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

Ruben De Groote; Stefano Puliatti; Marco Amato; Elio Mazzone; Giuseppe Rossiello; Rui Farinha; Artur Paludo; Liesbeth Desender; Ben Van Cleynenbreugel; Brendan P. Bunting; Alexandre Mottrie; Anthony G. Gallagher; Alessandro Larcher; Pieter Uvin; Jasper Decoene; Tom Tuyten; Mathieu D’Hondt; Nicolas Hubert; Charles Chatzopoulos; Bart De Troyer

doi:10.1111/bju.15811

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

Ruben De Groote, Stefano Puliatti, Marco Amato, Elio Mazzone, Giuseppe Rossiello, Rui Farinha, Artur Paludo, Liesbeth Desender, Ben Van Cleynenbreugel, Brendan P. Bunting, Alexandre Mottrie, Anthony G. Gallagher, Alessandro Larcher, Pieter Uvin, Jasper Decoene, Tom Tuyten, Mathieu D’Hondt, Nicolas Hubert, Charles Chatzopoulos, Bart De Troyer

Research output: Contribution to journal › Article › peer-review

8 Citations (Scopus)

115 Downloads (Pure)

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-naïve 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 ~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.

Original language	English
Pages (from-to)	528-535
Number of pages	8
Journal	BJU International
Volume	130
Issue number	4
Early online date	25 May 2022
DOIs	https://doi.org/10.1111/bju.15811
Publication status	Published (in print/issue) - 31 Oct 2022

Bibliographical note

Funding Information:
This study was conducted on behalf of the Junior European Association of Urology (EAU) Robotic Urology Section (ERUS)/Young Academic Urologists working group on robot-assisted surgery of the EAU and the ERUS Education Working Group. ERUS Scientific Committee sponsorship of the seven Belgian surgeons is acknowledged. Alessandro Larcher (Division of Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy), Pieter Uvin (Department of Urology, AZ Sint-Jan, Bruges, Belgium), Jasper Decoene (Department of Urology, OLV van Lourdes Hospital, Waregem, Belgium), Tom Tuyten (Department of Urology, Jessa Hospital, Hasselt, Belgium), Mathieu D'Hondt (Department of Surgery, AZ Groeninge, Kortrijk, Belgium), Nicolas Hubert (Department of Urology, CHR de la Citadelle, Liège, Belgium), Charles Chatzopoulos (Department of Urology, Chirec Hospital, Brussels, Belgium), Bart De Troyer (Department of Urology, AZ Nikolaas, Sint-Niklaas, Belgium).

Publisher Copyright:
© 2022 BJU International.

Keywords

Urology
basic skills training
#Urology
surgical simulation
training
proficiency-based progression
robotic surgery

Access to Document

10.1111/bju.15811

BJU International - 2022 - De Groote - Proficiency based progression training for robotic skill training a randomizedAuthor Accepted Manuscript, 847 KB

Cite this

De Groote, R., Puliatti, S., Amato, M., Mazzone, E., Rossiello, G., Farinha, R., Paludo, A., Desender, L., Van Cleynenbreugel, B., Bunting, B. P., Mottrie, A., Gallagher, A. G., Larcher, A., Uvin, P., Decoene, J., Tuyten, T., D’Hondt, M., Hubert, N., Chatzopoulos, C., & De Troyer, B. (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

@article{3f92ffd99e464c24a8b03c1c82fccdcd,

title = "Proficiency-based progression training for robotic surgery skills training: a randomized clinical trial",

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-na{\"i}ve 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 ~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 = "Urology, basic skills training, #Urology, surgical simulation, training, proficiency-based progression, robotic surgery",

author = "{De Groote}, Ruben and Stefano Puliatti and Marco Amato and Elio Mazzone and Giuseppe Rossiello and Rui Farinha and Artur Paludo and Liesbeth Desender and {Van Cleynenbreugel}, Ben and Bunting, {Brendan P.} and Alexandre Mottrie and Gallagher, {Anthony G.} and Alessandro Larcher and Pieter Uvin and Jasper Decoene and Tom Tuyten and Mathieu D{\textquoteright}Hondt and Nicolas Hubert and Charles Chatzopoulos and {De Troyer}, Bart",

note = "Funding Information: This study was conducted on behalf of the Junior European Association of Urology (EAU) Robotic Urology Section (ERUS)/Young Academic Urologists working group on robot-assisted surgery of the EAU and the ERUS Education Working Group. ERUS Scientific Committee sponsorship of the seven Belgian surgeons is acknowledged. Alessandro Larcher (Division of Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy), Pieter Uvin (Department of Urology, AZ Sint-Jan, Bruges, Belgium), Jasper Decoene (Department of Urology, OLV van Lourdes Hospital, Waregem, Belgium), Tom Tuyten (Department of Urology, Jessa Hospital, Hasselt, Belgium), Mathieu D'Hondt (Department of Surgery, AZ Groeninge, Kortrijk, Belgium), Nicolas Hubert (Department of Urology, CHR de la Citadelle, Li{\`e}ge, Belgium), Charles Chatzopoulos (Department of Urology, Chirec Hospital, Brussels, Belgium), Bart De Troyer (Department of Urology, AZ Nikolaas, Sint-Niklaas, Belgium). Publisher Copyright: {\textcopyright} 2022 BJU International.",

year = "2022",

month = oct,

day = "31",

doi = "10.1111/bju.15811",

language = "English",

volume = "130",

pages = "528--535",

journal = "BJU International",

issn = "1464-4096",

publisher = "John Wiley & Sons, Inc.",

number = "4",

}

De Groote, R, Puliatti, S, Amato, M, Mazzone, E, Rossiello, G, Farinha, R, Paludo, A, Desender, L, Van Cleynenbreugel, B, Bunting, BP, Mottrie, A, Gallagher, AG, Larcher, A, Uvin, P, Decoene, J, Tuyten, T, D’Hondt, M, Hubert, N, Chatzopoulos, C & De Troyer, B 2022, 'Proficiency-based progression training for robotic surgery skills training: a randomized clinical trial', BJU International, vol. 130, no. 4, pp. 528-535. https://doi.org/10.1111/bju.15811

TY - JOUR

T1 - Proficiency-based progression training for robotic surgery skills training

T2 - a randomized clinical trial

AU - De Groote, Ruben

AU - Puliatti, Stefano

AU - Amato, Marco

AU - Mazzone, Elio

AU - Rossiello, Giuseppe

AU - Farinha, Rui

AU - Paludo, Artur

AU - Desender, Liesbeth

AU - Van Cleynenbreugel, Ben

AU - Bunting, Brendan P.

AU - Mottrie, Alexandre

AU - Gallagher, Anthony G.

AU - Larcher, Alessandro

AU - Uvin, Pieter

AU - Decoene, Jasper

AU - Tuyten, Tom

AU - D’Hondt, Mathieu

AU - Hubert, Nicolas

AU - Chatzopoulos, Charles

AU - De Troyer, Bart

N1 - Funding Information: This study was conducted on behalf of the Junior European Association of Urology (EAU) Robotic Urology Section (ERUS)/Young Academic Urologists working group on robot-assisted surgery of the EAU and the ERUS Education Working Group. ERUS Scientific Committee sponsorship of the seven Belgian surgeons is acknowledged. Alessandro Larcher (Division of Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy), Pieter Uvin (Department of Urology, AZ Sint-Jan, Bruges, Belgium), Jasper Decoene (Department of Urology, OLV van Lourdes Hospital, Waregem, Belgium), Tom Tuyten (Department of Urology, Jessa Hospital, Hasselt, Belgium), Mathieu D'Hondt (Department of Surgery, AZ Groeninge, Kortrijk, Belgium), Nicolas Hubert (Department of Urology, CHR de la Citadelle, Liège, Belgium), Charles Chatzopoulos (Department of Urology, Chirec Hospital, Brussels, Belgium), Bart De Troyer (Department of Urology, AZ Nikolaas, Sint-Niklaas, Belgium). Publisher Copyright: © 2022 BJU International.

PY - 2022/10/31

Y1 - 2022/10/31

N2 - 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-naïve 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 ~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.

AB - 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-naïve 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 ~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.

KW - Urology

KW - basic skills training

KW - #Urology

KW - surgical simulation

KW - training

KW - proficiency-based progression

KW - robotic surgery

U2 - 10.1111/bju.15811

DO - 10.1111/bju.15811

M3 - Article

C2 - 37382230

SN - 1464-4096

VL - 130

SP - 528

EP - 535

JO - BJU International

JF - BJU International

IS - 4

ER -

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

Abstract

Bibliographical note

Keywords

Access to Document

Fingerprint

Cite this