S. Williams-Perez1, C. Anbarasu1, J. Chen1, S. Awad1,3, E. Choi1,3, G. Van Buren1, W. Fisher1, Y. Rojas-Khalil1, S. Kuy1,3, R. Fernandez1, P. Parikh1, T. Rosengart1, N. Becker2, C. Chai1,3, R. Cotton1,3, D. Erstad1,3 1Baylor College Of Medicine, Surgery, Houston, TX, USA 2Hackensack Meridian Health, Surgery, Hackensack, NJ, USA 3Michael E. DeBakey Veterans Affairs Medical Center, Surgery, Houston, TX, USA
Introduction: Robotic-assisted surgery (RAS) utilization for general surgery procedures has rapidly increased. There is currently no standardized RAS education curriculum, and residency programs have addressed this issue with grassroots efforts. Curricula are often heterogeneous in training components and length in addition to being poorly attended by residents. The Baylor College of Medicine general surgery residency previously employed a condensed, four-week training curriculum. We report barriers to training and preferred components to prepare residents for practice readiness.
Methods: The program included four-week cycles of weekly didactic sessions, simulation, and online modules. Categorical and preliminary general surgery residents offered the program received an electronic, confidential survey via institutional email one year after partaking in the curriculum.
Results: Responses were provided by 38 (50%) general surgery residents distributed evenly across clinical years. Twenty-six percent never attended the prior training sessions, and only 13% attended all sessions. Barriers to participation included time of day (4 pm) (36.1%) and lack of clinical coverage (33.3%). Eighty percent created an online Intuitive account, but only 44% reported completing online learning modules. Reported limitations to training included unclear milestones by clinical year (73%), lack of organized curriculum (68%), and too few freestanding training consoles (54%). Only 3 (8%) respondents indicated a lack of interest in robotic surgery training. Overall, residents prefer a curriculum that spans the duration of residency (84.2%) rather than one-month (13%). Surgeon console time (78%) and simulation (15%) were perceived as the highest yield modalities for learning. While 86% felt comfortable operating as bedside assist following the training program, only 36% felt comfortable operating on the robotic console. Among senior residents (PGY4-5), only 31% reported feeling practice-ready with RAS after the prior program.
Conclusion: General surgery residents prefer robotic surgery training curriculum that spans the duration of training with specific milestones for each post-graduate year. Console time, both in the operating room and simulation, was perceived as the highest yield method for skill acquisition. Barriers to undergoing training include clinical duties and time of day. Based on these findings, we have transitioned to a longitudinal, 5-year curriculum with focus on console experience.