Modular Training for Robot-Assisted Radical Prostatectomy: Where to Begin?
| Autor: | Henk G. van der Poel, Prokar Dasgupta, Ben Challacombe, Kamran Ahmed, Alex Mottrie, James O. Peabody, Giacomo Novara, Khurshid A. Guru, Catherine Lovegrove |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Male
safety medicine.medical_specialty Longitudinal study Internationality Urology medicine.medical_treatment education 030232 urology & nephrology Simulation Training/methods RARP Education 03 medical and health sciences Patient safety Prostatectomy/education 0302 clinical medicine Operating theater Robotic Surgical Procedures modular training surgical training Surgery 3304 Humans Medicine Medical physics Longitudinal Studies Prospective Studies Fellowships and Scholarships Simulation Training Robotic Surgical Procedures/education Prostatectomy business.industry Australia Education Medical Graduate/methods Modular design United Kingdom Urology/education Europe Education Medical Graduate Learning curve 030220 oncology & carcinogenesis Cohort Observational study Clinical Competence business |
| Zdroj: | Lovegrove, C, Ahmed, K, Novara, G, Guru, K, Mottrie, A, Challacombe, B, der Poel, H V, Peabody, J & Dasgupta, P 2017, ' Modular Training for Robot-Assisted Radical Prostatectomy : Where to Begin? ', Journal Of Surgical Education, vol. 74, no. 3, pp. 486-494 . https://doi.org/10.1016/j.jsurg.2016.11.002 |
| DOI: | 10.1016/j.jsurg.2016.11.002 |
| Popis: | OBJECTIVE: Effective training is paramount for patient safety. Modular training entails advancing through surgical steps of increasing difficulty. This study aimed to construct a modular training pathway for use in robot-assisted radical prostatectomy (RARP). It aims to identify the sequence of procedural steps that are learnt before surgeons are able to perform a full procedure without an intervention from mentor.DESIGN: This is a multi-institutional, prospective, observational, longitudinal study. We used a validated training tool (RARP Score). Data regarding surgeons' stage of training and progress were collected for analysis. A modular training pathway was constructed with consensus on the level of difficulty and evaluation of individual steps. We identified and recorded the sequence of steps performed by fellows during their learning curves.SETTING AND PARTICIPANTS: We included 15 urology fellows from UK, Europe, and Australia.RESULTS: A total of 15 surgeons were assessed by mentors in 425 RARP cases over 8 months (range: 7-79) across 15 international centers. There were substantial differences in the sequence of RARP steps according to the chronology of the procedure, difficulty level, and the order in which surgeons actually learned steps. Steps were not attempted in chronological order. The greater the difficulty, the later the cohort first undertook the step (p = 0.021). The cohort undertook steps of difficulty level I at median case number 1. Steps of difficulty levels II, III, and IV showed more variation in median case number of the first attempt. We recommend that, in the operating theater, steps be learned in order of increasing difficulty. A new modular training route has been designed. This incorporates the steps of RARP with the following order of priority: difficulty level > median case number of first attempt > most frequently undertaken in surgical training.CONCLUSIONS: An evidence-based modular training pathway has been developed that facilitates a safe introduction to RARP for novice surgeons. |
| Databáze: | OpenAIRE |
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