19 Introduction and Outline of the Thesis Outline of the thesis The first section of the thesis focusses on surgical training. In this section four chapters will focus on the different aspects of surgical training and evaluation of the shortterm and long-term effects of surgical training. In this section research questions one, two and three will be answered in multiple chapters (figure 1). In Chapter 2 we investigate research question 1 ‘Are novice robot surgeons able to accurately self-assess their knowledge and dexterity skills?’ by investigating the ability of novice robot surgeons to assess their own robot assisted surgery skills and knowledge of robot assisted surgery. We compare the results of the surgical skills simulation exercises to the self-assessment of their own dexterity skills after a oneday robot assisted surgery training. Chapter 3 investigates research question 2 ‘What is the influence of structured skills training and structured feedback on the surgical skills of novice robot assisted surgeons?’ in order to evaluate the effectiveness of a simulation based surgical skills training in the vesico-urethral anastomosis of the Robot Assisted Radical Prostatectomy (RARP) in novice robot surgeons. In order to evaluate the effects of expert proctoring or simulation-based training by the simulator on technical skills and participant satisfaction. In Chapter 4 research question 2 ‘What is the influence of structured skills training and structured feedback on the surgical skills of novice robot assisted surgeons?’ and research question 3 ‘What are the effects of structured robotic surgery skills training and structured feedback?’are investigated. In this chapter, the results of a snap shot survey amongst Dutch residents and recently graduated urologist are combined with the results of residents who participated in an advanced course in Robot Assisted Surgery. This chapter provides valuable insight into the current state of robot assisted surgery training and the requirements set by the educators before the residents are allowed to take their first steps in robot assisted surgery. In addition, the short-term and long-term effect of structured robot assisted surgery training on novice robot surgeons was reviewed. Chapter 5 focusses on research question 3 ‘What are the effects of structured robotic surgery skills training and structured feedback?’. In this chapter, we evaluate the long-term effects of a robot assisted surgery fellowship. The evaluation consisted of a questionnaire amongst the participants of a robot assisted surgery fellowship in order to investigate the long-term influence of this fellowship on the surgeons work and their patient’s outcome.