Background
A minimally-invasive approach is the standard for most benign pelvic surgeries, which now are increasingly performed with robotic assistance. Currently, there is no standardized curriculum for robotic training among Ob-Gyn residents and no method of quantitative assessment of robot confidence at Creighton. 

Methods
PGY1-PGY3s completed a pre-survey to establish baseline comfort with robotic surgery. A Likert scale (1 - very unsatisfied or not at all confident, 5 - very satisfied or extremely confident) was used to determine self-assessed comfort with robotic components: port and instrument placement, docking, bipolar and monopolar instrumentation, camera, switching instruments, suturing, and overall comfort with surgery. Residents completed an Intuitive training module for the da Vinci Xi P8 robot. An in-person training was led by a representative and attending where residents were taught basics of robotic surgery and how to access the simulation trainer and complete modules independently. PGY1-PGY3s completed a post-survey to evaluate changes in competence and confidence in robotic training.

Results
Paired T-tests were performed using pre and post-responses. There was a significant increase in overall satisfaction of gynecologic training opportunities among all residents (p < 0.001). The average satisfaction before intervention increased from 2.58 to 4.36. PGY1s had improved confidence with basic components of robotic surgery, from 1 to 2.66 (p = 0.03). There was no difference in confidence regarding suturing and performing an entire DaVinci surgery. PGY2s had improved confidence with port placement of instruments and docking the camera & instruments at the bedside (both p = 0.01). Average confidence of port placement and docking improved from 2.5 to 4.5. There were no significant increases in PGY3s’ confidence among measured components. Among all residents, confidence increased in components of robotic surgery except for suturing and performing an entire surgery (p < 0.05).

Conclusion
Residents indicated improved satisfaction with the robot curriculum. They demonstrated improved confidence in several robot surgery components, aside from overall confidence in completing a robotic surgery. In future iterations, residents will have online and in-person training during intern orientation, simulator sessions during didactics, and simulator modules correlated to each year.

Improving Ob/Gyn Resident Confidence and Competence in Robotic-Assisted Surgery through Establishing a Robot Curriculum

Medical Education Innovation | Obstetrics and Gynecology

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Improving Ob/Gyn Resident Confidence and Competence in Robotic-Assisted Surgery through Establishing a Robot Curriculum

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