Surgical Endoscopy

, Volume 32, Issue 3, pp 1389–1396 | Cite as

Can fatigue affect acquisition of new surgical skills? A prospective trial of pre- and post-call general surgery residents using the da Vinci surgical skills simulator

  • Weston Robison
  • Sonya K. Patel
  • Akshat Mehta
  • Tristan Senkowski
  • John Allen
  • Eric Shaw
  • Christopher K. Senkowski



To study the effects of fatigue on general surgery residents’ performance on the da Vinci Skills Simulator (dVSS).


15 General Surgery residents from various postgraduate training years (PGY2, PGY3, PGY4, and PGY5) performed 5 simulation tasks on the dVSS as recommended by the Robotic Training Network (RTN). The General Surgery residents had no prior experience with the dVSS. Participants were assigned to either the Pre-call group or Post-call group based on call schedule. As a measure of subjective fatigue, residents were given the Epworth Sleepiness Scale (ESS) prior to their dVSS testing. The dVSS MScore™ software recorded various metrics (Objective Structured Assessment of Technical Skills, OSATS) that were used to evaluate the performance of each resident to compare the robotic simulation proficiency between the Pre-call and Post-call groups.


Six general surgery residents were stratified into the Pre-call group and nine into the Post-call group. These residents were also stratified into Fatigued (10) or Nonfatigued (5) groups, as determined by their reported ESS scores. A statistically significant difference was found between the Pre-call and Post-call reported sleep hours (p = 0.036). There was no statistically significant difference between the Pre-call and Post-call groups or between the Fatigued and Nonfatigued groups in time to complete exercise, number of attempts, and high MScore™ score.


Despite variation in fatigue levels, there was no effect on the acquisition of robotic simulator skills.


Fatigue Robotic Education dVSS General surgery resident 



da Vinci Skills Simulator


Epworth Sleepiness Scale


Objective structure assessment of technical skills


Postgraduate year


Robotic training network


Accreditation Council for Graduate Medical Education


Virtual surgery simulator


Virtual reality


Institutional Review Board


Statistical package of social sciences



The authors are grateful for Craig Smith M.D. and his involvement in our study.


This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Compliance with ethical standards

Conflict of interest

Weston Robison, Sonya K. Patel, Akshat Mehta, Tristan Senkowski, John Allen, Eric Shaw, and Christopher K. Senkowski declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

464_2017_5820_MOESM1_ESM.docx (79 kb)
Supplementary material 1 (DOCX 78 kb)
464_2017_5820_MOESM2_ESM.docx (50 kb)
Supplementary material 2 (DOCX 50 kb)


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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Weston Robison
    • 1
  • Sonya K. Patel
    • 2
  • Akshat Mehta
    • 1
  • Tristan Senkowski
    • 3
  • John Allen
    • 2
  • Eric Shaw
    • 1
  • Christopher K. Senkowski
    • 2
  1. 1.Mercer School of Medicine, Memorial University Medical CenterSavannahUSA
  2. 2.Department of SurgeryMemorial University Medical Center, Mercer School of MedicineSavannahUSA
  3. 3.Savannah Country Day SchoolMemorial University Medical CenterSavannahUSA

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