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Multidisciplinary perceptions on robotic surgical training: the robot is a stimulus for surgical education change

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Abstract

Background

It is unclear how to best establish successful robotic training programs or if subspecialty robotic program principles can be adapted for general surgery practice. The objective of this study is to understand the perspectives of high-volume robotic surgical educators on best practices in robotic surgery training and to provide recommendations transferable across surgical disciplines.

Methods

This multi-institutional qualitative analysis involved semi-structured interviews with high-volume robotic educators from academic general surgery (AGS), community general surgery (CGS), urology (URO), and gynecology (GYN). Purposeful sampling and snowballing ensured high-volume status and geographically balanced representation across four strata. Interviews were transcribed, deidentified, and independently, inductively coded. A codebook was developed and refined using constant comparative method until interrater reliability kappa reached 0.95. A qualitative thematic, framework analysis was completed.

Results

Thirty-four interviews were completed: AGS (n = 9), CGS (n = 8), URO (n = 9), and GYN (n = 8) resulting in 40 codes and four themes. Theme 1: intangibles of culture, resident engagement, and faculty and administrative buy-in are as important as tangibles of robot and simulator access, online modules, and case volumes. Theme 2: robotic OR integration stresses the trainee-autonomy versus patient-safety balance. Theme 3: trainees acquire robotic skills along individual learning curves; benchmark assessments track progress. Theme 4: AGS can learn from URO and GYN through multidisciplinary collaboration but must balance pre-existing training program use with context-specific curricular needs.

Conclusions

Robotic surgical experts emphasize the importance of universal training paradigms, such as a strong educational culture that balances autonomy and patient safety, collaboration between disciplines, and routine assessments for continuous growth. Often, introduction and acceptance of the robot serves as a stimulus to discuss broader surgical education change.

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Abbreviations

FLS:

Fundamentals of Laparoscopic Surgery

FRS:

Fundamentals of Robotic Surgery

ACS:

American College of Surgeons

AEI:

Accredited Education Institutes

OR:

Operating room

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Acknowledgements

The research team would like to thank our surgical education research assistant Isra Hamdi for her help with organizing the robotic interview transcripts to maintain de-identification.

Funding

This work is supported by a Center of Expertise in Medical Education grant from the Partners Office of Graduate Medical Education.

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Authors and Affiliations

  1. Department of Surgery, Mayo Clinic Arizona, 5777 East Mayo Blvd, Phoenix, AZ, USA

    Kristen M. Jogerst, Victor Davila & David Pearson

  2. Department of Surgery, Massachusetts General Hospital, Boston, MA, USA

    Kristen M. Jogerst, Taylor M. Coe, Emil Petrusa, Roy Phitayakorn & Denise Gee

  3. Department of Medicine, Massachusetts General Hospital, Boston, MA, USA

    Jordan Neil

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  1. Kristen M. Jogerst
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Correspondence to Taylor M. Coe.

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Disclosures

Denise Gee MD: Serves on advisory boards for New View Surgical and Boston Scientific Corporation. Consultant for Medtronic and Ethicon Johnson and Johnson. Kristen M Jogerst, Taylor M Coe MD, Emil Petrusa, Jordan Neil, Victor Davila, David Pearson, Roy Phitayakorn MD MHPE have no conflict of interest or financial ties to disclose.

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Jogerst, K.M., Coe, T.M., Petrusa, E. et al. Multidisciplinary perceptions on robotic surgical training: the robot is a stimulus for surgical education change. Surg Endosc 37, 2688–2697 (2023). https://doi.org/10.1007/s00464-022-09708-7

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