Comparison of synchronous and nonsynchronous imitation in robotic surgical training: a pilot randomized-controlled...

Video-based learning, a form of nonsynchronous imitation, is widely used in robotic surgical training. However, the effectiveness of synchronous imitation, in which trainees replicate expert movements in real time, remains unclear. This study aimed to evaluate the effect of synchronous imitation on robotic surgical skill acquisition.

A randomized-controlled trial was conducted with 20 novices in robotic surgery, between April 2023 and March 2024. Participants were stratified by suturing experience and randomly assigned to either the synchronous or nonsynchronous group. The training task was "Thread the Rings" on the da Vinci Skills Simulator. Before each of the 10 trials, participants in the synchronous group watched a recorded expert demonstration and attempted to mimic instrument movements in real time. In contrast, the nonsynchronous group viewed the same video passively without simultaneous imitation. Proficiency scores (0-100) were calculated automatically for each trial.

Both groups demonstrated improvement over time; however, mixed-effects regression models showed no significant difference in the rate of score improvement between the two groups (P = 0.88).

Synchronous imitation did not lead to superior skill acquisition compared with video-based observations alone. Further research with a larger sample size is warranted to validate these findings.