Proficiency Based Robotics Training Curriculum: Skill Acquisition & Transferability of Skills to Live Porcine Models

Study Overview
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Brief Summary
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The goal of the project is to define the optimal learning environment and protocol for dvSS® simulation activities using medical students as robotic-naïve research participants.

Detailed Description
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The goal of the project is to define the optimal learning environment and protocol for dvSS® simulation activities using medical students as robotic-naïve research participants. The investigators propose to accomplish this goal through the following aims: Specific Aim #1: to investigate the total training time and the total number of repetitions required for participants to achieve proficiency (as defined on the dvSS® as 91%) for each of the selected exercises in selected dVSS activities. Specific Aim #2: to measure the transferability of skills acquired through a robotic simulation to live porcine models compared to nonintervention controls. The study will compare the effect of training with the dVSS to similar nonintervention controls by grading a suturing procedure on a live porcine model. Findings generated from this study will provide new insight into the efficacy of the dVSS as a simulation- based training tool for medical practitioners. Collectively, this work will build upon the narrow knowledge base on how to develop a nationally accredited simulation-based robotics curriculum. This study undoubtedly furthers the GWU SMHS mission of education, research, and healing. The study seeks to understand the learning curve students can achieve by simulation-based training and then to directly apply that training to a safe in vivo model in order to determine training interventions that can inform a robotic curriculum both locally at GWU and throughout the country. Additionally, this study is innovative in that it is the first of its kind to correlate skills acquired on a robotic-simulation gynecology based tool to a live porcine model. It seeks to enhance the current GWU GYN robotics- curriculum and assist with the development of a specific curriculum within the next year. Although the immediate goal is for planning toward a gynecology robotic curriculum, results of this study could also inform development of robotic programs in other disciplines such as general surgery and urology. Considering, the limited development of simulation-based robotics curriculum, further refining the curriculum would allow GWU to continue to be globally recognized as a medical center that embraces the challenge of…transforming health care, and expanding research to enrich and improve the lives of those [served]. It also serves to leverage the SMHS brand to enhance opportunities for recognition, distinction..& marketing. Preparing a generation of well-trained and confident gynecologic surgeons will allow providers to administer safe care to women.

Official Title
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Proficiency Based Robotics Training Curriculum: Skill Acquisition & Transferability of Skills

Conditions
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Medical Students Naive to Surgical Robotics

Intervention / Treatment
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* Behavioral: Surgical Simulation Practice Modules


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: medical & physician assistant students at George Washington University with no prior experience using a surgical robot Exclusion Criteria: medical & physician assistant students at George Washington University with prior experience using a surgical robot students not enrolled in the medical or physician assistant program at George Washington University
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Control Group<br>Participants in the Control Group (CG) were asked to attend an orientation reviewing the study. Three weeks later they returned and were filmed timed completing a suturing activity on the porcine model. | |
| Experimental: Experimental Group<br>Participants in the Experimental Group (EG) were asked to attend an orientation reviewing the study. Then they were instructed to complete 4 activities on the dvSS ® that modeled suturing techniques in minimally invasive robotics-assisted surgery. EG participants repeated these 4 activities over a period of 2 weeks until they reached proficiency (91%) in all 4 activities. 4. Participants were asked to return where they were filmed and timed completing a suturing activity on the porcine model. | Behavioral: Surgical Simulation Practice Modules<br>* The surgical simulation practice modules simulate surgical settings for suturing.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Global Evaluative Assessment of Robotic Skills (GEARS) Scale | GEARS is a validated assessment tool for grading overall technical proficiency for robotic surgery. The overall proficiency score is a composite score of five different measures: depth perception, bimanual dexterity, efficiency, force sensitivity, and robotic control. Each of these subscale scores are graded 1-5, with 1 being poor and 5 being excellent. The total score is the summation of the scores from each of the five subscales and ranges from 5 to 25. | Three weeks after orientation | 
| Amount Time to Suture | time, measured in minutes, it took each participant to perform the suturing activity | Three weeks after orientation | 
| Amount of Time to Achieve Proficiency | time, measured in minutes, it took each participant in the intervention group to achieve surgical proficiency on the robotic simulator. | assessed after the orientation and prior to the three week date for the final suturing assessment |