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Multi-institutional study reveals increased simulator practice among surgical residents during a gamified tournament, suggesting competition boosts robotic skills training.
INTRODUCTION: Modern robotic surgical education typically incorporates simulation-an instructional strategy that provides residents a low-risk environment to learn specific robot skills, receive immediate feedback, and engage in deliberate, metric-guided practice. Despite these benefits, limited trainee engagement is a barrier to robotic simulation achieving its full potential. Gamification, the application of game design principles, has been shown to increase motivation and voluntary practice in medical education, prompting consideration of how it might be deployed to increase engagement with robotic simulation at our institution. We applied the principles of gamification alongside an existing robotic simulation program to increase resident engagement. HOW WE DID IT: We developed "Robotic March Madness," a multi-institutional, elimination-style tournament based on gamification theory, aimed at increasing resident use of the simulation platform. Robotic modules were selected from Intuitive's SimNow platform. OUTCOMES: Thirty-two general surgery residents, across 3 institutions, competed in a weekly robotic skills competition over a span of 6 weeks. Simulator engagement increased substantially compared to the preceding 6 weeks. Across all sites, the median total repetitions of these skills increased by 545%, and active time on the simulator by 78%.
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Gao et al. (2026) studied this question.
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