Shaw Robert D, Eid Mark A, Bleicher Josh, Broecker Justine, Caesar Ben, Chin Ryan, Meyer Courtney, Mitsakos Anastasios, Stolarksi Allan E, Theiss Lauren, Smith Brigitte K, Ivatury Srinivas J
Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire; VA Outcomes Group, VA Quality Scholars Program; Geisel School of Medicine, Hanover, New Hampshire.
J Surg Educ. 2022 May-Jun;79(3):606-613. doi: 10.1016/j.jsurg.2021.11.005. Epub 2021 Nov 26.
OBJECTIVE: To assess the current barriers in robotic surgery training for general surgery residents. DESIGN: Multi-institutional web-based survey. SETTING: 9 academic medical centers with a general surgery residency. PARTICIPANTS: General surgery residents of at least PGY-3 training level. RESULTS: 163 general surgery residents were contacted with 80 responses (49.1%). The most common responders were PGY-3s (38.8%) followed by PGY-5s (27.5%). The Northeast represented 42.5% of responses. Colorectal cases were the most common robotic case residents were involved in (51.3%). Residents' typical roles were assisting at the bedside (31.3%) and splitting time between assisting at the bedside and operating at the surgeon console (31.3%). 43% report to be either extremely or somewhat dissatisfied with their robotic surgery experience. 62.5% report they do not intend to integrate robotic surgery into their future practice. 93.8% of residents have a standardized robotic curriculum. 47.5% report using the simulator only during required didactic time with 52.5% having the robotic simulator conveniently located. The majority of residents report that the presence of dual consoles and first-assists in robotic cases enhance their robotic training (93% - 62%, respectively). 72.5% felt like they had more autonomy during laparoscopic cases and 96.8% of residents felt that an attendings' lack of experience impacted their time operating at the surgeon console. CONCLUSIONS: General surgery residents report lack of effective OR teaching, real clinical experience, and simulated experience as main barriers in their robotic surgery training. Dual consoles and first-assistants are favorably looked upon. Lack of attending experience and comfort were universally negatively associated with resident participation. For residents interested in robotic surgery, advocating for more robust investment in dual consoles, first-assistants, and faculty development would likely improve their robotic surgery training experience. However, residency programs should consider whether robotic surgery should be a core competency of an already time restricted training paradigm.
目的：评估普通外科住院医师机器人手术培训当前存在的障碍。 设计：基于网络的多机构调查。 地点：9个设有普通外科住院医师培训项目的学术医疗中心。 参与者：至少处于PGY - 3培训水平的普通外科住院医师。 结果：联系了163名普通外科住院医师，收到80份回复（49.1%）。最常见的回复者是PGY - 3级住院医师（38.8%），其次是PGY - 5级住院医师（27.5%）。东北部地区的回复占42.5%。结直肠手术病例是住院医师参与最多的机器人手术病例（51.3%）。住院医师的典型角色是在床边协助（31.3%）以及在床边协助和在主刀控制台操作之间分配时间（31.3%）。43%的人表示对他们的机器人手术经历极其或有些不满意。62.5%的人表示他们不打算在未来的实践中融入机器人手术。93.8%的住院医师有标准化的机器人课程。47.5%的人报告仅在规定的教学时间使用模拟器，52.5%的人表示机器人模拟器位置便利。大多数住院医师报告说，机器人手术病例中双控制台的存在和第一助手的配备增强了你他们的机器人手术培训（分别为93%和62%）。72.5%的人感觉他们在腹腔镜手术中有更多自主权，96.8%的住院医师认为主治医生缺乏经验影响了他们在主刀控制台操作的时间。 结论：普通外科住院医师报告称，缺乏有效的手术室教学、实际临床经验和模拟经验是他们机器人手术培训的主要障碍。双控制台和第一助手受到好评。主治医生缺乏经验和舒适度普遍与住院医师的参与呈负相关。对于对机器人手术感兴趣的住院医师，倡导对双控制台、第一助手和教员发展进行更有力的投资可能会改善他们的机器人手术培训体验。然而，住院医师培训项目应考虑机器人手术是否应成为本就时间紧张的培训模式的核心能力。
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Zotero 插件