Expert consensus on best content of a robotic surgical curriculum: a systematic review

Abstract

Formal Robotic Assisted Surgery (RAS) training has not yet been introduced into surgical training in Europe. It is still unclear what exactly constitutes the appropriate content of a comprehensive robotic surgical curriculum. A systematic review of the evidence for RAS curricula and teaching was conducted on the platforms Medline, PubMed, Embase, CINAHL and PsycINFO using a Boolean combination of subject heading terms and keyword searches of robotic surgery with surgical training. After removal of duplicates 10,001 references were returned. Title, abstract and full text screening using the PICO framework for eligibility identified 175 relevant studies, out of which 28 studies focused on RAS expert opinion regarding the ideal curricular content. Data were extracted and analysed systematically using a predeveloped extraction tool, grouping results into curriculum elements, defined skills and curriculum content. Analysis focused on recurrent themes and differences among included studies. The review was registered on PROSPERO under ID Number CRD42024566778. The 28 studies (2008-2025) had a considerable degree of agreement on curriculum components, skills and implementation factors. The key components mentioned were e-learning, simulation, video, team training, non-technical skills (NTS), and modular operative training with proficiency-based progression to benchmarked metrics defined by surgical societies. RAS experts strongly recommend the implementation of a standardised RAS curriculum adaptable to surgeons' skills and specialty with a common pathway. Simulation and objective assessment with feedback have overwhelming agreement among RAS surgeons. Intraoperative teaching should be modular, encompassing operative steps of increasing difficulty and defined by specialty societies.