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Elspeth M. McDougall, MD, chair of the AUA Office of Education, discusses developing both a curriculum and a training program for robotic surgery in clinical practice.
Q What is the current status of standards for both robotic surgery and credentialing?
A Unfortunately, there are no established standards for credentialing or even certifying with respect to robotic surgery training. Through its Laparoscopy & Robotic Surgery Committee, the AUA has identified a need and an initiative to develop such standards. It is a much-needed focus for the specialty of urology. There's no other specialty that's better equipped to help develop both a curriculum and a training program because we have the most experience with the robot clinically.
The knowledge component of the curriculum has already been developed and is available free on the AUA web site as the "AUA Handbook of Laparoscopic and Robotic Fundamentals." The Laparoscopy & Robotic Surgery Committee is finalizing the skill tasks for testing, and this should be completed within the next year. The construct and validity testing of this curriculum will be the time-consuming part of the project and will likely require 2 to 3 years to complete.
Q Can you elucidate some of the challenges to moving forward with this curriculum?
We're now seeing the same thing happening with robotic surgery. These technologies are exploding so quickly into the clinical practice of surgery that they're being adopted by clinicians and used before the educational component can catch up to them. Educational programs are needed that will provide surgeons with the basic training to proceed in a safe and effective clinical fashion with these new technologies and procedures.
Q What role has industry played in this process to date, and what role should they play moving forward?
For that reason, I think it is absolutely critical that the AUA partner with them to some extent but also create our own expert-driven curricula for teaching these particular procedural techniques. Industry can help us and has helped us nicely by providing the basic knowledge of how the equipment works. Intuitive Surgical has created very good teaching modules that delineate how the different types of their three clinical robots work and how to troubleshoot them, but the actual procedural and skills training should be directed by expert clinicians and educators.
That's where the AUA has the expertise. We have the ability to bring thought leaders together to create a very robust, thorough, and effective training program.