Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.
Department of Urology, Catharina Hospital, P.O. Box 1350, 5602 ZA, Eindhoven, The Netherlands.
J Robot Surg. 2019 Jun;13(3):435-447. doi: 10.1007/s11701-018-0894-2. Epub 2018 Nov 22.
To fulfil the need for a basic level of competence in robotic surgery (Brinkman et al., Surg Endosc Other Interv Tech 31(1):281-287, 2017; Dutch Health inspectorate (Inspectie voor de gezondheidszorg), Insufficient carefulness at the introduction of surgical robots (in Dutch: Onvoldoende zorgvuldigheid bij introductie van operatierobots), Igz, Utrecht, 2010), the NIVEL (Netherlands Institute for Healthcare Research) developed the 'Basic proficiency requirements for the safe use of robotic surgery' (BPR). Based on the BPR a 1-day robotic surgery training was organised to answer the following research questions: (1) Are novice robot surgeons able to accurately self-assess their knowledge and dexterity skills? (2) Is it possible to include the teaching of all BPRs in a 1-day training?
Based on the BPR, a robot surgery course was developed for residents and specialists (surgery, gynaecology and urology). In preparation, the participants completed an online e-module. The 1-day training consisted of a practical part on robot set-up, a theoretical section, and hands-on exercises on virtual reality robot simulators. Multiple online questionnaire was filled out by the participants at the end of the training to evaluate the perceived educational value of the course and to self-assess the degree to which BPRs were reached.
20 participants completed the training during the conference of the Dutch Association for Endoscopic Surgery (NVEC) in 2017. Participants indicated nearly all competency requirements were mastered at the end of the training. The competency requirements not mastered were, however, critical requirements for the safe use of the surgical robot. Skill simulation results show a majority of participants are unable to reach a proficient simulation score in basic skill simulation exercises.
Results show novice robot surgeons are too positive in the self-assessment of their own dexterity skills after a 1-day training. Self-assessment revealed uncertainty of the obtained knowledge level on requirements for the safe use of the surgical robot. Basic courses on robotic training should inform trainees about their results to enhance learning and inform them of their competence levels.
为了满足机器人手术基本能力的需求（Brinkman 等人，Surg Endosc Other Interv Tech 31(1):281-287, 2017；荷兰卫生监督局（Inspectie voor de gezondheidszorg），在引入手术机器人时不够谨慎（荷兰语：Onvoldoende zorgvuldigheid bij introductie van operatierobots），Igz，乌得勒支，2010 年），NIVEL（荷兰医疗保健研究协会）制定了“安全使用机器人手术的基本能力要求”（BPR）。基于 BPR，组织了为期 1 天的机器人手术培训，以回答以下研究问题：（1）新手机器人外科医生是否能够准确地自我评估他们的知识和灵巧技能？（2）是否可以在 1 天的培训中包含所有 BPR 的教学内容？
根据 BPR，为住院医师和专家（外科、妇科和泌尿科）开发了机器人手术课程。在准备阶段，参与者完成了在线电子模块。为期 1 天的培训包括机器人设置的实践部分、理论部分以及虚拟现实机器人模拟器的实践练习。培训结束后，参与者通过多项在线问卷评估课程的教育价值，并自我评估达到 BPR 的程度。
20 名参与者在 2017 年荷兰内窥镜外科学会（NVEC）会议期间完成了培训。参与者表示，在培训结束时，几乎所有的能力要求都已掌握。然而，未掌握的能力要求是安全使用手术机器人的关键要求。技能模拟结果表明，大多数参与者在基本技能模拟练习中无法达到熟练的模拟分数。
结果表明，新手机器人外科医生在 1 天的培训后对自己的灵巧技能自我评估过于积极。自我评估显示，他们对安全使用手术机器人的要求的知识水平存在不确定性。机器人培训基础课程应告知学员他们的模拟结果，以增强学习并告知他们的能力水平。
