The end of "see one, do one, teach one" — Prof Stefano Puliatti | Show Me The Evidence Episode 9

Professor Stefano Puliatti is Professor of Urology at the University of Modena, a practising robotic surgeon, a faculty member of Surgquest, and the former Medical Director of Orsi Academy in Belgium, where much of the PBP research discussed here was carried out. Key takeaways Training quality should not depend on the luck of being assigned a gifted trainer. A shared methodology makes good outcomes reproducible. Errors, not speed or step count alone, are the real indicator of surgical quality. Process measures on their own do not guarantee it. A proficiency benchmark set at expert level is reachable by nearly all trainees, and usually faster than conventional training allows. Good simulation does not have to be expensive. A validated methodology on a low-cost model can outperform costly kit used without one. Diluting the method, for example by dropping the pre-lab benchmark, measurably slows learning and raises cost. Evidence and further reading The figures cited in this episode come from the peer-reviewed studies below. Please confirm the exact papers you want listed for this episode before publishing. De Groote R, et al. Proficiency-based training and evidence-based methodology: a systematic review and meta-analysis. BJU International. doi:10.1111/bju.70333 Mazzone E, Puliatti S, et al. A Systematic Review and Meta-analysis on the Impact of Proficiency-based Progression Simulation Training on Performance Outcomes. Annals of Surgery, 2021. PMID: 33630473 Puliatti S, et al. Can all surgical trainees be trained to proficiency for a robotic urethro-vesical anastomotic task using a chicken model? A prospective, randomized trial. PMID: 40351291 Randomised trial on the economic impact of proficiency-based progression versus conventional robotic surgical training. PMC12907777 Development and validation of the objective assessment of robotic suturing and knot tying skills for a chicken anastomotic model. Surgical Endoscopy, 2020. doi:10.1007/s00464-020-07918-5 De Groote R, et al. Proficiency-based progression training for robotic surgery skills training: a randomized clinical trial. BJU International, 2022. doi:10.1111/bju.15811 Credits Show Me the Evidence is hosted by Professor Anthony G. Gallagher and produced by Flux Learning.