The Griffin Institute, Northwick Park & St Marks' Hospital, London, UK.
Wellcome/ESPRC Centre for Interventional Surgical Sciences (WEISS), University College London (UCL), London, UK.
J Robot Surg. 2024 Aug 6;18(1):305. doi: 10.1007/s11701-024-02062-x.
Standardised proficiency-based progression is the cornerstone of safe robotic skills acquisition, however, is currently lacking within surgical training curricula. Expert consensuses have defined a modular pathway to accredit surgeons. This study aimed to address the lack of a formal, pre-clinical core robotic skills, proficiency-based accreditation curriculum in the UK. Novice robotic participants underwent a four-day pre-clinical core robotic skills curriculum incorporating multimodal assessment. Modifiable-Global Evaluative Assessment of Robotic Skills (M-GEARS), VR-automated performance metrics (APMs) and Objective Clinical Human Reliability Analysis (OCHRA) error methodology assessed performance at the beginning and end of training. Messick's validity concept and a curriculum evaluation model were utilised. Feedback was collated. Proficiency-based progression, benchmarking, tool validity and reliability was assessed through comparative and correlational statistical methods. Forty-seven participants were recruited. Objective assessment of VR and dry models across M-GEARS, APMs and OCHRA demonstrated significant improvements in technical skill (p < 0.001). Concurrent validity between assessment tools demonstrated strong correlation in dry and VR tasks (r = 0.64-0.92, p < 0.001). OCHRA Inter-rater reliability was excellent (r = 0.93, p < 0.001 and 81% matched error events). A benchmark was established with M-GEARS and for the curriculum at 80%. Thirty (63.82%) participants passed. Feedback was 5/5 stars on average, with 100% recommendation. Curriculum evaluation fulfilled all five domains of Messick's validity. Core robotic surgical skills training can be objectively evaluated and benchmarked to provide accreditation in basic robotic skills. A strategy is necessary to enrol standardised curricula into national surgical training at an early stage to ensure patient safety.
标准化基于能力的进阶是安全机器人技能获取的基石,但目前在外科培训课程中缺乏这种进阶。专家共识已经定义了一种模块化的途径来认证外科医生。本研究旨在解决英国缺乏正式的、临床前核心机器人技能、基于能力的认证课程的问题。新手机器人参与者接受了为期四天的临床前核心机器人技能课程,包括多模态评估。可修改的全球机器人技能评估(M-GEARS)、虚拟现实自动性能指标(APMs)和客观临床人类可靠性分析(OCHRA)错误方法在培训开始和结束时评估表现。使用了 Messick 的有效性概念和课程评估模型。收集了反馈。通过比较和相关的统计方法评估基于能力的进阶、基准、工具有效性和可靠性。招募了 47 名参与者。在 M-GEARS、APMs 和 OCHRA 中,对 VR 和干模型的客观评估显示,技术技能有显著提高(p<0.001)。评估工具之间的并行有效性在干和 VR 任务中显示出很强的相关性(r=0.64-0.92,p<0.001)。OCHRA 内部评分者可靠性非常好(r=0.93,p<0.001,81%的匹配错误事件)。使用 M-GEARS 建立了基准,课程的基准为 80%。30 名(63.82%)参与者通过。反馈平均为 5/5 星,推荐率为 100%。课程评估满足了 Messick 有效性的所有五个领域。核心机器人手术技能培训可以进行客观评估和基准测试,以提供基本机器人技能的认证。需要制定一项策略,在早期将标准化课程纳入国家外科培训,以确保患者安全。
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