The impact of external stimuli on the acquisition of robotic surgery skills: the Im-AcRoSS study

Introduction: It is not clear if the acquisition of robotic simulation skills can be affected by external factors during the simulation. Methods: A cohort of medical students performed five times a basic simulation exercise. Performance indexes were collected to build up individual “learning curves”. The participants were randomly divided into five groups and Groups 2 to 5 were “disturbed” by classic music, heavy metal, radio podcast, irregular noises, respectively, whereas participants of Group 1 were not distracted. Results: In the whole series, there was a progressive improvement of all the simulation parameters and the variability among the participants reduced with time. Group 5 do not reach the higher standards of the other four groups. Conclusions: Our study demonstrated that simulation could standardize the skills of the trainees at the top level despite different starting points. Irregular noises during the training can delay the acquisition of robotic skills.