01.13 Assessing a Robotic Surgery Workshop’s Effect on General Surgery Trainees’ Confidence and Competence

S. Balaji1,2, S. Laplante1,2, H. Muaddi3, P. Patel2, N. Rukavina2, C. Shwaartz1,2  1University of Toronto, Toronto, Ontario, Canada 2University Health Network, Toronto, Ontario, Canada 3Mayo Clinic, Rochester, MN, USA

Introduction:  Robotic surgery is rapidly increasing globally and is well-integrated into various Canadian surgical specialties. Despite its significant adoption in general surgery, a formal training program and curriculum for general surgery trainees are currently lacking in Canada compared to urology and OBGYN training programs, where simulation training has been proven to be effective for skill development. Therefore, we designed a comprehensive didactic and hands-on technical training course for general surgery residents and subspecialty fellows at our institution. This study aimed to assess the workshop's impact on enhancing general surgery trainees’ confidence and competence in robotic surgery. 

Methods:  General surgery trainees (i.e., residents and fellows) from our institution were invited to participate in the study. At the beginning of the workshop, participants were asked to report their exposure to robotic surgery and confidence in 20 critical domains of using the technology, such as port placement, instrument handling, and managing collisions, via a self-rated numerical scale. Their competence was assessed using a multiple-choice knowledge test on high-yield concepts. Questionnaires were administered again immediately post-workshop. The paired t-test or Wilcoxon test were used, as appropriate, to compare participants’ responses before and after the workshop.

Results: Seven residents and eight fellows participated in the study. 57% (4/7) of residents and 38% (3/8) of fellows reported having no exposure to robotic surgery in the past year. Participants’ mean self-rated expertise on robotic surgery pre-workshop was 2.5 out of 10. After the workshop, both residents’ and fellows’ confidence increased [(2.0±0.4 vs. 5.7±1.1, p= <0.05) and (3.1±0.3 vs. 6.7±0.7, p= <0.001) respectively]. When tested on their knowledge about robotic surgery, trainees’ competence scores also improved after attending our workshop (residents: 47% vs. 63%, p=0.025 and fellows: 56% vs. 65%, p=0.13). All the participants agreed that the workshop helped reduce their anxiety levels regarding robotic surgery and that they feel safer using the robot in clinical settings after attending the workshop. There was unanimous agreement that they would like to see this course offered again in the future.

Conclusion: Our first-of-its-kind robotic workshop in Canada led to a significant improvement in trainees’ confidence about using robotic surgery. There was an effective improvement in general surgery residents' knowledge after the workshop, but there was not a significant increase in fellow’s competence, which indicates the need to tailor this workshop according to training level of surgical trainees. Our future efforts will focus on incorporating insight from this workshop and exploring different measures of technical competence to ultimately shape a longitudinal robotic curriculum in Canada.