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Proficiency-based progression training for robotic surgery skills training : a randomized clinical trial

Ruben De Groote, Stefano Puliatti, Marco Amato, Elio Mazzone, Giuseppe Rosiello, Rui Farinha, Artur Paludo, Liesbeth Desender (UGent) , Ben Van Cleynenbreugel, Brendan P. Bunting, et al.
(2022) BJU INTERNATIONAL. 130(4). p.528-535
Author
Organization
Abstract
Objective To determine whether proficiency-based progression (PBP) training leads to better robotic surgical performance compared to traditional training (TT), given that the value of PBP training for learning robotic surgical skills is unclear. Materials and Methods The PROVESA trial is a multicentric, prospective, randomized and blinded clinical study comparing PBP training with TT for robotic suturing and knot-tying anastomosis skills. A total of 36 robotic surgery-naive junior residents were recruited from 16 training sites and 12 residency training programmes. Participants were randomly allocated to metric-based PBP training or the current standard of care TT, and compared at the end of training. The primary outcome was percentage of participants reaching the predefined proficiency benchmark. Secondary outcomes were the numbers of procedure steps and errors made. Results Of the group that received TT, 3/18 reached the proficiency benchmark versus 12/18 of the PBP group (i.e. the PBP group were similar to 10 times as likely to demonstrate proficiency [P = 0.006]). The PBP group demonstrated a 51% reduction in number of performance errors from baseline to the final assessment (18.3 vs 8.9). The TT group demonstrated a marginal improvement (15.94 vs 15.44) in errors made. Conclusions The PROVESA trial is the first prospective randomized controlled trial on basic skills training in robotic surgery. Implementation of a PBP training methodology resulted in superior surgical performance for robotic suturing and knot-tying anastomosis performance. Compared to TT, better surgical quality could be obtained by implementing PBP training for basic skills in robotic surgery.
Keywords
basic skills training, proficiency-based progression, robotic surgery, training, surgical simulation, #Urology, OPERATING-ROOM, PERFORMANCE, ACQUISITION, SIMULATION, RESIDENTS

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MLA
De Groote, Ruben, et al. “Proficiency-Based Progression Training for Robotic Surgery Skills Training : A Randomized Clinical Trial.” BJU INTERNATIONAL, vol. 130, no. 4, Wiley, 2022, pp. 528–35, doi:10.1111/bju.15811.
APA
De Groote, R., Puliatti, S., Amato, M., Mazzone, E., Rosiello, G., Farinha, R., … Gallagher, A. G. (2022). Proficiency-based progression training for robotic surgery skills training : a randomized clinical trial. BJU INTERNATIONAL, 130(4), 528–535. https://doi.org/10.1111/bju.15811
Chicago author-date
De Groote, Ruben, Stefano Puliatti, Marco Amato, Elio Mazzone, Giuseppe Rosiello, Rui Farinha, Artur Paludo, et al. 2022. “Proficiency-Based Progression Training for Robotic Surgery Skills Training : A Randomized Clinical Trial.” BJU INTERNATIONAL 130 (4): 528–35. https://doi.org/10.1111/bju.15811.
Chicago author-date (all authors)
De Groote, Ruben, Stefano Puliatti, Marco Amato, Elio Mazzone, Giuseppe Rosiello, Rui Farinha, Artur Paludo, Liesbeth Desender, Ben Van Cleynenbreugel, Brendan P. Bunting, Alexandre Mottrie, and Anthony G. Gallagher. 2022. “Proficiency-Based Progression Training for Robotic Surgery Skills Training : A Randomized Clinical Trial.” BJU INTERNATIONAL 130 (4): 528–535. doi:10.1111/bju.15811.
Vancouver
1.
De Groote R, Puliatti S, Amato M, Mazzone E, Rosiello G, Farinha R, et al. Proficiency-based progression training for robotic surgery skills training : a randomized clinical trial. BJU INTERNATIONAL. 2022;130(4):528–35.
IEEE
[1]
R. De Groote et al., “Proficiency-based progression training for robotic surgery skills training : a randomized clinical trial,” BJU INTERNATIONAL, vol. 130, no. 4, pp. 528–535, 2022.
@article{01GS7JCFZE5DTNASZFJRNGC8TQ,
  abstract     = {{Objective

To determine whether proficiency-based progression (PBP) training leads to better robotic surgical performance compared to traditional training (TT), given that the value of PBP training for learning robotic surgical skills is unclear.

Materials and Methods

The PROVESA trial is a multicentric, prospective, randomized and blinded clinical study comparing PBP training with TT for robotic suturing and knot-tying anastomosis skills. A total of 36 robotic surgery-naive junior residents were recruited from 16 training sites and 12 residency training programmes. Participants were randomly allocated to metric-based PBP training or the current standard of care TT, and compared at the end of training. The primary outcome was percentage of participants reaching the predefined proficiency benchmark. Secondary outcomes were the numbers of procedure steps and errors made.

Results

Of the group that received TT, 3/18 reached the proficiency benchmark versus 12/18 of the PBP group (i.e. the PBP group were similar to 10 times as likely to demonstrate proficiency [P = 0.006]). The PBP group demonstrated a 51% reduction in number of performance errors from baseline to the final assessment (18.3 vs 8.9). The TT group demonstrated a marginal improvement (15.94 vs 15.44) in errors made.

Conclusions

The PROVESA trial is the first prospective randomized controlled trial on basic skills training in robotic surgery. Implementation of a PBP training methodology resulted in superior surgical performance for robotic suturing and knot-tying anastomosis performance. Compared to TT, better surgical quality could be obtained by implementing PBP training for basic skills in robotic surgery.}},
  author       = {{De Groote, Ruben and  Puliatti, Stefano and  Amato, Marco and  Mazzone, Elio and  Rosiello, Giuseppe and  Farinha, Rui and  Paludo, Artur and Desender, Liesbeth and  Van Cleynenbreugel, Ben and  Bunting, Brendan P. and  Mottrie, Alexandre and  Gallagher, Anthony G.}},
  issn         = {{1464-4096}},
  journal      = {{BJU INTERNATIONAL}},
  keywords     = {{basic skills training,proficiency-based progression,robotic surgery,training,surgical simulation,#Urology,OPERATING-ROOM,PERFORMANCE,ACQUISITION,SIMULATION,RESIDENTS}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{528--535}},
  publisher    = {{Wiley}},
  title        = {{Proficiency-based progression training for robotic surgery skills training : a randomized clinical trial}},
  url          = {{http://doi.org/10.1111/bju.15811}},
  volume       = {{130}},
  year         = {{2022}},
}
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