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Ten-year update on the European Association of Urology Robotic Section (ERUS) fellowship training for robot-assisted radical prostatectomy.

Researchers

Marco Paciotti, Christian Wagner, Nicola Frego, Edoardo Beatrici, Angelo Mottaran, Carlo Andrea Bravi, Federico Piramide, Maria Peraire Lores, Luca Sarchi, Adele Piro, Rui Farinha, Gabriele Sorce, Eleonora Balestrazzi, Luigi Nocera, Claudia Collà Ruvolo, Silvia Rebuffo, Nikolaos Liakos, Paolo Dell'Oglio, Mike Wenzel, Marcio Covas Moschovas, Filippo Turri, Fabrizio Di Maida, Edward Lambert, Christoph Wurnschimmel, Ruben De Groote, Ben van Cleynenbreugel, Alessandro Larcher, Iulia Andras, Nicolò Maria Buffi, Henk G van der Poel, Alberto Breda, Alexandre Mottrie, Anthony G Gallagher

Abstract

The aim of this paper is to evaluate fellowship outcomes 10&#x2009;years after implementation of the European Association of Urology Robotic Section (ERUS) structured curriculum for robot-assisted radical prostatectomy (RARP), with a focus on completion rates and reasons for non-completion. Data were obtained from institutional records and a trainee survey. The primary outcome was fellowship completion (i.e., Certificate of Excellence achievement). Secondary outcomes included reasons for non-completion and satisfaction. Completion rates were analysed annually, with trends assessed using the Cochran-Armitage test and log-linear regression for the Estimated Annual Percentage Change (EAPC). Comparisons before and after introduction of a procedural diary (2023) and between pandemic and non-pandemic years used Fisher's Exact Test. Among 126 fellows, a total of 42 (33%) completed the fellowship by achieving the Certificate of Excellence. The trainee survey achieved a response rate of 77%, supporting the representativeness of the collected data. The main barriers to fellowship completion included limited console access (49%), insufficient programme duration (20%), logistical difficulties (20%) and COVID-19-related disruptions (11%). Despite these limitations, overall satisfaction with the fellowship was high (83%), with particularly strong approval of the ORSI hands-on training week (100%). Completion rates demonstrated a progressive increase over time, rising from 20% in 2018 to 52% in 2023. The Cochran-Armitage test confirmed a statistically significant upward trend in completion rates over the study period (<i>p</i>&#x2009;&lt;&#x2009;0.001), while log-linear regression analysis showed a numerical but non-significant EAPC of 13% (95% CI -0.6 to 28.6). Although 2023 represented the highest observed completion rate, this peak was not significantly different from previous years (OR 2.63, 95% CI 0.91-7.63). The RARP ERUS Fellowship remains a benchmark in robotic training, but unsatisfactory completion rates highlight the need for improvement. Recent reforms, including the procedural diary, show promise and warrant expansion.
Source: PubMed (PMID: 42428668)View Original on PubMed