Pan-specialty access to robotic surgery in surgical training

Fleming, Christina; Ali, Oroog; Clements, Joshua; Hirniak, Johnathan; King, Martin; Mohan, Helen; Nally, Deirdre; Burke, Joshua

doi:10.1093/bjs/znab107

Cited by 5 publications

(7 citation statements)

References 4 publications

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“…The limited access to RS training for Irish trainees described herein and supported by recent data from trainee representative bodies [ 19 ] is concerning, particularly in the context of the rapid expansion in use of the technology. Our data are concordant with the existing body of literature which shows that this shift in practice is clearly appreciated by a majority of trainees, who perceive the technology to be highly relevant to their future practice and express a desire to receive training in the modality [ 7 , 8 , 10 ].…”

Section: Discussionmentioning

confidence: 90%

Attitudes and access of Irish general surgery trainees to robotic surgical training

O’Connell¹,

Hayes²,

Ismail³

et al. 2022

Surgery Open Science

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Section: Discussionmentioning

confidence: 90%

Attitudes and access of Irish general surgery trainees to robotic surgical training

O’Connell¹,

Hayes²,

Ismail³

et al. 2022

Surgery Open Science

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“…23 The British Association of Urological Surgeons' national registry results from 2016 to 2019 outlined that over 86% of radical prostatectomies in the UK were performed robotically, 24 and yet less than 30% of surgical trainees are gaining access to the required literacy and skill to deliver robotic surgery in their future consultant practice. 25,26 With the ability to record operations, and the development of laparoscopic and robotic technology, there is vast potential in our ability to better understand and measure how we train -if trainees are afforded access to these opportunities. In future, if done correctly, it is predicted that this may result in competence benchmarks or 'credentialing'.…”

Section: Unmet Needmentioning

confidence: 99%

“…Less than 30% of surgical trainees are gaining access to the required literacy and skill to deliver robotic surgery in their future consultant practice. 25,26 Having considered the evidence, the conclusions of the FOS:TEST Commission regarding trainee exposure to operating and how technology can enhance this are as follows.…”

Section: How Technology Partners Are Supporting Operating Skills Deve...mentioning

confidence: 99%

“…At present, there are various training modalities available for RAS including industry lead and subspecialty designed programmes. 25 Industry lead programmes, which are common among RAS trainees, include a modular training programme consisting of online training modules, virtual reality (VR) simulation, dry lab training and finally, live operating proctoring. 228 Subspecialty designed programmes have adopted a similar model.…”

Section: How Technology Can Support Assessment Of Trainee Competence ...mentioning

confidence: 99%

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Future of Surgery: Technology Enhanced Surgical Training: Report of the FOS:TEST Commission

Adebayo¹,

Aldoori²,

Allum³

et al. 2022

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Over the past 50 years the capability of technology to improve surgical care has been realised and while surgical trainees and trainers strive to deliver care and train; the technological ‘solutions’ market continues to expand. However, there remains no coordinated process to assess these technologies. The FOS:TEST Report aimed to (1) define the current, unmet needs in surgical training, (2) assess the current evidence-base of technologies that may be beneficial to training and map these onto both the patient and trainee pathway and (3) make recommendations on the development, assessment, and adoption of novel surgical technologies. The FOS:TEST Commission was formed by the Association of Surgeons in Training (ASiT), The Royal College of Surgeons of England (RCS England) Robotics and Digital Surgery Group and representatives from all trainee specialty associations. Two national datasets provided by Health Education England were used to identify unmet surgical training needs through qualitative analysis against pre-defined coding frameworks. These unmet needs were prioritised at two virtual consensus hackathons and mapped to the patient and trainee pathway and the capabilities in practice (CiPs) framework. The commission received more than 120 evidence submissions from surgeons in training, consultant surgeons and training leaders. Following peer review, 32 were selected that covered a range of innovations. Contributors also highlighted several important key considerations, including the changing pedagogy of surgical training, the ethics and challenges of big data and machine learning, sustainability, and health economics. This summates to 7 Key Recommendations and 51 concluding statements. The FOS:TEST Commission was borne out of what is a pivotal point in the digital transformation of surgical training. Academic expertise and collaboration will be required to evaluate efficacy of any novel training solution. However, this must be coupled with pragmatic assessments of feasibility and cost to ensure that any intervention is scalable for national implementation. Currently, there is no replacement for hands-on operating. However, for future UK and ROI surgeons to stay relevant in a global market, our training methods must adapt. The Future of Surgery: Technology Enhanced Surgical Training Report provides a blueprint for how this can be achieved.

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“…Despite this expansion and increasing adoption of RAS in clinical practice recognising the perceived benefits of improved dexterity, ergonomics and improved anatomical access [ 8 ], surgical trainee exposure to robotic-assisted surgical training (RAST) is limited. It is estimated that > 70% of current UK and Irish surgical trainees have had no access to any form of robotic surgery during their surgical training to date [ 9 , 10 ]. This same cohort of trainees, however, do place significant value on RAST prior to completion of training as they feel it will be important for their future consultant practice and they would support its incorporation into the UK and Irish surgical training curriculae [ 11 – 13 ].…”

Section: Introductionmentioning

confidence: 99%

Utilising an accelerated Delphi process to develop consensus on the requirement and components of a pre-procedural core robotic surgery curriculum

et al. 2023

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Robot-assisted surgery (RAS) continues to grow globally. Despite this, in the UK and Ireland, it is estimated that over 70% of surgical trainees across all specialities have no access to robot-assisted surgical training (RAST). This study aimed to provide educational stakeholders guidance on a pre-procedural core robotic surgery curriculum (PPCRC) from the perspective of the end user; the surgical trainee. The study was conducted in four Phases: P1: a steering group was formed to review current literature and summarise the evidence, P2: Pan-Specialty Trainee Panel Virtual Classroom Discussion, P3: Accelerated Delphi Process and P4: Formulation of Recommendations. Forty-three surgeons in training representing all surgical specialties and training levels contributed to the three round Delphi process. Additions to the second- and third-round surveys were formulated based on the answers and comments from previous rounds. Consensus opinion was defined as ≥ 80% agreement. There was 100% response from all three rounds. The resulting formulated guidance showed good internal consistency, with a Cronbach alpha of > 0.8. There was 97.7% agreement that a standardised PPCRC would be advantageous to training and that, independent of speciality, there should be a common approach (95.5% agreement). Consensus was reached in multiple areas: 1. Experience and Exposure, 2. Access and context, 3. Curriculum Components, 4 Target Groups and Delivery, 5. Objective Metrics, Benchmarking and Assessment. Using the Delphi methodology, we achieved multispecialty consensus among trainees to develop and reach content validation for the requirements and components of a PPCRC. This guidance will benefit from further validation following implementation.

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Pan-specialty access to robotic surgery in surgical training

Cited by 5 publications

References 4 publications

Attitudes and access of Irish general surgery trainees to robotic surgical training

Attitudes and access of Irish general surgery trainees to robotic surgical training

Future of Surgery: Technology Enhanced Surgical Training: Report of the FOS:TEST Commission

Utilising an accelerated Delphi process to develop consensus on the requirement and components of a pre-procedural core robotic surgery curriculum

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