Abstract:
Background: Over the past decade, Robotic and laparoscopic techniques in nipple-sparing mastectomy (NSM), have gained prominence in the field of breast surgery. However, the complexity of these procedures necessitates systematic training programs to ensure surgical competency. This study aimed to develop and evaluate a structured curriculum using the four-component instructional design (4C/ID) model to enhance the Robotic and laparoscopic skills of breast surgeons.
Methods: The curriculum was implemented through three rounds of training (June 2023–June 2024) under the National Health Commission’s Continuing Education Center (NHC-CBCEC). A total of 120 learners from hospitals across southern China participated. Training included theoretical modules, live demonstrations, simulator practice (LapSim®) and RobotiX Mentor simulator, Psychological survey and assessments via direct observation of procedural skills (DOPS) and Kirkpatrick’s evaluation model. Data were collected through surveys, interviews, and performance metrics.
Results: Of the 103 trainees, 99.03% reported being satisfied with the curriculum and significant improvements in skills, particularly with respect to NSM techniques. The use of LapSim® correlated with higher pass rates in later rounds (65.63% in Round 1 vs. 85.71% in Round 2 vs. 88.89% in Round 3). DOPS scores improved significantly in Round 3 compared with Round 1 (p < 0.05), with notable gains in efficiency and tissue handling. After the training, 59% of learners performed more surgeries independently compared to their pre-training numbers, while 76% demonstrated reduced operation duration.
Conclusion: The 4C/ID-based curriculum effectively bridges theoretical and practical training, improving surgical proficiency and certification rates. Continuous refinement using formative feedback and advanced simulators has potential for scalability and standardization in breast robotic and laparoscopy education.
