Standardising excellence in robotic surgery – this time it’s personal

In surgical robotics, training has traditionally followed a volume-based approach, with surgeons needing to spend a certain number of hours learning new skills. A fresh approach, focused on collecting data and personalised learning curves is leading to a smarter, faster, more personal pathway to proficiency – and helping to standardise care for patients.

Surgeons at training centre

How evolving our approach to training can mean a smarter, faster, more personal pathway to proficiency.

The tools and technologies used to perform surgery are constantly the subject of innovation and evolution, and indeed nothing feels more futuristic than the idea – and now the reality – of being operated on by a surgical robot (or at least a robot operated by a surgeon). However, the methods by which surgical teams are trained in these new procedures or on new technology, like a robot, must evolve to keep pace with the technology they are teaching.

A traditional method of training has been competency through volume, by which a surgeon must complete a standard number of training hours by the end of which they are deemed to be competent. This approach has been effective and relatively simple to implement in the past, and in-line with much of the training in the medical profession.

But in a world of specialised digital platforms with the ability and appetite for in-depth data capture, professional education teams are able to accurately chart the progress and aptitudes of an individual surgeon through their training.

This allows for a more personalised approach to training, individual feedback and the ability to shape a bespoke (and often shortened) learning curve. This is driving a significant shift away from volume-based training to proficiency-based or metrics-led training. And CMR Surgical is moving towards such an approach as it launches its new training pathway.

Maximising quality over quantity

Proficiency-based training is grounded in the requirement that those completing it are able to demonstrate a progressive series of key capabilities in order to reach the required standard.

This approach is more robust and flexible than volume-based training as, rather than assuming that after completing a set number of hours you are capable, you instead must pass specific milestones to prove proficiency in a skill before proceeding onwards. For CMR, these skill-based modules include eLearning modules, hand controller training, virtual reality training and observation from a surgical preceptor. Cases are also supervised via remote tele-monitoring.

Conducting training in this way is multifaceted and puts innovative learning and data capture technologies to good use. The seven-step CMR Surgical training programme includes a combination of virtual reality and eLearning as well as in-person training and oversight.

The wealth of qualitative and quantitative performance data gathered from both these digital platforms and face to face teaching provides a comprehensive picture of how an individual member of the surgical team is progressing through their training – their strengths and weaknesses, aptitudes, and challenges. From this, detailed, specific feedback can be provided, and a custom learning curve can be created based on how the participant is getting on in hitting the competency milestones.
Explore our metrics-based training programme

Connecting personalisation and standardisation

Training in this targeted way provides a number of advantages for surgical teams. It enables each participant to follow their own highly-personalised programme which, in many cases, can mean that training can be completed more quickly and the learning curve reduced compared to a volume-based training approach. This allows teams to get up and running with robotic surgery sooner and cases can start more quickly.

The requirement to demonstrate skills to a consistent, high standard is also key in ensuring that both the trainers and the surgical team undertaking the training feel confident and have the data to confirm that they are proficient. For some trainees this may take longer than others, but on completion they can be sure they have achieved proficiency.

A collaborative approach to development

In the absence of any formal robotics training in the surgical syllabus, companies like CMR Surgical have taken the lead in bringing proficiency training to the theatre. However, the desire for a new approach is shared by many surgeons already working, or considering working, in robotic surgery.

For CMR Surgical, development of the proficiency training for the Versius Surgical Robot involved in-depth consultation with surgical teams already using the system to understand what a best practice programme should contain.

“The close partnerships we have with our surgeons – often operating as an extension of their team – meant that we were able to hear first-hand how best to focus the content, method, milestones and feedback of the training. The discussions gave expert validation to our thinking and interestingly, often supplied unexpected insights that sometimes challenged or re-shaped our approach for the better. However, what came out loud and clear is that surgeons wanted a more data-led, personalised approach to training.”

Mark Slack
Chief Medical Officer, CMR Surgical

Putting metrics-based training into practice

The Gynaecology surgical team at Cardiff and Vale University Health Board were the first team in the world to complete CMR Surgical’s new training programme. Dr Aarti Sharma is a Consultant Gynaecological Oncological Surgeon at Cardiff and Vale University Health Board, a hospital site that has recently installed Versius as part of the all-Wales National Robotic Assisted Surgery Programme. She found that taking a more personalised approach to training has had considerable benefits for her team.

“It’s been exciting to be the first team to fully experience and pioneer the new training with CMR. The new training programme allows each member of the team to progress at their own pace whilst ensuring consistency in performance as everyone has to hit specific competency milestones. The detailed training and feedback has ensured that the team can start using Versius with confidence and we look forward to seeing how robotic surgery can transform the patient experience at the hospital.”

Dr Aarti Sharma
Consultant Gynaecological Oncological Surgeon, Cardiff and Vale University Health Board

Time to get personal

Due to the demands within the surgical curriculum, it is crucial that industry works together with surgical teams to ensure that training is effective and of the highest standard.

New metrics-led training programmes must deliver the consistency that surgical teams demand, and patients deserve. They must deliver the technology-driven data and feedback worthy of the devices they are training for. And, they must deliver a personalised learning curve that recognises quality over quantity and allows patients to experience the benefits that robotic surgery brings, sooner.

Metrics-based training programmes like the one developed by CMR Surgical are leading the way in surgical education, and are surely a step in the right direction towards ensuring proficiency within surgical robotics for surgeons and the wider surgical team.

How can we help you?