Abstract: PD41-08
Sources of Funding: Roswell Park Alliance Foundation

Introduction

Patient safety is fundamental to surgical practice and it is critical to ensure surgical training and competence. Little has been published on brain cognitive states during learning and retention of basic Robot-Assisted Surgical skills. We sought to evaluate the feasibility of utilizing a novel brain functional states to evaluate surgical competency.

Methods

27 medical students were evaluated while performing four key tasks of the validated Fundamental Skills of Robot Surgery (FSRS) Curriculum and one advanced surgical module - the Hands-on Surgical Training (HoST) over six sessions, utilizing the robotic Surgery Simulator (RoSS). The four FSRS tasks evaluated were - Instrument Control Task, Ball Placement Task, Spatial Control II Task, Threading string through a series of hoops and 4th Arm Tissue Retraction. Tool –based metrics were assessed and recorded by RoSS. Brain states are extracted using the pairwise phase synchronization between EEG channels and are presented as functional brain networks. The functional brain networks are then quantified using network statistics, and spectral density of signals for all channels (mental workload).

Results

The average mental workload initially increases before significantly decreasing across sessions(Fig 1). This trend is also observed in functional brain states during the four tool-based metrics, as integration and segregation features increase at the beginning of learning and later decrease (Fig 2). We observed significant correlations between brain state and tool-based metrics (RoSS), while performing HOST task, where brain states do not correlate.

Conclusions

We report to our knowledge, the first study that evaluates brain states during skill acquisition and learning after simulation-based training. Various brain areas are functionally activated and integrated while acquiring new skills but these interactions decrease after preliminary learning.

Funding

Roswell Park Alliance Foundation