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Alexandre Mottrie - One of the best experts on this subject based on the ideXlab platform.
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The European Association of Urology Robotic Training Curriculum: An Update
European Urology Focus, 2016Co-Authors: Alexandre Mottrie, Giacomo Novara, Henk G. Van Der Poel, Prokar Dasgupta, Francesco Montorsi, Giorgio GandagliaAbstract:The European Association of Urology robotic Training Curriculum is a validated structured program to provide standardized Training and to certify surgeons for specific urologic procedures.
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pilot validation study of the european association of urology robotic Training Curriculum
European Urology, 2015Co-Authors: Alessandro Volpe, Giacomo Novara, Prokar Dasgupta, Kamran Ahmed, Vincenzo Ficarra, Henk G Van Der Poel, Alexandre MottrieAbstract:Abstract Background The development of structured and validated Training curricula is one of the current priorities in robot-assisted urological surgery. Objective To establish the feasibility, acceptability, face validity, and educational impact of a structured Training Curriculum for robot-assisted radical prostatectomy (RARP), and to assess improvements in performance and ability to perform RARP after completion of the Curriculum. Design, setting, and participants A 12-wk Training Curriculum was developed based on an expert panel discussion and used to train ten fellows from major European teaching institutions. The Curriculum included: (1) e-learning, (2) 1 wk of structured simulation-based Training (virtual reality synthetic, animal, and cadaveric platforms), and (3) supervised modular Training for RARP. Outcome measurements and statistical analysis The feasibility, acceptability, face validity, and educational impact were assessed using quantitative surveys. Improvement in the technical skills of participants over the Training period was evaluated using the inbuilt validated assessment metrics on the da Vinci surgical simulator (dVSS). A final RARP performed by fellows on completion of their Training was assessed using the Global Evaluative Assessment of Robotic Skills (GEARS) score and generic and procedure-specific scoring criteria. Results and limitations The median baseline experience of participants as console surgeon was 4 mo (interquartile range [IQR] 0–6.5 mo). All participants completed the Curriculum and were involved in a median of 18 RARPs (IQR 14–36) during modular Training. The overall score for dVSS tasks significantly increased over the Training period ( p 10 (scale 4–16) for all procedural steps using a generic dedicated scoring tool. In performance comparison using this scoring tool, the experts significantly outperformed the fellows (mean score for all steps 13.6 vs 11). Conclusions The European robot-assisted urologic Training Curriculum is acceptable, valid, and effective for Training in RARP. Patient summary This study shows that a 12-wk structured Training program including simulation-based Training and mentored Training in the operating room allows surgeons with limited robotic experience to increase their robotic skills and their ability to perform the surgical steps of robot-assisted radical prostatectomy.
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Development of a standardised Training Curriculum for robotic surgery: a consensus statement from an international multidisciplinary group of experts.
BJU International, 2015Co-Authors: Kamran Ahmed, Alexandre Mottrie, Reenam S. Khan, Catherine Lovegrove, Ronny Abaza, Rajesh Ahlawat, Thomas E. Ahlering, Göran Ahlgren, Walter Artibani, Eric BarretAbstract:Objectives: To explore the views of experts about the development and validation of a robotic surgery Training Curriculum, and how this should be implemented. Materials and methods: An international expert panel was invited to a structured session for discussion. The study was of a mixed design, including qualitative and quantitative components based on focus group interviews during the European Association of Urology (EAU) Robotic Urology Section (ERUS) (2012), EAU (2013) and ERUS (2013) meetings. After introduction to the aims, principles and current status of the Curriculum development, group responses were elicited. After content analysis of recorded interviews generated themes were discussed at the second meeting, where consensus was achieved on each theme. This discussion also underwent content analysis, and was used to draft a Curriculum proposal. At the third meeting, a quantitative questionnaire about this Curriculum was disseminated to attendees to assess the level of agreement with the key points. Results: In all, 150 min (19 pages) of the focus group discussion was transcribed (21 316 words). Themes were agreed by two raters (median agreement kappa 0.89) and they included: need for a Training Curriculum (inter-rater agreement kappa 0.85); identification of learning needs (kappa 0.83); development of the Curriculum contents (kappa 0.81); an overview of available curricula (kappa 0.79); settings for robotic surgery Training ((kappa 0.89); assessment and Training of trainers (kappa 0.92); requirements for certification and patient safety (kappa 0.83); and need for a universally standardised Curriculum (kappa 0.78). A Training Curriculum was proposed based on the above discussions. Conclusion: This group proposes a multi-step Curriculum for robotic Training. Studies are in process to validate the effectiveness of the Curriculum and to assess transfer of skills to the operating room.
A V Spiteri - One of the best experts on this subject based on the ideXlab platform.
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Development of a virtual reality Training Curriculum for phacoemulsification surgery
Eye, 2014Co-Authors: A V Spiteri, Ara W. Darzi, Rajesh Aggarwal, L. Benjamin, Martin Šíra, Thomas L Kersey, P A BloomAbstract:PurposeTraining within a proficiency-based virtual reality (VR) Curriculum may reduce errors during real surgical procedures. This study used a scientific methodology to develop a VR Training Curriculum for phacoemulsification surgery (PS).Patients and methodsTen novice-(n) (performed 500) surgeons were recruited. Construct validity was defined as the ability to differentiate between the three levels of experience, based on the simulator-derived metrics for two abstract modules (four tasks) and three procedural modules (five tasks) on a high-fidelity VR simulator. Proficiency measures were based on the performance of experienced surgeons.ResultsAbstract modules demonstrated a 'ceiling effect' with construct validity established between groups (n) and (i) but not between groups (i) and (e)-Forceps 1 (46, 87, and 95; P
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development of a virtual reality Training Curriculum for phacoemulsification surgery
Eye, 2014Co-Authors: A V Spiteri, Ara W. Darzi, Rajesh Aggarwal, L. Benjamin, Martin Šíra, Thomas L Kersey, Philip BloomAbstract:Purpose Training within a proficiency-based virtual reality (VR) Curriculum may reduce errors during real surgical procedures. This study used a scientific methodology to develop a VR Training Curriculum for phacoemulsification surgery (PS). Patients and methods Ten novice-(n) (performed 500) surgeons were recruited. Construct validity was defined as the ability to differentiate between the three levels of experience, based on the simulator-derived metrics for two abstract modules (four tasks) and three procedural modules (five tasks) on a high-fidelity VR simulator. Proficiency measures were based on the performance of experienced surgeons. Results Abstract modules demonstrated a 'ceiling effect' with construct validity established between groups (n) and (i) but not between groups (i) and (e)-Forceps 1 (46, 87, and 95; P<0.001). Increasing difficulty of task showed significantly reduced performance in (n) but minimal difference for (i) and (e)-Anti-tremor 4 (0, 51, and 59; P<0.001), Forceps 4 (11, 73, and 94; P<0.001). Procedural modules were found to be construct valid between groups (n) and (i) and between groups (i) and (e)-Lens-cracking (0, 22, and 51; P<0.05) and Phacoquadrants (16, 53, and 87; P<0.05). This was also the case with Capsulorhexis (0, 19, and 63; P<0.05) with the performance decreasing in the (n) and (i) group but improving in the (e) group (0, 55, and 73; P<0.05) and (0, 48, and 76; P<0.05) as task difficulty increased. Conclusion Experienced/intermediate benchmark skill levels are defined allowing the development of a proficiency-based VR Training Curriculum for PS for novices using a structured scientific methodology.
Rajesh Aggarwal - One of the best experts on this subject based on the ideXlab platform.
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Development of a virtual reality Training Curriculum for phacoemulsification surgery
Eye, 2014Co-Authors: A V Spiteri, Ara W. Darzi, Rajesh Aggarwal, L. Benjamin, Martin Šíra, Thomas L Kersey, P A BloomAbstract:PurposeTraining within a proficiency-based virtual reality (VR) Curriculum may reduce errors during real surgical procedures. This study used a scientific methodology to develop a VR Training Curriculum for phacoemulsification surgery (PS).Patients and methodsTen novice-(n) (performed 500) surgeons were recruited. Construct validity was defined as the ability to differentiate between the three levels of experience, based on the simulator-derived metrics for two abstract modules (four tasks) and three procedural modules (five tasks) on a high-fidelity VR simulator. Proficiency measures were based on the performance of experienced surgeons.ResultsAbstract modules demonstrated a 'ceiling effect' with construct validity established between groups (n) and (i) but not between groups (i) and (e)-Forceps 1 (46, 87, and 95; P
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development of a virtual reality Training Curriculum for phacoemulsification surgery
Eye, 2014Co-Authors: A V Spiteri, Ara W. Darzi, Rajesh Aggarwal, L. Benjamin, Martin Šíra, Thomas L Kersey, Philip BloomAbstract:Purpose Training within a proficiency-based virtual reality (VR) Curriculum may reduce errors during real surgical procedures. This study used a scientific methodology to develop a VR Training Curriculum for phacoemulsification surgery (PS). Patients and methods Ten novice-(n) (performed 500) surgeons were recruited. Construct validity was defined as the ability to differentiate between the three levels of experience, based on the simulator-derived metrics for two abstract modules (four tasks) and three procedural modules (five tasks) on a high-fidelity VR simulator. Proficiency measures were based on the performance of experienced surgeons. Results Abstract modules demonstrated a 'ceiling effect' with construct validity established between groups (n) and (i) but not between groups (i) and (e)-Forceps 1 (46, 87, and 95; P<0.001). Increasing difficulty of task showed significantly reduced performance in (n) but minimal difference for (i) and (e)-Anti-tremor 4 (0, 51, and 59; P<0.001), Forceps 4 (11, 73, and 94; P<0.001). Procedural modules were found to be construct valid between groups (n) and (i) and between groups (i) and (e)-Lens-cracking (0, 22, and 51; P<0.05) and Phacoquadrants (16, 53, and 87; P<0.05). This was also the case with Capsulorhexis (0, 19, and 63; P<0.05) with the performance decreasing in the (n) and (i) group but improving in the (e) group (0, 55, and 73; P<0.05) and (0, 48, and 76; P<0.05) as task difficulty increased. Conclusion Experienced/intermediate benchmark skill levels are defined allowing the development of a proficiency-based VR Training Curriculum for PS for novices using a structured scientific methodology.
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Development of a virtual reality Training Curriculum for laparoscopic cholecystectomy.
British Journal of Surgery, 2009Co-Authors: Rajesh Aggarwal, P. Crochet, A. Dias, A. Misra, Paul Ziprin, Ara W. DarziAbstract:Background: Training within a proficiency-based virtual reality (VR) Curriculum may reduce errors during real surgical procedures. This study used a scientific methodology for development of a VR Training Curriculum for laparoscopic cholecystectomy. Methods: Inexperienced (had performed fewer than ten laparoscopic cholecystectomies), intermediate (20‐50) and experienced (more than 100) surgeons were recruited. Construct validity was defined as the ability to differentiate between the three levels of experience, based on simulator-derived metrics for nine basic skills, four procedural tasks and full laparoscopic cholecystectomy on a high-fidelity VR simulator. Inexperienced subjects performed ten repetitions for learning curve analysis. Proficiency measures were based on the performance of experienced surgeons. Results: Thirty inexperienced, 11 intermediate and 16 experienced operators were recruited. Eight of nine basic skills and three of four procedural tasks were found to be construct valid. The full procedure revealed significant intergroup differences for time (1541, 673 and 816 s; P = 0·002), movements (1021, 595 and 638; P = 0·006) and path length (2038, 1235 and 1303 cm; P = 0·033). Learning curves plateaued between the second and ninth sessions. Conclusion: This study shows that it is possible to define and develop a whole-procedure VR Training Curriculum for laparoscopic cholecystectomy using structured scientific methodology.
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A competency-based virtual reality Training Curriculum for the acquisition of laparoscopic psychomotor skill.
The American Journal of Surgery, 2006Co-Authors: Rajesh Aggarwal, Teodor P. Grantcharov, Krishna Moorthy, Julian Hance, Ara DarziAbstract:Abstact Background Studies have demonstrated the beneficial effect of Training novice laparoscopic surgeons using virtual reality (VR) simulators, although there is still no consensus regarding an optimal VR Training Curriculum. This study aims to establish and validate a structured VR Curriculum to provide an evidence-based approach for laparoscopic Training programmes. Methods The minimally invasive VR simulator (MIST-VR) has 12 abstract laparoscopic tasks, each at 3 graduated levels of difficulty (easy, medium, and hard). Twenty medical students completed 2 sessions of all tasks at the easy level, 10 sessions at the medium level, and finally 5 sessions of the 2 most complex tasks at the hard level. At the medium level, subjects were randomized into 2 equal groups performing either all 12 tasks (group A) or the 2 most complex tasks (group B). Performance was measured by time taken, path length, and errors for each hand. The results were compared between groups, and to those of 10 experienced laparoscopic surgeons. Results Baseline performance of both groups was similar at the easy level. At the medium level, learning curves for all 3 parameters reached plateau at the second (group A, P P Conclusion A graduated laparoscopic Training Curriculum enables trainees to familiarise, train and be assessed on laparoscopic VR simulators. This study can aid the incorporation of VR simulation into established surgical Training programmes.
Ara W. Darzi - One of the best experts on this subject based on the ideXlab platform.
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Development of a virtual reality Training Curriculum for phacoemulsification surgery
Eye, 2014Co-Authors: A V Spiteri, Ara W. Darzi, Rajesh Aggarwal, L. Benjamin, Martin Šíra, Thomas L Kersey, P A BloomAbstract:PurposeTraining within a proficiency-based virtual reality (VR) Curriculum may reduce errors during real surgical procedures. This study used a scientific methodology to develop a VR Training Curriculum for phacoemulsification surgery (PS).Patients and methodsTen novice-(n) (performed 500) surgeons were recruited. Construct validity was defined as the ability to differentiate between the three levels of experience, based on the simulator-derived metrics for two abstract modules (four tasks) and three procedural modules (five tasks) on a high-fidelity VR simulator. Proficiency measures were based on the performance of experienced surgeons.ResultsAbstract modules demonstrated a 'ceiling effect' with construct validity established between groups (n) and (i) but not between groups (i) and (e)-Forceps 1 (46, 87, and 95; P
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development of a virtual reality Training Curriculum for phacoemulsification surgery
Eye, 2014Co-Authors: A V Spiteri, Ara W. Darzi, Rajesh Aggarwal, L. Benjamin, Martin Šíra, Thomas L Kersey, Philip BloomAbstract:Purpose Training within a proficiency-based virtual reality (VR) Curriculum may reduce errors during real surgical procedures. This study used a scientific methodology to develop a VR Training Curriculum for phacoemulsification surgery (PS). Patients and methods Ten novice-(n) (performed 500) surgeons were recruited. Construct validity was defined as the ability to differentiate between the three levels of experience, based on the simulator-derived metrics for two abstract modules (four tasks) and three procedural modules (five tasks) on a high-fidelity VR simulator. Proficiency measures were based on the performance of experienced surgeons. Results Abstract modules demonstrated a 'ceiling effect' with construct validity established between groups (n) and (i) but not between groups (i) and (e)-Forceps 1 (46, 87, and 95; P<0.001). Increasing difficulty of task showed significantly reduced performance in (n) but minimal difference for (i) and (e)-Anti-tremor 4 (0, 51, and 59; P<0.001), Forceps 4 (11, 73, and 94; P<0.001). Procedural modules were found to be construct valid between groups (n) and (i) and between groups (i) and (e)-Lens-cracking (0, 22, and 51; P<0.05) and Phacoquadrants (16, 53, and 87; P<0.05). This was also the case with Capsulorhexis (0, 19, and 63; P<0.05) with the performance decreasing in the (n) and (i) group but improving in the (e) group (0, 55, and 73; P<0.05) and (0, 48, and 76; P<0.05) as task difficulty increased. Conclusion Experienced/intermediate benchmark skill levels are defined allowing the development of a proficiency-based VR Training Curriculum for PS for novices using a structured scientific methodology.
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Development of a virtual reality Training Curriculum for laparoscopic cholecystectomy.
British Journal of Surgery, 2009Co-Authors: Rajesh Aggarwal, P. Crochet, A. Dias, A. Misra, Paul Ziprin, Ara W. DarziAbstract:Background: Training within a proficiency-based virtual reality (VR) Curriculum may reduce errors during real surgical procedures. This study used a scientific methodology for development of a VR Training Curriculum for laparoscopic cholecystectomy. Methods: Inexperienced (had performed fewer than ten laparoscopic cholecystectomies), intermediate (20‐50) and experienced (more than 100) surgeons were recruited. Construct validity was defined as the ability to differentiate between the three levels of experience, based on simulator-derived metrics for nine basic skills, four procedural tasks and full laparoscopic cholecystectomy on a high-fidelity VR simulator. Inexperienced subjects performed ten repetitions for learning curve analysis. Proficiency measures were based on the performance of experienced surgeons. Results: Thirty inexperienced, 11 intermediate and 16 experienced operators were recruited. Eight of nine basic skills and three of four procedural tasks were found to be construct valid. The full procedure revealed significant intergroup differences for time (1541, 673 and 816 s; P = 0·002), movements (1021, 595 and 638; P = 0·006) and path length (2038, 1235 and 1303 cm; P = 0·033). Learning curves plateaued between the second and ninth sessions. Conclusion: This study shows that it is possible to define and develop a whole-procedure VR Training Curriculum for laparoscopic cholecystectomy using structured scientific methodology.
Giacomo Novara - One of the best experts on this subject based on the ideXlab platform.
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The European Association of Urology Robotic Training Curriculum: An Update
European Urology Focus, 2016Co-Authors: Alexandre Mottrie, Giacomo Novara, Henk G. Van Der Poel, Prokar Dasgupta, Francesco Montorsi, Giorgio GandagliaAbstract:The European Association of Urology robotic Training Curriculum is a validated structured program to provide standardized Training and to certify surgeons for specific urologic procedures.
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pilot validation study of the european association of urology robotic Training Curriculum
European Urology, 2015Co-Authors: Alessandro Volpe, Giacomo Novara, Prokar Dasgupta, Kamran Ahmed, Vincenzo Ficarra, Henk G Van Der Poel, Alexandre MottrieAbstract:Abstract Background The development of structured and validated Training curricula is one of the current priorities in robot-assisted urological surgery. Objective To establish the feasibility, acceptability, face validity, and educational impact of a structured Training Curriculum for robot-assisted radical prostatectomy (RARP), and to assess improvements in performance and ability to perform RARP after completion of the Curriculum. Design, setting, and participants A 12-wk Training Curriculum was developed based on an expert panel discussion and used to train ten fellows from major European teaching institutions. The Curriculum included: (1) e-learning, (2) 1 wk of structured simulation-based Training (virtual reality synthetic, animal, and cadaveric platforms), and (3) supervised modular Training for RARP. Outcome measurements and statistical analysis The feasibility, acceptability, face validity, and educational impact were assessed using quantitative surveys. Improvement in the technical skills of participants over the Training period was evaluated using the inbuilt validated assessment metrics on the da Vinci surgical simulator (dVSS). A final RARP performed by fellows on completion of their Training was assessed using the Global Evaluative Assessment of Robotic Skills (GEARS) score and generic and procedure-specific scoring criteria. Results and limitations The median baseline experience of participants as console surgeon was 4 mo (interquartile range [IQR] 0–6.5 mo). All participants completed the Curriculum and were involved in a median of 18 RARPs (IQR 14–36) during modular Training. The overall score for dVSS tasks significantly increased over the Training period ( p 10 (scale 4–16) for all procedural steps using a generic dedicated scoring tool. In performance comparison using this scoring tool, the experts significantly outperformed the fellows (mean score for all steps 13.6 vs 11). Conclusions The European robot-assisted urologic Training Curriculum is acceptable, valid, and effective for Training in RARP. Patient summary This study shows that a 12-wk structured Training program including simulation-based Training and mentored Training in the operating room allows surgeons with limited robotic experience to increase their robotic skills and their ability to perform the surgical steps of robot-assisted radical prostatectomy.
