Proficiency-based progression training for robotic surgery skills training: a randomized clinical trial

Area of Science:

• Surgical Education
• Minimally Invasive Surgery
• Medical Training Technologies

Background:

• The effectiveness of proficiency-based progression (PBP) training for robotic surgery skills remains unclear.
• Traditional training (TT) is the current standard for learning robotic surgical techniques.

Purpose of the Study:

• To compare the efficacy of PBP training versus TT in developing robotic surgical skills.
• To assess the impact of PBP training on surgical performance metrics.

Main Methods:

• The PROVESA trial, a multicenter, prospective, randomized, blinded study.
• 36 surgical residents were randomized to PBP or TT for robotic suturing and knot-tying.
• Primary outcome: percentage of participants reaching proficiency benchmark; Secondary outcomes: procedure steps and errors.

Main Results:

• 12/18 participants in the PBP group achieved proficiency versus 3/18 in the TT group (P = 0.006).
• The PBP group showed a 51% reduction in performance errors (18.3 to 8.9).
• The TT group had a marginal improvement in errors (15.94 to 15.44).

Conclusions:

• PBP training leads to superior robotic surgical performance in suturing and knot-tying.
• Implementing PBP training can enhance surgical quality for basic robotic surgery skills.
• This study provides the first prospective randomized controlled trial evidence for PBP in robotic surgery basic skills training.