Video-based Coaching Improves Trainee Robotic Technical Performance

Purpose While video-based surgical coaching (VBC) can improve operative performance, it is not widely utilized in surgical training due to limited video access. New robotic platforms enable automated access to operative video and performance metrics. The aim of this study is to evaluate the effect of structured robotic VBC on technical skills of surgical trainees. Methods Surgical resident participants were randomized to control or coaching groups over a 1-year intervention period. Both groups obtained operative assessments (RO-SCORE) during rotations, and active control time (ACT) robotic case participation metric was also analyzed. The coaching group received 1-hour VBC with trained robotic faculty coaches between operative assessments. Wilcoxon, paired t-tests, and descriptive statistics were applied. Results Fourteen residents completed the study (6 control, 8 coaching). Overall technical performance on RO-SCORES improved for coached residents (median 2.0 v 3.0, p  = 0.031) with greatest improvement in procedural efficiency and flow (median 3.0 v 4.0, p  = 0.0156). Overall technical performance did not change for the control (median 3.0 v 3.0, p  = 0.50). Although mean percent ACT increased for the coaching group (44 ± 9.0 v 49 ± 20, p  = 0.42) this was not statistically significant. Mean percent ACT was unchanged for control (49 ± 12 v 48 ± 38, p  = 0.92). Most coached residents (88%) found VBC very or extremely valuable and were highly satisfied with coaching feedback. Conclusions This study demonstrates that VBC within robotic surgery can accelerate resident technical skill development. Residents who received coaching reported high value and satisfaction compared to traditional teaching. With improved video access, training programs should implement VBC to support competency development in minimally invasive technologies.