The Association of Surgeons in Training, Royal College of Surgeons of England, London, England, UK.
Robotics and Digital Surgery Initiative, Royal College of Surgeons of England, London, England.
J Robot Surg. 2023 Aug;17(4):1443-1455. doi: 10.1007/s11701-022-01518-2. Epub 2023 Feb 9.
Robot-assisted surgery (RAS) continues to grow globally. Despite this, in the UK and Ireland, it is estimated that over 70% of surgical trainees across all specialities have no access to robot-assisted surgical training (RAST). This study aimed to provide educational stakeholders guidance on a pre-procedural core robotic surgery curriculum (PPCRC) from the perspective of the end user; the surgical trainee. The study was conducted in four Phases: P1: a steering group was formed to review current literature and summarise the evidence, P2: Pan-Specialty Trainee Panel Virtual Classroom Discussion, P3: Accelerated Delphi Process and P4: Formulation of Recommendations. Forty-three surgeons in training representing all surgical specialties and training levels contributed to the three round Delphi process. Additions to the second- and third-round surveys were formulated based on the answers and comments from previous rounds. Consensus opinion was defined as ≥ 80% agreement. There was 100% response from all three rounds. The resulting formulated guidance showed good internal consistency, with a Cronbach alpha of > 0.8. There was 97.7% agreement that a standardised PPCRC would be advantageous to training and that, independent of speciality, there should be a common approach (95.5% agreement). Consensus was reached in multiple areas: 1. Experience and Exposure, 2. Access and context, 3. Curriculum Components, 4 Target Groups and Delivery, 5. Objective Metrics, Benchmarking and Assessment. Using the Delphi methodology, we achieved multispecialty consensus among trainees to develop and reach content validation for the requirements and components of a PPCRC. This guidance will benefit from further validation following implementation.
机器人辅助手术(RAS)在全球范围内持续发展。尽管如此,在英国和爱尔兰,据估计,所有专业的外科培训生中,超过 70%都无法接受机器人辅助手术培训(RAST)。本研究旨在从外科培训生的角度为教育利益相关者提供关于术前核心机器人手术课程(PPCRC)的指导。该研究分四个阶段进行:P1:成立指导小组,审查现有文献并总结证据;P2:泛专业培训生小组虚拟课堂讨论;P3:加速德尔菲过程;P4:制定建议。来自所有外科专业和培训水平的 43 名受训外科医生参与了三轮德尔菲调查。根据前几轮的答案和意见,对第二轮和第三轮调查进行了补充。共识定义为≥80%的一致同意。三轮调查的回复率均为 100%。制定的指导意见显示出良好的内部一致性,Cronbach's alpha 值>0.8。所有三轮调查均有 100%的受访者认为标准化的 PPCRC 将有利于培训,并且无论专业如何,都应该采用共同的方法(95.5%的受访者同意)。在多个领域达成了共识:1. 经验和暴露;2. 获取和背景;3. 课程组成部分;4. 目标群体和交付;5. 客观指标、基准和评估。使用德尔菲法,我们在培训生中达成了多专业共识,制定并达成了 PPCRC 的要求和组成部分的内容验证。在实施后,该指南将需要进一步验证。