Table 3.
Comments regarding the role of simulation and simulators in robotic surgery education
| Representative Comments | |
|---|---|
| Skills Simulator | |
| “I think learning about the console and how it works and how to control, learning how to clutch and change instruments, I think that’s all fine. I think they actually put together a pretty decent simulator.” (Resident 1, junior resident) | |
| “The exercises, like the simulations, where you move a ring across a line…it helps get you comfortable with moving the camera and the position. I feel like the best utilization of it is that our attendings have been very helpful in letting us on the console if you’ve shown that you’ve done the exercises.” (Resident 4, senior resident) | |
| “When you’re on the simulation, you’re doing all the same movements as if you’re in the case. You can simulate open surgery with plastic, but on the robot, you’re getting used to using the instruments. It’s a much more realistic scenario when using the simulated robot. When you’re tying knots on a table, the sensation is a lot different. While on the robot, it’s pretty much the same.” (Resident 17, junior resident) | |
| “I think some of the feedback on the modules were not very good. You failed because your efficiency wasn’t high enough, but it didn’t tell me how to increase my efficiency.” (Resident 19, junior resident) | |
| “I do like the sim modules, I enjoy them, they were actually useful. I can relate them to real situations.’ (Attending 2) | |
| “It would start with the sim modules. I think they’re super helpful not just for robotic surgery, but really helpful for open surgery. I think they teach a lot of techniques, like economy of motion, tension on tissue, which we have a hard time teaching to residents.” (Attending 6) | |
| “It would have to involve, before they step into the OR, doing the online modules and getting yourself on the simulator for a few of them, even if it’s just one day.” (Attending 7) | |
| Simulation Lab | |
| “I actually did bedside in the OR first…and then doing them in the dry lab did help to know how to maneuver the instruments, so I think that’s necessary. It’s probably better to do them in the dry lab first.” (Resident 5, senior resident) | |
| “It’s kind of difficult in lab because there’s not a ton of attendings around to give you specific instructions. We were just playing around with how to use it. We weren’t getting specific ways on how to use it the right way…there was a time there was a fellow that was walking us through things, it was really good.” (Resident 10, junior resident) | |
| “I don’t think we have a very well-established robotic curriculum for the residents. I think it essentially is messing around in the pig lab when you get a chance to.” (Resident 11, junior resident) | |
| “I like the hands-on labs we have, the introductions to them. I like the animal labs, I think they’re helpful. I think it would be helpful if we could get the more junior residents to complete the online curriculum and the exercises earlier in their residency. Perhaps during the labs, we can have protected time to actually complete those training modules, instead of just going in to play around. Go in with the goal to actually completing the curriculum.” (Resident 15, senior resident) | |
| “We had two pigs and no faculty, the MIS fellow was the only one there. I had the device reps change the instruments for me. So, I just got on to try to do a roux-en-Y with no direction. So that was the most operating I got to do on the robot and that was really fun. I actually did a couple more after that with more people and more instruction. It was nice to have someone to actually instruct but free-play was kind of nice because there was no one to tell you what to do, and it’s really different.” (Resident 19, junior resident) | |
| “Starting in the skills lab is the best. Just to start getting comfortable with the controls, and the movements, and subtle things like adjusting the camera without moving the instruments. Those are all good skills to learn in the skills center, and that’s what I did as a fellow.” (Attending 1) | |
| “I think [residents] would spend time in the [simulation lab], so they can learn about the robot. I think that should be done by the Intuitive rep, to show them the data on the robot, how it works, this is the arms. Their initial training would be about exchanging the instruments, then training on the simulator.” (Attending 4) | |
| Access Problems | |
| “I don’t even know where I would go to do [the simulation modules].” (Resident 3, intern) | |
| “I know there’s a bunch of modules I need to do, but I just haven’t had time to get on the console and do them.” (Resident 5, senior resident) | |
| “Usually, there’s not a lot of time on the vast majority of rotations to step away and go and find a robot to use.” (Resident 8, junior resident) | |
| “It would be nice to have the console readily available…it seems like robotic education would be great, but I’m not sure if we the strongest administrative support for that.” (Resident 14, senior resident) | |
| “I definitely would [use the simulation modules more]. Especially on the night rotation, definitely. During the day, I don’t know of any rotations that I had enough time. That’s the other problem, I can’t even imagine doing the sim packs during the day. Getting to the [simulation lab] is impossible.” (Resident 17, junior resident) | |
| “My theory is that if we had better access to [simulation resources] and a better system in place, that we were better trained on it, then we would be able to get to do more in the OR.” (Resident 19, junior resident) |