title: General surgery training and robotics: Are residents improving their skills?
abstract: BACKGROUND
  While robotic-assisted operations have become more prevalent, many general surgery residencies do not have a formal robotic training curriculum. We sought to ascertain how well current general surgery training permits acquisition of robotic skills by comparing robotic simulation performance across various training levels.
  
  
  METHODS
  Thirty-six participants were categorized by level of surgical training: eight medical students (MS), ten junior residents (JR), ten mid-level residents (MLR), and eight senior residents (SR). Participants performed three simulation tasks on the da Vinci (®) Skills Simulator (MatchBoard, EnergyDissection, SutureSponge). Each task's scores (0-100) and cumulative scores (0-300) were compared between groups.
  
  
  RESULTS
  There were no differences in sex, hand dominance, video gaming history, or prior robotic experience between groups; however, SR was the oldest (p < 0.001). The median overall scores did not differ: 188 (84-201) for MS, 183 (91-234) for JR, 197 (153-218) for MLR, and 205 (169-229) for SR (p = 0.14). The median SutureSponge score was highest for SR (61, range 39-81) compared to MS (43, range 26-61), JR (43, range 11-72), and MLR (55, range 36-68) (p = 0.039). However, there were no significant differences in MatchBoard (p = 0.27) or EnergyDissection (p = 0.99) scores between groups. There was a positive correlation between SutureSponge score and number of laparoscopic cases logged (p = 0.005, r(2) = 0.21), but this correlation did not exist for the MatchBoard or EnergyDissection tasks. Lastly, there was no correlation between total lifetime hours of video gaming and overall score (p = 0.89, R(2) = 0.0006).
  
  
  CONCLUSIONS
  Robotic skillsets acquired during general surgery residency show minimal improvement during the course of training, although laparoscopic experience is correlated with advanced robotic task performance. Changes in residency curricula or pursuit of fellowship training may be warranted for surgeons seeking proficiency.
authors.affiliation: Department of Surgery, New York Presbyterian Hospital - Weill Cornell Medical College, 525 E. 68th Street, New York, NY, 10065, USA. bmf9002@nyp.org.
authors.forename: Brendan M
authors.initials: BM
authors.lastname: Finnerty
authors.affiliation: Department of Surgery, New York Presbyterian Hospital - Weill Cornell Medical College, 525 E. 68th Street, New York, NY, 10065, USA.
authors.forename: Cheguevara
authors.initials: C
authors.lastname: Afaneh
authors.affiliation: Department of Surgery, New York Presbyterian Hospital - Weill Cornell Medical College, 525 E. 68th Street, New York, NY, 10065, USA.
authors.forename: Anna
authors.initials: A
authors.lastname: Aronova
authors.affiliation: Department of Surgery, New York Presbyterian Hospital - Weill Cornell Medical College, 525 E. 68th Street, New York, NY, 10065, USA.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Fahey
authors.affiliation: Department of Surgery, New York Presbyterian Hospital - Weill Cornell Medical College, 525 E. 68th Street, New York, NY, 10065, USA.
authors.forename: Rasa
authors.initials: R
authors.lastname: Zarnegar
mesh_terms: D000328:Adult; D002983:Clinical Competence; D015331:Cohort Studies; D003198:Computer Simulation; D003479:Curriculum; D004501:Education, Medical / Q000379:methods; D005260:Female; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D010535:Laparoscopy / Q000193:education; D008297:Male; D010820:Physicians; D011446:Prospective Studies; D065287:Robotic Surgical Procedures / Q000193:education*; D000066908:Simulation Training / Q000379:methods*; D013337:Students, Medical; D013647:Task Performance and Analysis; D055815:Young Adult
keywords: General surgery training; Robotic education; Robotic surgery; Virtual reality robotic simulation