Assessment and application of non-technical skills in robotic-assisted surgery: a systematic review.
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Authors
Mahendran, Vimaladhithan
Turpin, Laura
Boal, Matthew
Francis, Nader
Issue Date
2024-04
Type
Systematic Review
Journal Article
Journal Article
Language
en
Keywords
Assessment , Human factors , Non-technical skills , Robotic surgery , Surgical training
Alternative Title
Abstract
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: 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: 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: 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.
Description
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
Citation
Mahendran, V.; Turpin, L.; Boal, M. and Francis, N. (2024) 'Assessment and application of non-technical skills in robotic-assisted surgery: a systematic review', Surgical Endoscopy, 38(4) pp. 1758-1774. Available at: https://doi.org/10.1007/s00464-024-10713-1
Publisher
Springer
License
© 2024. Crown.
Journal
Surgical endoscopy
Volume
38
Issue
4
PubMed ID
ISSN
1432-2218