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

Area of Science:

• Medical Education
• Surgical Skills Assessment
• Robotic Surgery

Background:

• Robotic surgery training requires standardized competency assessment across diverse specialties.
• Existing assessment methods may lack discriminatory validity for heterogeneous training populations.

Purpose of the Study:

• To evaluate the discriminatory validity of a randomized, double-blind protocol using the Global Evaluative Assessment of Robotic Skills (GEARS) for cross-specialty robotic surgery training assessment.
• To determine the reliability and consistency of the GEARS scoring system in distinguishing trainee proficiency.

Main Methods:

• Prospective, randomized, double-blind evaluation of 49 surgical trainees across general surgery, urology, and gynecology.
• Training involved simulator and porcine models, followed by clinical observation, with anonymized video assessment by blinded experts.
• Statistical analysis included factor analysis, Cronbach's α, and Bland-Altman methods to assess validity and reliability.

Main Results:

• The GEARS-based protocol demonstrated good validity (KMO=0.836, 85% variance) and reliability (Cronbach's α=0.765).
• The system effectively distinguished trainees from experts (p<0.05) and showed cross-modal scoring consistency (Bland-Altman -2.1-3.8).
• The assessment was stable across specialties, training models, and sexes; older trainees showed comparable live tissue performance to younger ones.

Conclusions:

• The randomized, double-blind GEARS assessment protocol is a valid and reliable tool for evaluating robotic surgery trainee competency.
• This system objectively differentiates operational abilities, supporting its use as a standardized assessment for heterogeneous robotic surgery training programs.