot-assisted radical prostatectomy.
authors.affiliation: OLV Vattikuti Robotic Surgery Institute, Aalst, Belgium; Division of Urology, University of Eastern Piedmont, Novara, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Volpe
authors.affiliation: MRC Centre for Transplantation, Kings College London, Guy's Hospital, London, UK.
authors.forename: Kamran
authors.initials: K
authors.lastname: Ahmed
authors.affiliation: MRC Centre for Transplantation, Kings College London, Guy's Hospital, London, UK.
authors.forename: Prokar
authors.initials: P
authors.lastname: Dasgupta
authors.affiliation: OLV Vattikuti Robotic Surgery Institute, Aalst, Belgium; Department of Experimental and Clinical Medical Sciences, Division of Urology, University of Udine, Udine, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Ficarra
authors.affiliation: OLV Vattikuti Robotic Surgery Institute, Aalst, Belgium; Department of Surgical, Oncological and Gastrointestinal Sciences, Division of Urology, University of Padua, Padua, Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Novara
authors.affiliation: Division of Urology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
authors.forename: Henk
authors.initials: H
authors.lastname: van der Poel
authors.affiliation: OLV Vattikuti Robotic Surgery Institute, Aalst, Belgium; Division of Urology, Onze-Lieve-Vrouw Hospital, Aalst, Belgium. Electronic address: a.mottrie@telenet.be.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Mottrie
mesh_terms: D000328:Adult; D000818:Animals; D002102:Cadaver; D002983:Clinical Competence; D003198:Computer Simulation; D003194:Computer-Assisted Instruction; D003479:Curriculum; D004503:Education, Medical, Graduate / Q000379:methods*; D005060:Europe; D005240:Feasibility Studies; D006801:Humans; D008137:Longitudinal Studies; D008611:Mentors; D023421:Models, Animal; D009048:Motor Skills; D010865:Pilot Projects; D011446:Prospective Studies; D011468:Prostatectomy / Q000193:education* / Q000379:methods; D065287:Robotic Surgical Procedures / Q000193:education* / Q000379:methods; D012955:Societies, Medical; D013647:Task Performance and Analysis; D013663:Teaching / Q000379:methods*; D013997:Time Factors; D014741:Video Recording
keywords: Curriculum; Radical prostatectomy; Robotics; Simulation; Training