Design: This was an IRB-exempt prospective study conducted with multidisciplinary surgical trainees from August 2021 – February 2023.

Setting: Trainees from three academic centers were invited to participate in this study.

Patients or Participants: Medical students and surgical residents from gynecology, urology, and general surgery were invited to participate.

Interventions: Participants initially performed a baseline robotic suturing task in which they were instructed to tie as many interrupted square knots in a 10-minute period as possible. Participants then completed a virtual reality simulation curriculum involving 23 exercises until they were able to achieve 90% proficiency on all tasks. Participants then repeated the suturing task. Both pre- and post- curriculum suturing tasks were filmed, de-identified, and scored by expert graders using a GEARS score.

Measurements and Main Results: 25 trainees completed the pre-curriculum suturing task, the VR curriculum, followed by the post-curriculum suturing tasks. Trainees demonstrated significant improvement in their post-test GEARS score by 2.43 points (95% CI 1.19 - 3.66, p<0.05) and were able to tie three additional knots within the allotted time after completion of the curriculum (95% CI 1.54 - 3.58, p<0.05). Trainees also demonstrated a faster time to complete their first knot (129.24 second improvement, 95% CI 65.66 - 192.82, p<0.05) after completion of the curriculum. PGY3 trainees were able to tie significantly more knots prior to the curriculum as compared to PGY1 trainees and medical students (p<0.05), but this difference was no longer significant after all groups completed the curriculum (p=0.24).

Conclusion: Surgical trainees and medical students with limited prior robotic surgical experience demonstrated higher GEARS scores when comparing pre-curriculum and post-curriculum performance, and were able to tie more knots with greater efficiency.