Assessment of face and content validity of performance metrics for basic robotic surgery skills PBP curriculum: a J-ERUS/YAU consensus on dry-lab training models.

Abstract

The increasing use of robotic systems in urologic surgery necessitates standardized training curricula to ensure novice surgeons acquire essential skills. This study developed and validated performance metrics for two dry-lab models-a proficiency-based progression (PBP)-based orange model for dissection, suturing, and knot-tying and a catheter-balloon model for vesicourethral anastomosis. An international expert group from the Young Academic Urologists Robotics and the European Robotic Urology Section utilized a Delphi-based consensus process to develop and refine procedural steps, errors, and critical errors for the two models. The orange model simulated dissection, suturing, and knot-tying, while the catheter-balloon model simulated vesicourethral anastomosis during radical prostatectomy. The Delphi rounds ensured > 80% agreement on steps and critical and non-critical errors for each task, refining the models' performance metrics to maximize their educational value. Consensus was achieved on the performance metrics for both models. For the orange model, the procedure was divided into three steps-dissection, suturing, and knot-tying-identifying nine, 13, and five non-critical errors, respectively, with three critical errors recognized. The catheter-balloon model included two steps-suturing and knot-tying-identifying 13 and five non-critical errors, respectively, with three critical errors recognized, including anastomosis leakage. The developed performance metrics for the orange and catheter-balloon models offer a structured and accessible approach to training novice surgeons in essential robotic surgical skills. These models can be easily integrated into various training settings and form a core component of a PBP curriculum, ensuring the safe and effective training of future robotic surgeons.