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Updated: Apr 20, 2026
Emergency Undocking in Robotic Surgery: A Simulation Curriculum
Published on: May 20, 2018
Use of decision-based simulations to assess resident readiness for operative independence
Anne-Lise D D'Angelo1, Elaine R Cohen1, Calvin Kwan1
1Department of Surgery, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue H4/385A CSC, Madison, WI 53792-3236, USA.
Background:
Recent literature has called into question resident readiness for operative independence at the end of general surgery training.
Methods:
We used a simulation-based exit examination to assess resident readiness. Six chief residents performed 3 simulated procedures: bowel anastomosis, laparoscopic ventral hernia (LVH) repair, and pancreaticojejunostomy. Faculty assessed resident performance using task-specific checklists, Objective Structured Assessment of Technical Skills (OSATS), and final product analysis.
Results:
Residents' individual task-specific checklist scores ranged from 25% to 100% across all 3 procedures. Mean OSATS scores ranged from 4.06 to 4.23/5.0. Residents scored significantly higher on "instrument knowledge" (mean = 4.78, standard deviation [SD] = 23) than "time and motion" (mean = 3.94, SD = .48, P = .025) and "ability to adapt to individual pathologic circumstances" (mean = 4.06, SD =.12, P = .002). Final product analysis revealed a range of errors, including incorrect technique and poor intraoperative planning.
Conclusions:
Despite relatively high OSATS ratings, residents had a wide range of errors and procedure outcomes. Exit assessments using multiple evaluation metrics may improve awareness of residents' learning needs.
