Poster3-01: ROBOTIC SURGERY: GOOD FOR SURGEONS, BAD FOR THIRD YEAR MEDICAL STUDENTS.
Donald J Mattia, Autefeh S Sajjadi, Bianka N Bubic, Kristina Chapple, Jordan Weinberg, MD, FACS, Ronald A Gagliano, MD, FASCRS, FACS, Thomas L Gillespie, MD, FACS; Creighton University School of Medicine

Introduction: Today, robotic surgery is performed in over one third of the hospitals in the United States.  In many ways it has become a disruptive technology fraught with unintended consequence.  One clear change the technology has brought about is that the surgeon needs very little assistance during surgical cases.  Recently, conversations regarding how the educational paradigm for training surgical residents in robotic surgery has changed resident surgical education for the worse in many ways.  The goal of this project was to report on medical student attitudes toward their surgical education during robotic surgical cases in comparison to open and laparoscopic surgery.

Methods: A single class of third year medical students in two cities were surveyed using a ten item Likert survey summarizing their surgical experience and attitudes. Composite scores reflecting attitudes toward robotic surgical education experiences were created by summing the survey item weights.

Results: 93 of 154 students completed the survey.  Seventy percent of participants had experience with 5 or more robotic surgeries, and 67% had experience with 20 or more total surgeries. 51.6% reported robotic surgical cases as slightly or moderately important and 48.4% reported it to be significantly or extremely important. When compared to laparoscopic and open surgery, the use of robotics in surgery was associated with decreased educational value for the third year medical student during their surgical clerkship. Student attitudes towards robotic surgery were increasingly less negative as viewpoints toward technological innovation became more important when compared to both open (P=.011) and laparoscopic surgical cases (p=.009).

Conclusion: Given the intertwined nature of medicine and technology, innovation will have a continued presence in the surgical learning environment.  Our study concluded that students found the use of robotics in surgery as detrimental to their surgical education.  However, if students inherently valued technological innovation, this detrimental effect was attenuated.  Medical schools may want to introduce courses on the integration of technology in medicine.  Similarly, clinical surgical rotations may want to integrate students into robotic cases such as teaching them how to load and change instruments on the patient cart.