Article 1
Targeted Needs Assessment for Developing a Robotic Surgery Training Curriculum for Acute Care Surgery Fellows: A Mixed-Methods Analysis. Katsura M, Brabender D, Sullivan ME, Ichiuji B, Obara H, Martin MJ, Inaba K, Matsushima K. J Am Coll Surg. 2026 Mar 5.
Summary:
This article is a mixed-methods study that combines semi-structured interviews with web-based surveys to identify the ideal robotic curriculum as envisioned by current Acute Care Surgery (ACS) fellows. Between 2023-2025, 17 fellows from both 1- and 2-year fellowships at Level 1 trauma centers were interviewed and surveyed. Participants first had a 30-50 minute, semi-structured interview. They then completed a survey. The interview and survey focused on evaluating the individuals’ experience in robotic surgery during residency, desired robotic training needs in fellowship, and career plans in robotic surgery. The interview transcripts were coded to generate themes in an iterative fashion.
77% of fellows graduated residency with a certificate in training. 47% of fellows reported >40 bedside cases in residency and 59% had console experience of 21-40 cases. Only 11% reported a formal robotic surgery curriculum in fellowship. Key themes that arose included curricular design, barriers to learning, and benefits of robotics training in fellowship. The authors then report multiple sub-themes within each of these key themes. The authors identified that the interviews were strongly shaped by residency experience, perceived applications for robotics, and career goals / outlook of the fellows. The authors point to this data to advocate for a flexible, individualized robotics curricula in ACS fellowships with the goal of building on previous training to develop independent practice.
Review:
This study, while better characterized as a pilot investigation, provides meaningful insight into the robotic training needs of current ACS fellows. A key observation is the variability in fellows’ prior experience with most console time concentrated on cholecystectomy and hernias. The authors clearly described their methodology conducting their study with rigor. The identified themes and sub-themes are well supported by the data provided and collectively demonstrate the growing importance of robotic surgery within ACS fellowship curriculum. The authors acknowledged key limitations particularly the low response rate and the homogenous sample (only four fellowship programs included). However, the manuscript would be strengthened if they provided a response rate or information regarding the respondents’ residency training backgrounds.
Ultimately, this study provides valuable preliminary data supporting the need for a flexible and individualized approach to robotic training in ACS fellowships. Despite its limited scope, this may serve as a catalyst for broader investigation into the optimal design and/or implementation of a robotic curriculum in ACS fellowships.
Article 2
Concerning Trends in Acute Care Surgeries Among General Surgery Trainees. Yousef S, Park J, Burg F, Gurung TM, Shah P, Barpujari A, Lingnurkar R, Jen J, Trehan K, Seamon M, Tohamy A, Kish K, Ramachandra P. J. Surg Educ. 2026 Jan;83(1):103776.
The authors of this study sought to clarify general surgery resident’s preparedness to manage acute care surgery (ACS) pathologies in the current era of minimally invasive surgery, advanced endoscopy, and interventional radiology. This was done through a query into the ACGME case log reports of general surgery residents between 1999 and 2023, specifically looking at the number of important ACS surgeries performed by residents each year. The list of surgeries that were deemed important was created by a panel of expert acute care and general surgeons. The authors found that while overall case numbers significantly increased between 1999 and 2023, core ACS procedures significantly declined. Important surgeries that declined in prevalence included splenectomy and common bile duct exploration. Additionally, common cases such as appendectomies, cholecystectomies, colectomies, and hernia repairs saw a decrease in open exposures with an associated rise in laparoscopic exposures. The authors concluded these trends reflect that current state of surgery and may adequately prepare residents to enter the current field but ill prepares residents going into ACS that will need to know bail out techniques and open surgeries.
This article highlights the current state of surgical education where there is a juxtaposition between patient-centered outcomes and surgical knowledge. While minimally invasive surgery and watchful waiting have improved patient outcomes, general surgery residents lose exposure to bail out techniques that can be utilized in critically ill patients. It is important to note that the authors used ACGME case logs, and as a result, their findings are limited due to the quantitative nature of the data. A resident’s true involvement in the surgery was not represented, nor was the knowledge gained from the case. The volume of cases is important, but surgical skill also hinges meaningful operative exposures. Data regarding resident perceptions on skills gained following surgery and how residents feel about their ability to perform core acute care surgery cases independently would bolster this study's findings. By including these qualitative components, the authors could begin to establish that a decline in case numbers correlates with decreased ability to perform core acute care surgery cases. Overall, this article aligns with current literature that suggests general surgery residents are less exposed to bailout and open techniques that are more commonly utilized in the acute care setting and emphasizes the need to re-structure surgical education to address this deficit.
