Walshaw Josephine, Fadel Michael G, Boal Matthew, Yiasemidou Marina, Elhadi Muhammed, Pecchini Francesca, Carrano Francesco Maria, Massey Lisa H, Fehervari Matyas, Khan Omar, Antoniou Stavros A, Nickel Felix, Perretta Silvana, Fuchs Hans F, Hanna George B, Francis Nader K, Kontovounisios Christos
Leeds Institute of Medical Research, St James's University Hospital, University of Leeds, Leeds, United Kingdom.
Department of Surgery and Cancer, Imperial College London, London, United Kingdom.
Int J Surg. 2025 Apr 1;111(4):2791-2809. doi: 10.1097/JS9.0000000000002284.
The rapid adoption of robotic surgical systems has overtook the development of standardized training and competency assessment for surgeons, resulting in an unmet educational need in this field. This systematic review aims to identify the essential components and evaluate the validity of current robotic training curricula across all surgical specialties.
A systematic search of MEDLINE, EMBASE, Emcare, and CINAHL databases was conducted to identify the studies reporting on multi-specialty or specialty-specific surgical robotic training curricula, between January 2000 and January 2024. We extracted the data according to Kirkpatrick's curriculum evaluation model and Messick's concept of validity. The quality of studies was assessed using the Medical Education Research Study Quality Instrument (MERSQI).
From the 3687 studies retrieved, 66 articles were included. The majority of studies were single-center ( n = 52, 78.8%) and observational ( n = 58, 87.9%) in nature. The most commonly reported curriculum components include didactic teaching ( n = 48, 72.7%), dry laboratory skills ( n = 46, 69.7%), and virtual reality (VR) simulation ( n = 44, 66.7%). Curriculum assessment methods varied, including direct observation ( n = 44, 66.7%), video assessment ( n = 26, 39.4%), and self-assessment (6.1%). Objective outcome measures were used in 44 studies (66.7%). None of the studies were fully evaluated according to Kirkpatrick's model, and five studies (7.6%) were fully evaluated according to Messick's framework. The studies were generally found to have moderate methodological quality with a median MERSQI of 11.
Essential components in robotic training curricula identified were didactic teaching, dry laboratory skills, and VR simulation. However, variability in assessment methods used and notable gaps in curricula validation remain evident. This highlights the need for standardized evidence-based development, evaluation, and reporting of robotic curricula to ensure the effective and safe adoption of robotic surgical systems.
机器人手术系统的迅速普及超过了外科医生标准化培训和能力评估的发展速度，导致该领域的教育需求未得到满足。本系统评价旨在确定基本组成部分，并评估当前所有外科专业机器人培训课程的有效性。
对MEDLINE、EMBASE、Emcare和CINAHL数据库进行系统检索，以确定2000年1月至2024年1月期间报告多专业或特定专业手术机器人培训课程的研究。我们根据柯克帕特里克的课程评估模型和梅西克的效度概念提取数据。使用医学教育研究质量工具（MERSQI）评估研究质量。
在检索到的3687项研究中，纳入了66篇文章。大多数研究本质上是单中心的（n = 52，78.8%）和观察性的（n = 58，87.9%）。最常报告的课程组成部分包括理论教学（n = 48，72.7%）、模拟实验室技能（n = 46，69.7%）和虚拟现实（VR）模拟（n = 44，66.7%）。课程评估方法各不相同，包括直接观察（n = 44，66.7%）、视频评估（n = 26，39.4%）和自我评估（6.1%）。44项研究（66.7%）使用了客观结果指标。没有一项研究根据柯克帕特里克模型进行全面评估，五项研究（7.6%）根据梅西克框架进行了全面评估。总体而言，这些研究的方法学质量中等，MERSQI中位数为11。
确定的机器人培训课程基本组成部分包括理论教学、模拟实验室技能和VR模拟。然而，所使用的评估方法存在差异，课程验证方面也存在明显差距。这凸显了对机器人课程进行标准化的循证开发、评估和报告的必要性，以确保机器人手术系统的有效和安全应用。
