Alexander Beulens

16 Chapter 1 tools can accurately assess NTS in complex robot assisted surgeries such as robot assisted radical cystectomy. With the introduction of the Interpersonal and Cognitive Assessment for Robotic Surgery (ICARS)51, adaptation to the robot assisted surgical setting has started. The question remains whether the introduction of robot assisted surgery leads to a change in NTS which could influence the outcome of the surgery. Research questions In this thesis the following general research question is answered: 1. What are the best methods to educate surgeons in robotic surgery? and 2. How can the performance of robotic surgeon’s best be assessed? 3. What is the relation between a surgeon’s performance and a patient’s postoperative outcomes These questions will be answered by answering the following research questions in 11 chapters (figure 1). 1. Are novice robot surgeons able to accurately self-assess their knowledge and dexterity skills? 2. What is the influence of structured skills training and structured feedback on the surgical skills of novice robot assisted surgeons? 3. What are the effects of structured robotic surgery skills training and structured feedback? 4. Which technical and non-technical skills factors in robot assisted surgery (competence, teamwork, dedicated OR team, patient factors, environmental factors) influence clinical and patient-related outcomes? 5. Is video analysis a valid measuring tool to assess the competence of surgeons? 6. Is it possible to find differences between surgeries that are relevant to the outcome of the intervention by analysing video material?