Ethical implications of AI in robotic surgical training: A Delphi consensus statement

Area of Science:

• Medical Education
• Artificial Intelligence
• Surgical Training

Background:

• The expanding role of artificial intelligence (AI) in healthcare necessitates ethical guidelines.
• Awareness of potential AI pitfalls requires structured guidance for safe implementation.

Purpose of the Study:

• To provide ethical guidance for developing narrow AI applications in surgical training curricula.
• To establish standardized approaches for AI-driven surgical training, addressing ethical implications of AI on surgical data.

Main Methods:

• A 3-phase project involving a steering group, an expert panel, and an online Delphi process.
• Literature review, expert discussion, survey creation, and 3 rounds of Delphi consensus among 30 experts.
• Consensus defined as ≥80% agreement, with guidance formulation based on expert input.

Main Results:

• 100% consensus on the lack of current guidance for AI in robotic surgical training.
• Achieved consensus on critical areas: data protection, privacy, reproducibility, transparency, predictive analytics, inherent biases, and optimal training areas for AI.
• Guidance demonstrated good internal consistency (Cronbach alpha >0.8).

Conclusions:

• International expert consensus was achieved via Delphi methodology for ethical AI in surgical training.
• Developed content-validated guidance provides an ethical foundation for narrow AI applications in surgical training.
• Further validation of the developed guidance is recommended.