Department of Surgery, Division of Cardiothoracic Surgery, University of Colorado School of Medicine, 12631 E. 17th Ave, MS C-302, Aurora, CO, 80045, USA.
Adult and Child Consortium for Health Outcomes Research (ACCORDS), University of Colorado School of Medicine, 12631 E. 17th Ave, MS C-302, Aurora, CO, 80045, USA.
J Robot Surg. 2022 Apr;16(2):393-400. doi: 10.1007/s11701-021-01255-y. Epub 2021 May 23.
The objective of this study was to evaluate the educational impact following the implementation of a robotic thoracic surgery program on cardiothoracic (CT) surgery trainees. We hypothesized that the introduction of a robotic thoracic surgery program would adversely affect the CT surgery resident experience, decreasing operative involvement and subsequent competency of surgical procedures. CT surgery residents and thoracic surgery attendings from a single academic institution were administered a recurring, electronic survey from September 2019 to September 2020 following each robotic thoracic surgery case. Surveys evaluated resident involvement and operative performance. This study was exempt from review by our Institutional Review Board. Attendings and residents completed surveys for 86 and 75 cases, respectively. Residents performed > 50% of the operation independently at the surgeon console in 66.2 and 73.3% of cases according to attending and resident responses, respectively. The proportion of trainees able to perform > 75% of the operation increased with each increasing year in training (p = 0.002). Based on the Global Evaluative Assessment of Robotic Skills grading tool, third-year residents averaged higher scores compared to first-year residents (22.9 versus 17.4 out of 30 possible points, p < 0.001), indicating that more extensive prior operative experience could shorten the learning curve of robotic thoracic surgery. CT surgery residents remain actively involved in an operative role during the establishment of a robotic thoracic surgery program. The transition to a robotic thoracic surgery platform appears feasible in a large academic setting without jeopardizing the educational experience of resident trainees.
本研究旨在评估在实施机器人辅助胸腔手术项目后对心胸外科(CT)外科受训者的教育影响。我们假设,机器人辅助胸腔手术项目的引入将对 CT 外科住院医师的经验产生不利影响,减少手术参与度和随后手术程序的熟练程度。在每次机器人辅助胸腔手术后,我们对来自同一学术机构的 CT 外科住院医师和胸外科主治医生进行了一次重复的电子调查。调查评估了住院医师的参与度和手术表现。本研究豁免了我们机构审查委员会的审查。主治医生和住院医师分别完成了 86 例和 75 例调查。根据主治医生和住院医师的答复,住院医师分别独立在手术控制台完成了超过 50%和 73.3%的手术操作。随着培训年限的增加,能够完成超过 75%手术操作的受训者比例也随之增加(p=0.002)。根据全球机器人技能评估工具(Global Evaluative Assessment of Robotic Skills,GEARS)评分,三年级住院医师的平均得分高于一年级住院医师(30 分制中分别为 22.9 分和 17.4 分,p<0.001),这表明更多的手术经验可以缩短机器人辅助胸腔手术的学习曲线。在机器人辅助胸腔手术项目建立的过程中,CT 外科住院医师仍然积极参与手术。在大型学术环境中,向机器人辅助胸腔手术平台的过渡似乎是可行的,而不会危及住院医师的教育经验。