Seeing Eye to Eye During Robotic Training: Do Residents and Faculty Agree on Operative Time and Performance...

This study aimed to characterize the robotic experience of residents and how their self-reported level of competency and active robotic console time (ARCT) aligned with that of faculty.

Survey data were prospectively gathered from index robotic urology cases within a single institution during the 2024 to 2025 academic year from both residents and faculty. Case-related data (perceived difficulty, procedure, etc.), including an estimation of resident ARCT, were recorded. The Zwisch scale of surgical autonomy was used to assess experienced and potential competency for each surgical step (defined a priori). Statistical analysis was performed using chi-squared, two-way Analysis of Variance (ANOVA), Wilcoxon rank sum, and Kruskal-Wallis tests as appropriate.

The University of Kentucky, a tertiary care academic medical center in Lexington, KY.

All residents and faculty within the Urology Department who perform robotic surgery.

A total of 64 paired surveys were completed from 10 residents and 6 faculty for robotic radical nephrectomy (n = 10), partial nephrectomy (n = 13), cystectomy with intracorporeal ileal conduit (n = 3), radical prostatectomy (n = 22), and pyeloplasty (n = 16). Junior residents (PGY-2&3) reported overall lower ARCT (20% vs 53%, p < 0.001) and Zwisch scores (2.22 vs 2.73, p = 0.004) than senior residents (PGY-4&5), and those differences were consistent with faculty reported ARCT (30% vs 50%, p < 0.001) and Zwisch scores (2.36 vs 2.75, p < 0.001) for both groups. Across all cases and PGY levels, Zwisch scores and ARCT were similar, regardless of if reported by resident or faculty. Resident reported ARCT was moderately associated with both resident (R = 0.52, p < 0.001) and faculty (R = 0.56, p < 0.001) reported Zwisch scores. Resident and faculty reported Zwisch scores were strongly associated with each other (R = 0.71, p < 0.001). However, gaps still exist between resident reported Zwisch scores and where they believe their potential Zwisch score could have been.

Residents and faculty agree on perceived ARCT and resident performance, and these 2 metrics are positively correlated. However, gaps still exist in experienced and potential autonomy of residents demonstrating continued work can be done to optimize the robotic experience to improve competency and ultimately enhance resident's ability to operate independently.