Department of Surgery, New York Medical College, Westchester Medical Center, Valhalla, New York.
Department of Surgery, New York Medical College, Westchester Medical Center, Valhalla, New York.
J Surg Educ. 2023 Nov;80(11):1723-1735. doi: 10.1016/j.jsurg.2023.08.019. Epub 2023 Sep 26.
The aim of this study was to evaluate the responsiveness of postgraduate year (PGY) general surgery residents (GSRs) to surgeon console ergonomics within the robotic-assisted surgery training (RAST) program.
This was a prospective educational study. GSRs were prepared with a pretraining educational video. Faculty provided one-on-one resident hands-on training and testing. Nine proficiency criteria (emergency stop & recover; left side pod adjustments; touchpad controls; footswitch panel; energy control pedals; camera control & focus; arm swap; master & finger clutch; dual console settings control) were assessed with a 5-point Likert-scale. Responsiveness was defined as change in performance over time. The robotic platform was Da Vinci Xi (Intuitive Surgical, Sunnyvale, CA). The Dundee ready educational environment measure (DREEM) inventory was used by GSRs to assess the educational environment.
Tertiary care academic teaching institution.
A total of 22 GSRs: 4 PGY 1, 4 PGY 2, 4 PGY 3, 5 PGY 4, 5 PGY 5.
From June 2022 to March 2023 the hands-on console time decreased at testing when compared to baseline: median 39.0 (range 37-41) vs 20.1 (range 19-22) minutes, respectively. There was no difference in mean hands-on testing scores stratified by PGY: 4.85±0.4 PGY1; 4.98 ± 0.3 PGY2; 4.86 ± 0.4 PGY3, 4.88 ± 0.2 PGY4, and 4.91 ± 0.1 PGY5 (ANOVA test; p = 0.095). The overall DREEM score was 167.1 ± 16.9 with CAC = 0.908 (excellent internal consistency).
Training in ergonomics on the surgeon console impacted the responsiveness of the GSRs with 51% console time reduction. There were no differences in hands-on testing scores among PGYs. Perception of the educational environment by the GSRs was high.
本研究旨在评估机器人辅助手术培训（RAST）计划中住院医师（GSR）对手术控制台人体工程学的反应能力。
这是一项前瞻性教育研究。GSR 接受了预培训教育视频的培训。教员提供一对一的居民动手培训和测试。九项熟练标准（紧急停止和恢复；左侧吊舱调整；触摸板控制；脚踏板；能量控制踏板；摄像头控制和焦点；手臂交换；主和手指离合器；双控制台设置控制）使用 5 分李克特量表进行评估。响应性被定义为随时间的性能变化。机器人平台是达芬奇 Xi（直觉外科公司，加利福尼亚州森尼韦尔）。GSR 使用邓迪准备教育环境量表（DREEM）清单评估教育环境。
三级保健学术教学机构。
共 22 名 GSR：4 名 PGY1、4 名 PGY2、4 名 PGY3、5 名 PGY4、5 名 PGY5。
2022 年 6 月至 2023 年 3 月，与基线相比，测试时的实际控制台时间减少：中位数 39.0（范围 37-41）与 20.1（范围 19-22）分钟。按 PGY 分层，实际测试得分无差异：4.85±0.4 PGY1；4.98 ± 0.3 PGY2；4.86 ± 0.4 PGY3、4.88 ± 0.2 PGY4 和 4.91 ± 0.1 PGY5（方差分析检验；p=0.095）。总体 DREEM 评分为 167.1 ± 16.9，CAC=0.908（内部一致性良好）。
手术控制台人体工程学培训对 GSR 的反应能力产生了影响，控制台时间减少了 51%。PGY 之间的实际测试得分没有差异。GSR 对教育环境的感知度较高。
