How effective and sustainable is proctoring in robotic surgery? A retrospective analysis based on interviews with surgeons.

Background: Robot-assisted surgery is one of several minimally invasive techniques which have become increasingly important in recent years. Education and training are key factors of sustainable success, and surgical tutoring by an experienced external surgeon (proctoring) has emerged as a very useful method of training surgeons. Proctoring enables surgeons to train their respective skills and eventually improve the overall quality of surgical care.

Methods: To evaluate the sustainability of proctoring, we conducted telephone interviews with colleagues who participated in a single-center surgical proctoring program. The aim was to analyze the feasibility of the concept for being established in the future, how well it suits the surgeons (depending on their individual work experience), and which areas of clinical practice would benefit from proctoring. Furthermore, the surgeons provided free-text comments to the questions on a feedback form handed out after the proctoring.

Results: Surgical skills were significantly enhanced and operating times were reduced after proctoring. Given favorable structural conditions, the number of cases and the case-mix index were also significantly increased. It was found that the learning needs of surgeons differ, depending on their medical function, work experience, and the frequency of robotic surgery. On the feedback forms, proctoring was consistently rated as a positive and supportive measure.

Conclusions: Proctoring is an important aspect of the individual development of surgeons. Depending on learning needs, a structured curriculum is crucial and should be established for the future. Regular feedback modules should be a part of any surgical training concept.