The aim of this study was to evaluate the effect of training on the performance outcome with the da Vinci Skills Simulator by representing learning curves. Following the question of investigation of a structured training program for robotic surgical skills for robotic novices, this study focused on the da Vinci Skills Simulator known as an effective training tool for the acquisition of proficiency level. The present prospective study was conducted from January to December 2013 In the department

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... of otorhinolaryngology, Philipps Universität Marburg and included 40 participants. Students and robotic novices were equally distributed into two groups for a fourweek training curriculum. By getting a short briefing in using the da Vinci Skills Simulator one group performed four training sessions on day 1, 8, 15 and 22 of three consecutive repetitions of five exercises (Match Board I, Match Board II, Match Board III, Ring & Rail I, Ring & Rail II) and a final unpracticed exercise (Needle Control). The second group started by receiving the same briefing on day 1 and finished on day 22 (without day 8 and 15) with the final exercise (Needle Control). After each completed repetition, data was analyzed for the parameters time to complete exercise, economy of motion, excessive instrument force, instruments out of view, collisions and drops summarized to a calculated overall score by the system. Furthermore, the participants in group one were additionally distributed into three groups depending on their day-overall score of each exercise in order to investigate their learning progress. The results showed a skills gain in overall performance on the first and second day in group one in nearly all parameters. Considering higher overall scores in group one due to a shorter rate of repetitions compared to group two, group one has been shown stagnation in Ring & Rail I and Match Board II in the parameters time to complete exercise, economy of motion, excessive instrument force and instruments out of v [...]