886 DEVELOPMENT & VALIDATION OF A COMPOSITE GRADING & SCORING SYSTEM FOR ROBOT-ASSISTED SURGICAL TRAINING — THE ROBOTIC SKILLS ASSESSMENT SCALE

Abstract

You have accessJournal of UrologyTechnology & Instruments: Surgical Education & Skills Assessment (1)1 Apr 2013886 DEVELOPMENT & VALIDATION OF A COMPOSITE GRADING & SCORING SYSTEM FOR ROBOT-ASSISTED SURGICAL TRAINING — THE ROBOTIC SKILLS ASSESSMENT SCALE Ashirwad Chowriappa, Syed Raza, Andrew Stegemann, Kamran Ahmed, Yi Shi, Gregory Wilding, Jihad H. Kaouk, James Peabody, Mani Menon, Thenkurussi Kesavadas, and Khurshid Guru Ashirwad ChowriappaAshirwad Chowriappa East Amherst, NY More articles by this author , Syed RazaSyed Raza East Amherst, NY More articles by this author , Andrew StegemannAndrew Stegemann East Amherst, NY More articles by this author , Kamran AhmedKamran Ahmed London, United Kingdom More articles by this author , Yi ShiYi Shi Buffalo, NY More articles by this author , Gregory WildingGregory Wilding East Amherst, NY More articles by this author , Jihad H. KaoukJihad H. Kaouk Cleveland, OH More articles by this author , James PeabodyJames Peabody Detroit, MI More articles by this author , Mani MenonMani Menon Detroit, MI More articles by this author , Thenkurussi KesavadasThenkurussi Kesavadas Buffalo, NY More articles by this author , and Khurshid GuruKhurshid Guru East Amherst, NY More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.457AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Evaluation of technical skills is based on crucial surgical tenets that ultimately define a master surgeon. No scoring system exists to evaluate, validate and integrate virtual reality-based metrics into a scale to describe safe and crucial surgical skills/steps during Robot-assisted Surgery. This study aims to develop an assessment scale along with its construct validation. METHODS Following an expert consensus (Delphi), critical safety determining procedural steps were identified and a hierarchical task decomposition of multiple parameters using a variety of metrics was used to develop the multi-metric scoring system. “The Robotic Skills Assessment Scale” (RSA-Scale) focuses on safety in operative field, critical error, economy, bimanual dexterity and time. All subjects performed key tasks (Table) on the Fundamental Skills of Robotic Surgery (FSRS) curriculum, which were recorded, and metrics were stored. Ten relevant metrics used during curriculum (FSRS) were utilized to assess technical skills. All tasks in the RSA-Scale were essential and contributed equally towards training and the final score. The RSA-Scale was further evaluated for construct validation and feasibility. The RSA-Scale was also implemented to assess development of critical surgical tenets. Spearman' Correlation tests performed between tasks using the RSA Scores indicate no cross correlation. Wilcoxon Rank-Sum tests were performed between the two groups. RESULTS The proposed RSA-Scale was evaluated on (n=15) non-robotic surgeons and (n=12) expert-robotic surgeons. The expert group demonstrated significantly better performance on all four tasks in comparison to the novice group. CONCLUSIONS The Robotic Skills Assessment Scale is a valid tool that could be incorporated in other virtual reality based surgical simulators to achieve standardized assessment of fundamental surgical tents during robot-assisted surgery. Wilcoxon Rank-Sum tests performed between Expert and Novice surgeons Tasks Novice (N=15) Expert (N=12) p-value Ball Placement (Mean/SD) 2.1/0.2 3.5/0.1 <.001 Fourth Arm Control (Mean/SD) 3.1/0.1 3.5/0.1 0.002 Needle Handling and Exchange (Mean/SD) 2.5/0.1 3.5/0.1 <.001 Coordinated Tool Control (Mean/SD) 2.5/0.1 3.5/0.1 <.001 © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e365-e366 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ashirwad Chowria