Discussion
Our study found that upon completion of the FRS course, all participants improved in proficiency; however, a significantly greater improvement in mean proficiency scores was seen if participants had undertaken VCT skills sessions in addition to the FRS curriculum.Our findings are consistent with other feasibility studies demonstrating improvement in technical skill performance and confidence level by novice trainees following participation in a structured robotic surgery skills training curriculum [Furthermore, all participants in our study retained proficiency of acquired skills over the duration of the training programme between the two assessment points, albeit this was over a period of 2 weeks and further assessment would be required to assess for longer term retention. The FRS curriculum integrates the principles of the PBP model [The COVID-19 pandemic has propelled the adoption of virtual classroom technology in surgical education. The performance of the FRS and VCT group, and the cross-over group who undertook VCT corroborates the findings of Autry et al. who conducted a randomised-controlled trial investigating VCT for knot-tying. Over a 4-week period, 18 interns independently practiced knot-tying, nine of the interns were then randomly selected to receive three additional hours of VCT. Participants who attended VCT demonstrated greater proficiency improvement than the control group [The FRS educational curriculum consists of online didactic modules and simulation-based self-practice. Supplementing the course with interactive virtual classroom teaching sessions offers an opportunity to receive mentorship from expert robotic surgeons. Our results highlight the beneficial effects of interactive sessions on objective performance scores and subjective confidence in performing robotic skill tasks. The importance of interactive learning has been acknowledged by teaching institutions, licensing bodies, and surgeons, especially when compared to didactic teaching. A prospective randomised-controlled trial by Tejos et al. demonstrated significantly inferior suturing skills training for medical students in the absence of concurrent peer or expert feedback [The principal limitation of this study is its single institutional nature. The applicability to smaller centres, where continued access to VCT technology and robotic simulators may be challenging, is not known. Moreover, there was a small sample size (Robot-assisted surgery has gained momentum at an unprecedented pace, creating training challenges for novice surgical trainees. A recent pan-specialty trainee, cross-sectional study demonstrated that less than 12% of current surgical trainees reported having access to robotic surgery training opportunities [