title: Virtual reality suturing task as an objective test for robotic experience assessment.
abstract: BACKGROUND
  We performed a pilot study using a single virtual-simulation suturing module as an objective measurement to determine functional use of the robotic system. This study will assist in designing a study for an objective, adjunctive test for use by a surgical proctor.
  
  
  METHODS
  After IRB approval, subjects were recruited at a robotic renal surgery course to perform two attempts of the "Tubes" module without warm-up using the Da Vinci® Surgical Skills Simulator™. The overall MScore (%) from the simulator was compared among various skill levels to provide construct validity. Correlation with MScore and number of robotic cases was performed and pre-determined skill groups were tested. Nine metrics that make up the overall score were also tested via paired t test and subsequent logistic regression to determine which skills differed among experienced and novice robotic surgeons.
  
  
  RESULTS
  We enrolled 38 subjects with experience ranging from 0- < 200 robotic cases. Median time to complete both tasks was less than 10 min. The MScore on the first attempt was correlated to the number of previous robotic cases (R(2) = 0.465; p = 0.003). MScore was different between novice and more experienced robotic surgeons on the first (44.7 vs. 63.9; p = 0.005) and second attempt (56.0 vs. 69.9; p = 0.037).
  
  
  CONCLUSIONS
  A single virtual simulator exercise can provide objective information in determining proficient use of the robotic surgical system.
authors.affiliation: Department of Urology, UC San Diego Health System, San Diego, CA, USA. mliss008@gmail.com.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Liss
authors.affiliation: Department of Urology, UC San Diego Health System, San Diego, CA, USA. ckane@ucsd.edu.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Kane
authors.affiliation: University of California, San Diego School of Medicine, La Jolla, CA, USA. tc.tonychen@gmail.com.
authors.forename: Tony
authors.initials: T
authors.lastname: Chen
authors.affiliation: Department of Surgery, UC San Diego Health System, San Diego, CA, USA. j1baumgartner@ucsd.edu.
authors.forename: Joel
authors.initials: J
authors.lastname: Baumgartner
authors.affiliation: Department of Urology, UC San Diego Health System, San Diego, CA, USA. iderweesh@ucsd.edu.|UC San Diego Moores Cancer Center, 3855 Health Sciences Drive #0987, La Jolla, CA, 92093-0987, USA. iderweesh@ucsd.edu.
authors.forename: Ithaar H
authors.initials: IH
authors.lastname: Derweesh
mesh_terms: D002140:California; D002983:Clinical Competence / Q000706:statistics & numerical data*; D003194:Computer-Assisted Instruction / Q000379:methods / Q000706:statistics & numerical data; D004521:Educational Measurement / Q000379:methods* / Q000706:statistics & numerical data; D006801:Humans; D061646:Operative Time; D065287:Robotic Surgical Procedures / Q000193:education* / Q000706:statistics & numerical data*; D012984:Software; D013536:Suture Techniques / Q000193:education* / Q000706:statistics & numerical data*