87 Training novice robot surgeons: Proctoring provides same results as simulator-generated guidance Discussion In this study, we organised a training in robot simulation skills in order to investigate the influence of three different educational methods: proctoring, simulation guided training and self-study on the training of dexterity skills in novice surgeons. A total of 70 participants were included in the study. The participants were randomly divided in three groups. (1) The ability of novice robotic surgeons to learn the skills required to perform the vesicourethral anastomosis step of the RARP during a 2-hour training session. When comparing the pre-intervention results to the post-intervention results overall, all of the participants grew in their surgical skills during the training. The participants showed fewer instances of improper suturing technique and a decrease in the number of unnecessary needle piercing points in the post-intervention exercise. These metrics show the participants had a greater under-standing of the techniques required to perform RAS and especially how to suture using the surgical robot. The decrease in number of injuries to the urethra is also a sign of a better understanding of the technique required to perform a vesicourethral anastomosis. The participants were able to, through better understanding of the simulator and the exercise, increase the total number of en-trance and exit points through which the needle has passed which lead to a decrease in separation of the wound (anastomosis) after the intervention. This was done in the same period of time which shows the growth the participants experienced during the training. A separate analysis of the changes in simulation scores per intervention group shows some groups showed more growth than others. All groups showed a decrease in wound (anastomosis) separation in the post intervention scores compared to the pre-intervention scores. The non-intervention group showed a decrease in the clutch usage, the number of times the tissue was grabbed and in the number of movements with the right instrument. The proctor guided group showed a decrease in damage to the vital structures (urethra and bladder neck) and a decrease in the number of unnecessary needle piercing points. This could be the result of the proctoring since they received direct feedback by the proctor on their actions in order to adjust their behaviour accordingly. (2) The influence of the intervention on the learning curve of novice robotic surgeons. There was no significant difference in development of surgical skills between the
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