129 Structured robot-assisted surgery training curriculum for residents in Urology and impact on future surgical activity Do residents show a significant increase in Simulation-based surgical skills following the curriculum? Even though the baseline skills simulation results of the current study are high, the participants were still able to show a significant increase in overall scores of all skills simulation exercises during the final assessment. When comparing this increase to the study of Larcher et al.17 the increase in skills simulation exercise scores in the current study is 7 - 11 % lower, only in the Suture sponge 2 exercise was the median increase in skills simulation exercise scores in this study approximately 3% higher.17 This difference in increase in scores could be the results of high baseline skills simulation results of the participants in the current study which leaves less room to increase in simulation skills. Since the participants in the current study received the same training in ORSI as the participants in the study by Larcher et al. this could not be of influence on the increase in scores on the skills simulation exercises.17 Are residents allowed by their trainers to perform robot assisted surgery after the curriculum? The results of the follow-up data show residents were allowed by their trainers to perform robot assisted surgery after participating in the current course. At 6 and 12 months after the course, almost all respondents were allowed to perform robot assisted surgeries as first surgeon. More than half of the respondents were able to do 10 or more surgeries in the first 12 months after the course. All of the participants were able to do Robot Assisted Radical Prostatectomies six months after the course, at 12 months after the course 7 out of 10 were allowed to perform Robot Assisted Radical Prostatectomies. Some of the participants were allowed to do other urological surgeries using the robot i.e. nephrectomies, partial nephrectomies and cystectomies. This shows that even though the course was designed to train the participants in the skills needed for Robot Assisted Radical Prostatectomy, the participants were able to apply the skills they learned to different types of surgery. This is in line with the follow-up of the fellows of the CC-ERUS fellowship.19 Analysis shows the baseline skills simulation exercise scores and final skills simulation exercise scores cannot be used to predict the chances of a participant to perform 10 or more robot assisted surgeries in the first 6 months after the course. This could be explained by the fact that there is some discussion on the transference of simulator skills to real life situation.20 Although there are multiple studies showing expert robotic surgeons have a shorter learning curve21 or higher overall scores in simulator exercises21–24, only limited studies have proven the transference of skills learned during simulator training to real life situations.25,26 Despite this, the fact that most residents from the training group continued with robotic surgery in the period right after
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