Assessment and application of non-technical skills in robotic-assisted surgery: a systematic review.

Assessment Human factors Non-technical skills Robotic surgery Surgical training

Journal

Surgical endoscopy
ISSN: 1432-2218
Titre abrégé: Surg Endosc
Pays: Germany
ID NLM: 8806653

Informations de publication

Date de publication:
11 Mar 2024
Historique:
received: 01 11 2023
accepted: 28 01 2024
medline: 12 3 2024
pubmed: 12 3 2024
entrez: 12 3 2024
Statut: aheadofprint

Résumé

Undeniably, robotic-assisted surgery (RAS) has become very popular in recent decades, but it has introduced challenges to the workflow of the surgical team. Non-technical skills (NTS) have received less emphasis than technical skills in training and assessment. The systematic review aimed to update the evidence on the role of NTS in robotic surgery, specifically focusing on evaluating assessment tools and their utilisation in training and surgical education in robotic surgery. A systematic literature search of PubMed, PsycINFO, MEDLINE, and EMBASE was conducted to identify primary articles on NTS in RAS. Messick's validity framework and the Modified Medical Education Research Study Quality Instrument were utilised to evaluate the quality of the validity evidence of the abstracted articles. Seventeen studies were eligible for the final analysis. Communication, environmental factors, anticipation and teamwork were key NTS for RAS. Team-related factors such as ambient noise and chatter, inconveniences due to repeated requests during the procedure and constraints due to poor design of the operating room may harm patient safety during RAS. Three novel rater-based scoring systems and one sensor-based method for assessing NTS in RAS were identified. Anticipation by the team to predict and execute the next move before an explicit verbal command improved the surgeon's situational awareness. This systematic review highlighted the paucity of reporting on non-technical skills in robotic surgery with only three bespoke objective assessment tools being identified. Communication, environmental factors, anticipation, and teamwork are the key non-technical skills reported in robotic surgery, and further research is required to investigate their benefits to improve patient safety during robotic surgery.

Sections du résumé

BACKGROUND BACKGROUND
Undeniably, robotic-assisted surgery (RAS) has become very popular in recent decades, but it has introduced challenges to the workflow of the surgical team. Non-technical skills (NTS) have received less emphasis than technical skills in training and assessment. The systematic review aimed to update the evidence on the role of NTS in robotic surgery, specifically focusing on evaluating assessment tools and their utilisation in training and surgical education in robotic surgery.
METHODS METHODS
A systematic literature search of PubMed, PsycINFO, MEDLINE, and EMBASE was conducted to identify primary articles on NTS in RAS. Messick's validity framework and the Modified Medical Education Research Study Quality Instrument were utilised to evaluate the quality of the validity evidence of the abstracted articles.
RESULTS RESULTS
Seventeen studies were eligible for the final analysis. Communication, environmental factors, anticipation and teamwork were key NTS for RAS. Team-related factors such as ambient noise and chatter, inconveniences due to repeated requests during the procedure and constraints due to poor design of the operating room may harm patient safety during RAS. Three novel rater-based scoring systems and one sensor-based method for assessing NTS in RAS were identified. Anticipation by the team to predict and execute the next move before an explicit verbal command improved the surgeon's situational awareness.
CONCLUSION CONCLUSIONS
This systematic review highlighted the paucity of reporting on non-technical skills in robotic surgery with only three bespoke objective assessment tools being identified. Communication, environmental factors, anticipation, and teamwork are the key non-technical skills reported in robotic surgery, and further research is required to investigate their benefits to improve patient safety during robotic surgery.

Identifiants

DOI: 10.1007/s00464-024-10713-1 PMID: 38467862
pubmed: 38467862
doi: 10.1007/s00464-024-10713-1
pii: 10.1007/s00464-024-10713-1
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024. Crown.

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Auteurs

Vimaladhithan Mahendran (V)

MSc Patient Safety and Human Clinical Factors, University of Edinburgh, Edinburgh, UK.
Department of General Surgery, Yeovil District Hospital, Yeovil, UK.

Laura Turpin (L)

Division of Medicine, BSc Applied Medical Sciences, University College London, London, UK.

Matthew Boal (M)

Division of Surgery & Interventional Science, Royal Free Hospital Campus, University College London, London, UK.
The Griffin Institute, Northwick Park Hospital, Northwick Park and St Mark's Hospital, Y Block, Watford Rd, Harrow, HA1 3UJ, UK.
Wellcome/EPSRC Centre for Interventional and Surgical Sciences, Charles Bell House, University College London, London, UK.

Nader K Francis (NK)

Division of Surgery & Interventional Science, Royal Free Hospital Campus, University College London, London, UK. n.francis@griffininstitute.org.uk.
The Griffin Institute, Northwick Park Hospital, Northwick Park and St Mark's Hospital, Y Block, Watford Rd, Harrow, HA1 3UJ, UK. n.francis@griffininstitute.org.uk.
ORCID: 0000-0001-8498-9175

Classifications MeSH