Surgical residents and fellows acquire operative knowledge and skills by assisting attending surgeons in the operating room. Previous research has shown that practising technical skills prior to operating on patients can improve how skillfully laparoscopic surgery can be performed. Although an increasingly large number of patients are undergoing robotic hysterectomy and other robotic surgical procedures, little is known on how to ensure patient safety and treatment effectiveness when trainee surgeons participate in the operating room. Our study aims to determine the impact of immediate preoperative warm-up on a robotic surgery simulator by gynecologic surgical trainees on their intraoperative performance and on patient outcomes. The investigators are randomly assigning gynecologic surgical trainees at a major academic medical center to either warm-up immediately before surgery on a robotic surgery simulator or to not warm-up. The attending surgeon supervising the trainee in the operating room is unaware of whether the trainee was assigned to warm-up or no warm-up. The investigators will compare standard robotic surgical skills assessments of the trainees by the supervising attending surgeons and patient outcomes in the two groups.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
DOUBLE
Enrollment
22
Johns Hopkins Hospital
Baltimore, Maryland, United States
Johns Hopkins Bayview Medical Center
Baltimore, Maryland, United States
Global rating score - GEARS approach
Global rating scores assigned by the supervising surgeon immediately after each study surgical procedure. Global rating scores use two different approaches - the Objective Structured Assessment of Surgical Skills (OSATS) and the Global Evaluative Assessment of Robotic Surgery (GEARS).
Time frame: Assessed during the surgery (scheduled immediately following warm-up/no warm-up)
Global rating score - OSATS approach
Global rating scores assigned by the supervising surgeon immediately after each study surgical procedure. Global rating scores use two different approaches - the Objective Structured Assessment of Surgical Skills and the Global Evaluative Assessment of Robotic Surgery.
Time frame: Assessed during the surgery (scheduled immediately following warm-up/no warm-up)
Surgical skill metrics
Computed using surgical tool motion and/or video of procedure.
Time frame: Assessed during the surgery (scheduled immediately following warm-up/no warm-up)
Operative time
Time frame: Intraoperative
Estimated blood loss
Time frame: Intraoperative
Length of hospital stay
Time frame: We will follow patients in the study for the duration of their hospital stay; an anticipated average of about 5 days.
Change in hematocrit
Time frame: Postoperative days 1, 2, and 3
Readmission or emergency room visit
Time frame: 6 weeks after discharge from hospital (following initial admission for surgery)
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