Validation of a Multidisciplinary Virtual Reality (VR) Robotic Surgical Curriculum

Objective: To identify whether trainees demonstrate improvement in a standardized knot-tying task as assessed by Global Evaluative Assessment of Robotic Skills (GEARS) score after completion of a virtual reality (VR) robotic curriculum. Design: An IRB-exempt prospective study conducted with surgical trainees from August 2021 – February 2023. Participants initially performed a baseline robotic suturing task in which they were instructed to tie interrupted square knots in 10 minutes. Participants then completed a virtual reality simulation curriculum involving 23 exercises until they achieved 90% proficiency on all tasks. Participants then repeated the suturing task. Pre- and post- curriculum suturing tasks were recorded, de-identified, and scored by expert graders using a GEARS score. Setting: Trainees from three academic centers were invited to participate. Participants Medical students (MS1-MS3) and surgical residents from gynecology, urology, and general surgery were invited to participate. Results: 25 trainees completed the pre-curriculum suturing task, the VR curriculum, and the post-curriculum suturing task. Trainees demonstrated significant improvement in their post-test GEARS score by 2.43 points (95% CI 1.19 - 3.66, p<0.05) and were able to tie three additional knots within 10 minutes after completion of the curriculum (95% CI 1.54 - 3.58, p<0.05). Trainees also demonstrated a faster time to complete first knot (129.24 second improvement, 95% CI 65.66 - 192.82, p<0.05) after completion of the curriculum. PGY3 trainees were able to tie more knots prior to the curriculum as compared to PGY1 trainees and medical students (p<0.05), but this difference was no longer significant after all groups completed the curriculum (p=0.04). Conclusion: Surgical trainees and medical students with limited prior robotic surgical experience demonstrated objective improvement after completion of a standardized VR curriculum.