Korean essentials of robotic surgery (KEROS) program for novice robotic surgeons: evaluating the educational impact and participant satisfaction of simulation training for developing robotic surgical skills

Abstract

Introduction As robotic surgery expands, standardized training is crucial for novice robotic surgeons. The Korean Essentials of Robotic Surgery (KEROS) program, developed by the Korean Society of Endo-laparoscopic and Robotic Surgery, offers such training. This study evaluates KEROS's educational effectiveness and participant satisfaction. Methods Surgeons applied online for this prospective observational study. The KEROS program was conducted in 2023 and covered hepatobiliary-pancreatic (HBP), colorectal (CR), and upper gastrointestinal (UGI) divisions. Training included SimNow simulation, practice using synthetic models (Step I), and practice using a porcine model (Step II). Baseline experience was assessed via questionnaires. Objective surgical skillfulness was evaluated using structured checklists, and satisfaction was measured using Likert-scale surveys. Results Thirty-six surgeons participated. Baseline data revealed that 40% of the participants had no prior robotic training, and 50% had no first-assistant experience. Participants reported high satisfaction with the program's components, particularly the Step II animal model training, which was highly rated for realism and skill enhancement. The SimNow simulator was rated helpful for understanding the concept of using a third arm, finding a comfortable hand position using the clutch, and improving camera control skills. Questionnaire responses demonstrated reliable internal consistency (Cronbach index 0.69-0.85). Post-training, objective assessments using checklists during Step II animal model training revealed significant skill proficiency across all divisions (mean score: HBP 30.1/36, CR 85.4/100, UGI 82.3/100). Conclusions The KEROS program effectively enhances robotic surgical skills through a structured, simulation-based approach. High satisfaction and objective skill improvement support its role in robotic surgical education.