Comprehensive proficiency-based inanimate training for robotic surgery: reliability, feasibility, and educational benefit Nabeel A. Arain • Genevieve Dulan • Deborah C. Hogg • Robert V. Rege • Cathryn E. Powers • Seifu T. Tesfay • Linda S. Hynan • Daniel J. Scott Received: 20 January 2012 / Accepted: 10 March 2012 / Published online: 27 April 2012 Ó Springer Science+Business Media, LLC 2012 Abstract Background We previously developed a comprehensive proficiency-based robotic training curriculum demonstrat- ing construct, content, and face validity. This study aimed to assess reliability, feasibility, and educational benefit associated with curricular implementation. Methods Over an 11-month period, 55 residents, fellows, and faculty (robotic novices) from general surgery, urology, and gynecology were enrolled in a 2-month cur- riculum: online didactics, half-day hands-on tutorial, and self-practice using nine inanimate exercises. Each trainee completed a questionnaire and performed a single proc- tored repetition of each task before (pretest) and after (post- test) training. Tasks were scored for time and errors using modified FLS metrics. For inter-rater reliability (IRR), three trainees were scored by two raters and analyzed using intraclass correlation coefficients (ICC). Data from eight experts were analyzed using ICC and Cronbach’s a to determine test-retest reliability and internal consistency, respectively. Educational benefit was assessed by com- paring baseline (pretest) and final (post-test) trainee per- formance; comparisons used Wilcoxon signed-rank test. Results Of the 55 trainees that pretested, 53 (96 %) completed all curricular components in 9–17 h and reached proficiency after completing an average of 72 ± 28 repe- titions over 5 ± 1 h. Trainees indicated minimal prior robotic experience and ‘‘poor comfort’’ with robotic skills at baseline (1.8 ± 0.9) compared to final testing (3.1 ± 0.8, p \ 0.001). IRR data for the composite score revealed an ICC of 0.96 (p \ 0.001). Test-retest reliability was 0.91 (p \ 0.001) and internal consistency was 0.81. Performance improved significantly after training for all nine tasks and according to composite scores (548 ± 176 vs. 914 ± 81, p \ 0.001), demonstrating educational benefit. Conclusion This curriculum is associated with high reli- ability measures, demonstrated feasibility for a large cohort of trainees, and yielded significant educational benefit. Further studies and adoption of this curriculum are encouraged. Keywords Robotic surgery Á Robotic skills training Á Proficiency-based training Á Simulation Á Curriculum development and implementation Á Reliability Robot-assisted procedures have rapidly gained momentum in a variety of surgical fields. In fact, more than 85 % of radical prostatectomies performed today are done roboti- cally [1]. Similarly, robotics is being increasingly utilized for gynecological operations [2]. Even though adoption has been less widespread within general surgery, many tech- nology enthusiasts expect that robotics will play an Presented at the SAGES 2012 Annual Meeting, March 7–March 10, 2012, San Diego, CA. N. A. Arain (&) Á G. Dulan Á D. C. Hogg Á R. V. Rege Á C. E. Powers Á S. T. Tesfay Á D. J. Scott Department of Surgery, Robotic Surgical Skills Training Laboratory, Southwestern Center for Minimally Invasive Surgery, The University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-9156, USA e-mail: Nabeel.arain@UTsouthwestern.edu D. J. Scott e-mail: Daniel.Scott@UTSouthwestern.edu L. S. Hynan Clinical Sciences (Division of Biostatistics and Psychiatry), Robotic Surgical Skills Training Laboratory, Southwestern Center for Minimally Invasive Surgery, The University of Texas Southwestern Medical Center, Dallas, TX, USA 123 Surg Endosc (2012) 26:2740–2745 DOI 10.1007/s00464-012-2264-x and Other Interventional Techniques