Development of a virtual reality robotic surgical curriculum using the da Vinci Si surgical system

This study aimed to develop a training curriculum to evaluate the basic robotic skills necessary to reach an 80 % preset proficiency score and correlate the level of surgical experience with the overall performance obtained using the da Vinci Surgical Skills simulator. Twenty-two participants (4 faculty, 4 senior, and 14 junior residents) were enrolled in a 4-week robotic training curriculum developed at our institution. A set of seven robotic skills were selected based on the manufacturer's exercise primary endpoint. During their pretesting session, participants completed one trial of each of the seven simulated exercises. In two individual sessions over a 2 week period, trainees practiced a different set of exercises that evaluated the same basic robotic skills assessed during pretesting with the objective of reaching an overall score of 80 % on two consecutive attempts. If proficiency was not achieved, then a maximum of six trials per exercise was allowed before advancing to the next skill. During their fourth week of training, participants completed a post-testing session with the same set of exercises used during pretesting. Participants' overall performance and various metrics were recorded in an online database for further analysis. A significant skills gain from pre- to post-test was observed for each of the seven basic robotic skills regardless of participant's level of training (p < .001). Interestingly, participants only achieved an overall score of 80 % or more in only five of the seven exercises. No statistical difference in gain of skills was found between groups suggesting robotic skills development is independent of level of prior surgical expertise. A dedicated virtual reality robotic training curriculum significantly improves the seven basic robotic surgical skills necessary to operate the da Vinci Si surgical console. Six training trials appear to be insufficient to reach proficiency levels on more advanced skills.