AUA 2016: Variation in the Technical Skill of Surgeons Performing Robot-Assisted Radical Prostatectomy - Session Highlights

San Diego, CA USA ( The Michigan Urological Surgery Improvement Collaborative (MUSIC) evaluated the improvement of robot-assisted radical prostatectomy (RARP) performance via a video-based skills assessment. They found that crowd-sourced reviewers rated surgeons lowest technical skill scores equivalently with experts.

Dr. Ghani and colleagues identified a new procedure-specific tool and in comparison to a global instrument, evaluated the rating differences between peer and crowd-sourced reviewers.

Ten MUSIC surgeons provided RARP videos. Each video was segmented, and rated by peer and crowd reviewers using two tools: Prosteatectomy Assessment and Competence Evaluation (PACE) and Global Evaluative Assessment of Robotic Skills (GEARS). GEARS evaluated global skill and PACE was a procedure specific tool, which contained 7 different domains. Performance was evaluated on a 1-5 number scale and total scores were calculated by combining all individual segments.

Peer surgeons completed a total of 328 video ratings and crowd reviewers completed 2717 video ratings. Peer reviewed ratings for GEARS demonstrated that a surgeon's score varies throughout different segments of a surgery. Scores of peer and crowd assessments using PACE ranged from 3.34 to 4.39, 3.87, and 4.18. A positive correlation was observed between the two types of reviewers, with the strongest correlation appearing for the anastomosis step and the lowest for steps that are considered technically challenging. The authors concluded from their findings that for surgeons performing RARP, assessment of technical skill varies. Being that lay people and experts equally assessed anastomosis suggests that it may be used as a target for quality improvement strategies.


Presented By: Khurshid Ghani, MD


Written By: Brittany Uribe, BS; Junior Specialist, Department of Urology, University of California, Irvine at the 2016 AUA Annual Meeting - May 6 - 10, 2016 – San Diego, California, USA