TY - JOUR
T1 - Surgical Science–Simbionix Robotic Hysterectomy Simulator
T2 - Validating a New Tool
AU - Cope, Adela G.
AU - Lazaro-Weiss, Jose J.
AU - Willborg, Brooke E.
AU - Lindstrom, Elizabeth D.
AU - Mara, Kristin C.
AU - Destephano, Christopher C.
AU - Vetter, Monica Hagan
AU - Glaser, Gretchen E.
AU - Langstraat, Carrie L.
AU - Chen, Anita H.
AU - Martino, Martin A.
AU - Dinh, Tri A.
AU - Salani, Ritu
AU - Green, Isabel C.
N1 - Funding Information:
The authors thank the residents, fellows, and faculty in the Department of Obstetrics and Gynecology at Mayo Clinic Rochester, Mayo Clinic Florida, and Lehigh Valley Health Network for their participation in this study.
Funding Information:
This work was supported by an unrestricted educational grant from Intuitive Surgical. Support from Intuitive Surgical was limited to grant funding. Statistical analysis was performed independently at Mayo Clinic with no sharing of data or manuscript support.
Publisher Copyright:
© 2022 AAGL
PY - 2022/6
Y1 - 2022/6
N2 - Study Objective: To gather validity evidence for and determine acceptability of Surgical Science–Simbionix Hysterectomy Modules for the DaVinci Xi console simulation system (software; 3D Systems by Simbionix [now Surgical Science–Simbionix], Littleton, CO, and hardware; Intuitive Surgical, Inc., Sunnyvale, CA) and evaluate performance benchmarks between novice and experienced or expert surgeons. Design: Prospective education study (Messick validity framework). Setting: Multicenter, academic medical institutions. Participants: Residents, fellows, and faculty in obstetrics and gynecology were invited to participate at 3 institutions. Participants were categorized by experience level: fewer than 10 hysterectomies (novice), 10 to 50 hysterectomies (experienced), and more than 50 hysterectomies (expert). A total of 10 novice, 10 experienced, and 14 expert surgeons were included. Interventions: Participants completed 4 simulator modules (ureter identification, bladder flap development, colpotomy, complete hysterectomy) and a qualitative survey. Simulator recordings were reviewed in duplicate by educators in minimally invasive gynecologic surgery using the Modified Global Evaluative Assessment of Robotic Skills (GEARS) rating scale. Measurements and Main Results: Most participants felt that the simulator realistically simulated robotic hysterectomy (64.7%) and that feedback provided by the simulator was as or more helpful than feedback from previous simulators (88.2%) but less helpful than feedback provided in the operating room (73.5%). Participants felt that this simulator would be helpful for teaching junior residents. Simulator-generated metrics correlated with GEARS performance for the bladder flap and ureter identification modules in multiple domains including total movements and total time for completion. GEARS performance for the bladder flap module correlated with experience level (novice vs experienced/expert) in the domains of interest and total score but did not consistently correlate for the other procedural modules. Performance benchmarks were evaluated for the bladder flap module for each GEARS domain and total score. Conclusion: The modules were well received by participants of all experience levels. Individual simulation modules appear to better discriminate between novice and experienced/expert users than overall simulator performance. Based on these data and participant feedback, the use of individual modules in early residency education may be helpful for providing feedback and may ultimately serve as 1 component of determining readiness to perform robotic hysterectomy.
AB - Study Objective: To gather validity evidence for and determine acceptability of Surgical Science–Simbionix Hysterectomy Modules for the DaVinci Xi console simulation system (software; 3D Systems by Simbionix [now Surgical Science–Simbionix], Littleton, CO, and hardware; Intuitive Surgical, Inc., Sunnyvale, CA) and evaluate performance benchmarks between novice and experienced or expert surgeons. Design: Prospective education study (Messick validity framework). Setting: Multicenter, academic medical institutions. Participants: Residents, fellows, and faculty in obstetrics and gynecology were invited to participate at 3 institutions. Participants were categorized by experience level: fewer than 10 hysterectomies (novice), 10 to 50 hysterectomies (experienced), and more than 50 hysterectomies (expert). A total of 10 novice, 10 experienced, and 14 expert surgeons were included. Interventions: Participants completed 4 simulator modules (ureter identification, bladder flap development, colpotomy, complete hysterectomy) and a qualitative survey. Simulator recordings were reviewed in duplicate by educators in minimally invasive gynecologic surgery using the Modified Global Evaluative Assessment of Robotic Skills (GEARS) rating scale. Measurements and Main Results: Most participants felt that the simulator realistically simulated robotic hysterectomy (64.7%) and that feedback provided by the simulator was as or more helpful than feedback from previous simulators (88.2%) but less helpful than feedback provided in the operating room (73.5%). Participants felt that this simulator would be helpful for teaching junior residents. Simulator-generated metrics correlated with GEARS performance for the bladder flap and ureter identification modules in multiple domains including total movements and total time for completion. GEARS performance for the bladder flap module correlated with experience level (novice vs experienced/expert) in the domains of interest and total score but did not consistently correlate for the other procedural modules. Performance benchmarks were evaluated for the bladder flap module for each GEARS domain and total score. Conclusion: The modules were well received by participants of all experience levels. Individual simulation modules appear to better discriminate between novice and experienced/expert users than overall simulator performance. Based on these data and participant feedback, the use of individual modules in early residency education may be helpful for providing feedback and may ultimately serve as 1 component of determining readiness to perform robotic hysterectomy.
KW - Global Evaluative Assessment of Robotic Skills
KW - Robotic hysterectomy
KW - Robotic surgery
KW - Simulation
KW - Surgical education
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U2 - 10.1016/j.jmig.2022.01.016
DO - 10.1016/j.jmig.2022.01.016
M3 - Article
C2 - 35123040
AN - SCOPUS:85125835136
SN - 1553-4650
VL - 29
SP - 759
EP - 766
JO - Journal of the American Association of Gynecologic Laparoscopists
JF - Journal of the American Association of Gynecologic Laparoscopists
IS - 6
ER -