Essential components and validation of multi-specialty robotic surgical training curricula: a systematic review.

Abstract

Introduction: The rapid adoption of robotic surgical systems has overtook the development of standardised training and competency assessment for surgeons, resulting in an unmet educational need in this field. This systematic review aims to identify the essential components and evaluate the validity of current robotic training curricula across all surgical specialties.

Methods: A systematic search of MEDLINE, EMBASE, Emcare, and CINAHL databases was conducted to identify studies reporting on multi-specialty or specialty-specific surgical robotic training curricula, between January 2000 and January 2024. We extracted data according to Kirkpatrick's curriculum evaluation model and Messick's concept of validity. The quality of studies was assessed using the Medical Education Research Study Quality Instrument (MERSQI).

Results: From the 3,687 studies retrieved, 66 articles were included. The majority of studies were single-centre (n = 52, 78.8%) and observational (n = 58, 87.9%) in nature. The most commonly reported curriculum components included didactic teaching (n = 48, 72.7%), dry laboratory skills (n = 46, 69.7%), and virtual reality (VR) simulation (n = 44, 66.7%). Curricula assessment methods varied, including direct observation (n = 44, 66.7%), video assessment (n = 26, 39.4%), and self-assessment (6.1%). Objective outcome measures were used in 44 studies (66.7%). None of the studies were fully evaluated according to Kirkpatrick's model, and five studies (7.6%) were fully evaluated according to Messick's framework. The studies were generally found to have moderate methodological quality with a median MERSQI of 11.

Conclusions: Essential components in robotic training curricula identified include didactic teaching, dry laboratory skills, and VR simulation. However, variability in assessment methods used and notable gaps in curricula validation remain evident. This highlights the need for standardised, evidence-based development, evaluation, and reporting of robotic curricula to ensure the effective and safe adoption of robotic surgical systems.