Design and Implementation of an Emergency Undocking Curriculum for Robotic Surgery
| Autor: | Jimena Cubillos, Philip Rappold, Tyler Holler, Guan Wu, Patrick Saba, Prabhakar Mithal, Rachel Melnyk, Ahmed Ghazi, Hani Rashid, Jean V. Joseph, Katherine Cameron |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Epidemiology business.industry Medicine (miscellaneous) Cognition Bleed Checklist Education Task (project management) Retroperitoneal tumor Robotic Surgical Procedures Modeling and Simulation Physical therapy medicine Humans Computer Simulation Robotic surgery Clinical Competence Curriculum business Cognitive load |
| Zdroj: | Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare. 17:78-87 |
| ISSN: | 1559-713X 1559-2332 |
| Popis: | INTRODUCTION Current training for robotic surgery crisis management, specifically emergency robotic undocking protocol (ERUP), remains limited to anecdotal experience. A curriculum to impart the skills and knowledge necessary to recognize and complete a successful ERUP was developed using an education approach then evaluated. METHODS Baseline knowledge and confidence regarding ERUP were established for 5 robotic teams before completing 2 full-immersion simulations separated by an online self-paced learning module. In each simulation, teams operated on a perfused hydrogel model and were tasked to dissect a retroperitoneal tumor abutting a major vessel. During vascular pedicle ligation, a major vascular bleed and nonrecoverable robotic fault were remotely induced, necessitating ERUP with open conversion. After the simulation, participants completed surgery task load index (cognitive load assessment) and realism surveys. Weighted checklists scored participants' actions during each simulation. Surgical metrics including estimated blood loss, time to control bleeding, and undocking time were recorded. Curriculum retention was assessed by repeating the exercise at 6 months. RESULTS Participants experienced high levels of cognitive demand and agreed that the simulation's realism and stress mimicked live surgery. Longitudinal analysis showed significant knowledge (+37.5 points, p = 0.004) and confidence (+15.3 points, p < 0.001) improvements from baseline to completion. Between simulations, checklist errors, undocking time, and estimated blood loss decreased (38→17, -40 seconds, and -500 mL, respectively), whereas action scores increased significantly (+27 points, p = 0.008). At 6 months, insignificant changes from curriculum completion were seen in knowledge (-4.8 points, p = 0.36) and confidence (+3.7 points, p = 0.1). CONCLUSIONS This simulation-based curriculum successfully improves operative team's confidence, knowledge, and skills required to manage robotic crisis events. |
| Databáze: | OpenAIRE |
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