Robotic simulation in urology training: implementation, curricula, and barriers across U.S. residency programs

Robotic surgery has transformed urology. Simulation-based robotic training allows residents to develop skills in a controlled, risk-free environment and enhances proficiency. Our objective was to assess the integration of robotic simulation training in U.S. urology residency programs, focusing on adoption, curriculum types, mandatory status, and barriers to implementation. We distributed a Qualtrics survey to U.S. urology residency program directors to assess the presence and structure of robotic simulation curricula. If a program director did not respond, an email was sent to the program coordinator to survey them on the presence and structure of a curriculum. We surveyed only program directors' views of simulation training and assessed their responses using a 5-point Likert scale. Surveys were sent to 150 programs, with 33 (22%) responding; 17 program directors (51.5%) and 16 coordinators (48.5%). Of the responding programs, 31/33 (93.9%) reported access to and utilization of robotic simulation training. Simulation training was mandatory for residents in 21/31 (67.7%) of these programs. Structured curricula with objectives were reported by 16/31 programs (51.6%), while 15/31 (48.4%) relied on informal or self-directed methods. Supervised simulation training was reported by 24/31 programs (77.4%). Program directors viewed simulation training as beneficial, with an average agreement rating of 4.18/5 for its educational role and impact on performance. Our survey shows that most urology training programs have adopted robotic simulation; however, not all programs have made it mandatory for residents or implemented a structured learning curriculum. Addressing these issues could promote more uniform training practices.