Randomized double-blind protocol for cross-specialty competency assessment in robotic surgery training using GEARS: a...

Area of Science:

• Medical Education
• Surgical Technology
• Competency Assessment

Background:

• Robotic surgery training requires standardized, objective assessment methods.
• Existing cross-specialty competency evaluations for robotic surgery are limited.
• The Global Evaluative Assessment of Robotic Skills (GEARS) offers a potential framework.

Purpose of the Study:

• To evaluate the discriminatory validity of a randomized, double-blind protocol using the GEARS scoring system.
• To assess the reliability and consistency of the GEARS-based assessment in robotic surgery training.
• To determine the system's effectiveness in distinguishing trainee skill levels across surgical specialties.

Main Methods:

• Prospective, randomized, double-blind evaluation of 49 surgical trainees across general surgery, urology, and gynecology.
• Training involved simulator (dV-Trainer) and porcine models, followed by clinical observation.
• Anonymized operation videos were scored by blinded expert reviewers using the GEARS system, with internal controls for calibration.

Main Results:

• The GEARS-based protocol demonstrated good validity (KMO=0.836) and reliability (Cronbach's α=0.765).
• The system effectively distinguished trainees from experts in both simulator and live tissue operations (p<0.05).
• The assessment showed stability across specialties, training models, and sexes, with no significant differences in live tissue performance based on trainee age.

Conclusions:

• The randomized, double-blind GEARS assessment protocol is a valid and reliable tool for evaluating robotic surgery trainee competency.
• The system objectively differentiates operational abilities, supporting its use as a standardized assessment for heterogeneous robotic surgery training programs.
• GEARS has the potential to enhance the quality and consistency of surgical training evaluations.