130 Chapter 4 their training supports the chosen timing of the course in the residents curriculum. Of course, the possibility to perform robot assisted surgery is also dependent on external factors such as the availability of the surgery’s and competition for OR time with other residents or fellows. Strengths and limitations The results of the snapshot questionnaire give insight into the current state of training for robot assisted surgery and the possibility to perform robot assisted surgery during Dutch residency curriculum. Although the group studied was a selection (50 %) of all Dutch residents in urology and recently graduated urologist, they do show the implementation of robot assisted surgery training and the requirements set by the educators before the residents are allowed to take their first steps in robot assisted surgery. At several steps some of the respondents were directed to the end of the questionnaire based on their responses, for example residents who are not interested in performing robot assisted surgery and urologists who never performed robot assisted surgery were sent to the end of the questionnaire, this explains the reduction of the number of responses during the questionnaire. The goal of the questionnaire is to provide an overview of the availability of robot assisted surgery training and the possibility to perform robot assisted surgery during Dutch residency curriculum, the addition of participants who don’t find robot assisted surgery interesting or who never performed robot assisted surgery does not add to the strengths of the results. The performance of residents during a structured Advanced Course in Robot Assisted Surgery at ORSI academy combined with the 12-month follow-up of the participants provides information on the usefulness of the course and the chances of performing robot assisted surgery after completing the course. Although only a small number of residents participated in the course and some did not respond to the questionnaires the results do give a unique insight into the opportunities for residents to perform robot assisted surgery. A limitation of the follow-up using questionnaires could be an over representation of the success rate of the course, since it could be possible some of the participants of the course who did not responded were unable to perform robot assisted surgery and thus do not wish to respond to the questionnaires. Although participants show an increase in simulation-based surgical skills the question remains whether these results translate to real life surgery. It remains unclear if participants of a structured training program as provided in this study show significantly better postoperative outcomes (both functional outcome and complication rates) compared to colleagues who did not participate in this type of course. Additional research into the long-term effects of a structured training program should answer
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