title: Surgical competency for urethrovesical anastomosis during robot-assisted radical prostatectomy: development and validation of the robotic anastomosis competency evaluation.
abstract: OBJECTIVE
  To develop and validate an assessment tool for the performance of urethrovesical anastomosis (UVA).
  
  
  METHODS
  A multicenter, prospective, observational study was conducted in 2 phases. Phase 1, development and content validation, used a panel of 5 experienced robotic surgeons to develop a 6-domain scoring system, Robotic Anastomosis Competence Evaluation (RACE), to assess technical skills for performing UVA. Phase 2, construct validation and reliability, used 5 blinded experienced robotic surgeons to rate UVA recordings of expert, advanced beginner, and novice groups. Content validation index was determined to report consensus in phase 1. Phase 2 involved comparison of RACE scores among the 3 groups. Wilcoxon rank-sum tests were used to compare RACE scores.
  
  
  RESULTS
  Two rounds of Delphi methodology achieved consensus on language and content of RACE. Eight experts, 10 advanced beginners, and 10 novice robotic surgeons participated in the validation study. The overall score for the expert group (27.3) was higher than that of the advanced beginner (19.5; P = .04) and novice groups (13.6; P = .001). The advanced beginner and novice groups differed in overall scores (P = .03).
  
  
  CONCLUSIONS
  RACE allows evaluation of surgical competence to perform UVA for robot-assisted radical prostatectomy, when using an inanimate model.
authors.affiliation: Department of Urology, Roswell Park Cancer Institute, Buffalo, NY.
authors.forename: Syed Johar
authors.initials: SJ
authors.lastname: Raza
authors.affiliation: Department of Urology, Roswell Park Cancer Institute, Buffalo, NY.
authors.forename: Erinn
authors.initials: E
authors.lastname: Field
authors.affiliation: Department of Urology, Roswell Park Cancer Institute, Buffalo, NY.
authors.forename: Christopher
authors.initials: C
authors.lastname: Jay
authors.affiliation: Department of Urology, Temple University School of Medicine, Philadelphia, PA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Eun
authors.affiliation: Department of Urology, University of Illinois College of Medicine at Rockford, Rockford, IL.
authors.forename: Michael
authors.initials: M
authors.lastname: Fumo
authors.affiliation: Department of Urology, University of California, Los Angeles, CA.
authors.forename: Jim C
authors.initials: JC
authors.lastname: Hu
authors.affiliation: Division of Urology, Penn Presbyterian Medical Center, Philadelphia, PA.
authors.forename: David
authors.initials: D
authors.lastname: Lee
authors.affiliation: Department of Urology, Roswell Park Cancer Institute, Buffalo, NY.
authors.forename: Zayn
authors.initials: Z
authors.lastname: Mehboob
authors.affiliation: Department of Health Sciences: Pathology and Anatomical Sciences, Medical Illustrations and Graphics, University at Buffalo, Buffalo, NY.
authors.forename: John
authors.initials: J
authors.lastname: Nyquist
authors.affiliation: Vattikuti Urology Institute, Henry Ford Hospital, Detroit, MI.
authors.forename: James O
authors.initials: JO
authors.lastname: Peabody
authors.affiliation: Department of Urology, Wayne State University Medical School, Detroit, MI.
authors.forename: Richard
authors.initials: R
authors.lastname: Sarle
authors.affiliation: Vattikuti Urology Institute, Henry Ford Hospital, Detroit, MI.
authors.forename: Hans
authors.initials: H
authors.lastname: Stricker
authors.affiliation: Department of Urology, Roswell Park Cancer Institute, Buffalo, NY.
authors.forename: Zhengyu
authors.initials: Z
authors.lastname: Yang
authors.affiliation: Department of Urology, Roswell Park Cancer Institute, Buffalo, NY.
authors.forename: Gregory
authors.initials: G
authors.lastname: Wilding
authors.affiliation: Department of Urology, Roswell Park Cancer Institute, Buffalo, NY.
authors.forename: James L
authors.initials: JL
authors.lastname: Mohler
authors.affiliation: Department of Urology, Roswell Park Cancer Institute, Buffalo, NY. Electronic address: Khurshid.guru@roswellpark.org.
authors.forename: Khurshid A
authors.initials: KA
authors.lastname: Guru
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical / Q000592:standards; D002983:Clinical Competence; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011468:Prostatectomy / Q000379:methods*; D065287:Robotic Surgical Procedures; D014521:Urethra / Q000601:surgery*; D001743:Urinary Bladder / Q000601:surgery*; D013521:Urologic Surgical Procedures, Male / Q000379:methods