Teaching and learning robotic surgery at the dual console: a video-based qualitative analysis

Area of Science:

• Medical Education
• Surgical Training
• Human Factors in Medicine

Background:

• Robotic-assisted surgery (RAS) presents unique training challenges compared to traditional methods.
• The dual-console system and video recording in RAS offer novel opportunities for surgical training and supervision.
• Effective teaching strategies are crucial for developing surgical skills in the RAS environment.

Purpose of the Study:

• To investigate the teaching activities of a lead surgeon supervising a trainee in robotic-assisted visceral surgery.
• To analyze the skills-in-construction of surgeons during RAS training.
• To explore methods for balancing training needs with the demand for a quiet and efficient surgical environment.

Main Methods:

• Co-analysis of video recordings of RAS procedures with surgeons.
• Self-confrontation interviews with surgeons to examine teaching practices.
• Focus on three selected video sequences from visceral surgery training at a Swiss academic hospital.

Main Results:

• Identified key skills under development in trainees: team communication, three-handed instrument manipulation, and overall operating site awareness.
• Highlighted the tension between the need for verbalization for training and maintaining a quiet, efficient surgical setting.
• Demonstrated the value of video-based self-confrontation for enhancing mentor reflexivity and trainee verbalization.

Conclusions:

• Dedicated briefing and debriefing sessions are essential for effective RAS training.
• Video-based self-confrontation is a valuable tool for debriefing, supporting verbalization for both mentors and trainees.
• This methodology enhances mentor reflexivity on didactic choices and improves the overall training experience in robotic surgery.