Developing Game-based Leadership Training for Robotic Surgeons

All surgeons must simultaneously perform as skilled practitioners and effective team leaders in the operating room. This is further complicated in robotic surgery because the surgeon is removed a short distance from the operating table and works from within a specialized cockpit. This separation creates a unique hurdle when a crisis arises that requires the surgeon to disengage from the immediate steps of the surgery to provide leadership and guidance with issues involving the team, the equipment, the room, or the patient. To develop and test these skills we initially created a series of scenario-based videos with quizzes to evaluate surgeon understanding of these leadership responsibilities. Using these as a guide, we developed a game-based virtual environment containing the same information from the videos in a 3D interactive space which is accessible through a web browser. This environment presents accessible and engaging scenarios that include a scoring mechanism which can assess the time to react to events, the actions that occur before and after a decision, and the correctness of the decision made. The tool can also present alternative or repetitive scenarios when the student does not take the correct action. This paper describes the development process and the interactions with the surgeons and operating room teams which drove the design and content of the virtual environment. The paper also describes the longer term plans to validate the content and presentation of the game at multiple surgical training sites around the country. Though the virtual environment uses a more interactive method for presenting leadership and team decision making information, we are interested in whether it is more effective than the more traditional videos, textual instructions, role playing, and didactic lectures.