60 Chapter 3 ating room to train novice surgeons but is scarcely implemented in simulator based training due to time consumption and related costs.14–16 An alternative to human proctoring is the interactive task and procedural guidance by the simulator. Simulator generated guidance (SGG) is an option available on the newest simulation systems. Procedural guidance is provided by the simulator to guide the trainee trough the steps of a surgical procedure using visual cues.17 An advantage of SGG is the possibility to assess the effect of various training curricula on the progress of the surgeon’s surgical skills. It remains unclear if the effect of SGG is comparable to proctoring on the learning curve of the novice surgeon. The main aim of this study was to investigate the influence of individual personalised in-time guidance and feedback (proctored guidance) by an experienced trainer and of interactive task and procedural guidance by the simulator SGG on the development of dexterity skills (the ability to perform RAS) during the vesicourethral anastomosis. Moreover, we assess the satisfaction of the participants during different teaching modalities. Finally, we investigate the effect of general characteristics of the participants on the learning curve of a specific task. The research questions are: (1) Are novice surgeons able to learn the skills required to perform the vesicourethral anastomosis simulator step of the RARP during a short two-hour training session? (2) What is the influence of individual personalised in-time guidance and feedback (proctoring) by an experienced trainer, or interactive task and procedural guidance by the simulator (SGG) compared to no guidance on the learning curve of novice surgeons who were asked to perform the vesicourethral anastomosis step of the RARP on a robotic surgery simulation system? (3) What is the influence of individual personalised in-time feedback (proctoring) by an experienced trainer, or interactive task and procedural guidance by the simulator (SGG) compared to no guidance on the participant satisfaction of novice surgeons who were asked to perform the vesicourethral anastomosis step of the RARP on a robotic surgery simulation system? (4) Is there a difference in the effect of participant’s characteristics (i.e. age, gender, laparoscopic surgery experience, surgical experience in general, etc.) on the learning curve of novice surgeons? These questions will be answered by performing an intervention study amongst medical students, residents and PhD-candidates.
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