Optimizing Robotic Simulation Training Among Obstetrics and Gynecology (OBGYN) Residents: A Randomized Pilot Study

Study Objective To assess the efficacy of an accelerated robotic simulation protocol in reducing repetitions needed to achieve training proficiency among OBGYN residents. Design Randomized controlled trial. Setting University teaching hospital. Patients or Participants Fifteen robotic-naive OBGYN residents from post-graduate years 1 to 4 were randomized to one of two pathways. Of those, thirteen completed the study. Interventions Residents were randomized into either the Express (accelerated) Pathway to Proficiency (EPP) or the Basic (conventional) Pathway to Proficiency (BPP) Protocols for training on the da Vinci Skills Simulator. As chosen by an expert robotic surgeon, the BPP training exercises consisted of Sea Spike (SS) 1 and 2, Energy Pedal (EnP) 1 and 2, and Ring Rollercoaster (RR) 1 and 3, while the EPP intervention group trained on the highest level of each exercise, specifically SS 2, EnP 2, and RR 3. The residents performed each exercise until they reached a proficiency level of 80%. The primary outcome was the number of repetitions required to achieve proficiency for each training exercise. Transfer of the acquired skills to one non-practiced exercise, Vessel Energy Dissection (VED), was assessed as the secondary outcome. Measurements and Main Results Participants in the EPP group acquired proficiency significantly faster (fewer repetitions required) in the EnP exercise (2.00±0.58 [EPP] vs 3.17±0.41 [BPP], p=0.002). The number of repetitions needed to acquire proficiency for SS (17.29±15.06 reps [EPP] vs 17.50±5.17 reps [BPP], p=0.97) and RR (19.14±15.22 reps [EPP] vs 21.00±13.83 reps [BPP], p=0.82) was similar between groups. There was no significant difference between the two groups with VED (p=0.98). Conclusion The EPP protocol, consisting of fewer training exercises, was not shown to be inferior to the BPP protocol. Our study suggests residents can train on the EPP Protocol without significant difference in acquisition and transfer of skills. Further research into this novel accelerated training protocol is warranted as an alternative to conventional training.