TY - JOUR
T1 - Robotic Pancreatoduodenectomy Biotissue Curriculum has Validity and Improves Technical Performance for Surgical Oncology Fellows
AU - Tam, Vernissia
AU - Zenati, Mazen
AU - Novak, Stephanie
AU - Chen, Yong
AU - Zureikat, Amer H.
AU - Zeh, Herbert J.
AU - Hogg, Melissa E.
N1 - Funding Information:
This work was supported by Intuitive Surgical Education Grant #0041191. M.H. receives funding from the Veterans Administration in way of salary support.
Publisher Copyright:
© 2017
PY - 2017/11
Y1 - 2017/11
N2 - Objective Obtaining the proficiency on the robotic platform necessary to safely perform a robotic pancreatoduodenectomy is particularly challenging. We hypothesize that by instituting a proficiency-based robotic training curriculum we can enhance novice surgeons’ skills outside of the operating room, leading to a shorter learning curve. Design A biotissue curriculum was designed consisting of sewing artificial organs to simulate a hepaticojejunostomy (HJ), gastrojejunostomy (GJ), and pancreaticojejunostomy (PJ). Three master robotic surgeons performed each biotissue anastomosis to assess validity. Using video review, trainee performance on biotissue drills was evaluated for time, errors and objective structured assessment of technical skills (OSATS) by 2 blinded graders. Setting This study is conducted at the University of Pittsburgh Medical Center (Pittsburgh, PA), a tertiary care academic teaching hospital. Participants In total, 14 surgical oncology fellows completed the biotissue curriculum. Results Fourteen fellows performed 196 anastomotic drills during the first year: 66 (HJ), 64 (GJ), and 66 (PJ). The fellows’ performances were analyzed as a group by attempt. The attendings’ first attempt outperformed the fellows’ first attempt in all metrics for every drill (all p < 0.05). More than 5 analyzed attempts of the HJ, there was improvement in time, errors, and OSATS (all p < 0.01); however, no metric reached attending performance. For the GJ, time, errors, and OSATS all improved more than 5 attempts (all p < 0.01), whereas only errors and OSATS reached proficiency. For the PJ, errors and OSATS both improved over attempts (p < 0.01) and reached proficiency; however, time did not statistically improve nor reach proficiency. The graders scoring correlated for errors and OSATS (p < 0.0001). Conclusion A pancreatoduodenectomy biotissue curriculum has face and construct validity. The curriculum is feasible and improves errors and technical performance. Time is the most difficult technical parameter to improve. This curriculum is a valid tool for teaching robotic pancreatoduodenectomies with established milestones for reaching optimum performance.
AB - Objective Obtaining the proficiency on the robotic platform necessary to safely perform a robotic pancreatoduodenectomy is particularly challenging. We hypothesize that by instituting a proficiency-based robotic training curriculum we can enhance novice surgeons’ skills outside of the operating room, leading to a shorter learning curve. Design A biotissue curriculum was designed consisting of sewing artificial organs to simulate a hepaticojejunostomy (HJ), gastrojejunostomy (GJ), and pancreaticojejunostomy (PJ). Three master robotic surgeons performed each biotissue anastomosis to assess validity. Using video review, trainee performance on biotissue drills was evaluated for time, errors and objective structured assessment of technical skills (OSATS) by 2 blinded graders. Setting This study is conducted at the University of Pittsburgh Medical Center (Pittsburgh, PA), a tertiary care academic teaching hospital. Participants In total, 14 surgical oncology fellows completed the biotissue curriculum. Results Fourteen fellows performed 196 anastomotic drills during the first year: 66 (HJ), 64 (GJ), and 66 (PJ). The fellows’ performances were analyzed as a group by attempt. The attendings’ first attempt outperformed the fellows’ first attempt in all metrics for every drill (all p < 0.05). More than 5 analyzed attempts of the HJ, there was improvement in time, errors, and OSATS (all p < 0.01); however, no metric reached attending performance. For the GJ, time, errors, and OSATS all improved more than 5 attempts (all p < 0.01), whereas only errors and OSATS reached proficiency. For the PJ, errors and OSATS both improved over attempts (p < 0.01) and reached proficiency; however, time did not statistically improve nor reach proficiency. The graders scoring correlated for errors and OSATS (p < 0.0001). Conclusion A pancreatoduodenectomy biotissue curriculum has face and construct validity. The curriculum is feasible and improves errors and technical performance. Time is the most difficult technical parameter to improve. This curriculum is a valid tool for teaching robotic pancreatoduodenectomies with established milestones for reaching optimum performance.
KW - Biotissue
KW - Pancreatoduodenectomy
KW - Practice-Based Learning and Improvement
KW - Professionalism
KW - Robotic
KW - Surgical education
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U2 - 10.1016/j.jsurg.2017.05.016
DO - 10.1016/j.jsurg.2017.05.016
M3 - Article
C2 - 28578981
AN - SCOPUS:85020113112
SN - 1931-7204
VL - 74
SP - 1057
EP - 1065
JO - Journal of Surgical Education
JF - Journal of Surgical Education
IS - 6
ER -