Desafíos de la Integración de los Procedimientos Quirúrgicos Robóticos en la Educación Médica de Posgrado: Revisión del Estado del Arte.
Resumen
Introducción. La cirugía robótica está transformando progresivamente la educación médica de posgrado (GME); no obstante, su incorporación en los programas de formación continúa siendo heterogénea, con deficiencias persistentes en el acceso, la estandarización curricular, la autonomía del residente y la evaluación de competencias. Objetivo. Sintetizar y mapear los principales desafíos asociados con la integración de procedimientos quirúrgicos robóticos en la GME a través de siete dominios: acceso, currículo, apoyo institucional, experiencia del residente, evaluación, barreras y resultados. La pregunta guía fue: ¿cuáles son los desafíos de integrar procedimientos quirúrgicos robóticos en la educación médica de posgrado? Métodos. Se realizó una revisión temática narrativa de estudios revisados por pares, publicados en 2025, en idioma inglés e indexados en PubMed, Scopus y Web of Science. Se incluyeron estudios que evaluaran la integración de procedimientos robóticos en programas de residencia o beca y abordaran al menos uno de los dominios predefinidos. Se excluyeron estudios no relacionados con GME, informes técnicos sin resultados formativos, artículos de opinión, preprints, duplicados y entrenamientos no robóticos. Diez estudios cumplieron los criterios de inclusión. Los datos se extrajeron mediante un marco estandarizado y no se realizó metaanálisis. Resultados. Los programas reportaron acceso desigual a plataformas robóticas, sistemas de doble consola, simuladores y tiempo de formación protegido, lo que dio lugar a currículos fragmentados y basados en la competencia, con hitos poco definidos y apoyo institucional inconsistente. Aunque los residentes mostraron alta motivación, la exposición práctica fue variable y la autonomía en la consola limitada. Las herramientas de evaluación disponibles demostraron potencial, pero carecieron de validación robusta y alineación formal con los estándares de acreditación. La implementación se vio restringida además por los elevados costos, la escasez de docentes capacitados, preocupaciones médico-legales, limitaciones del flujo de trabajo y desigualdades estructurales. Los resultados evidenciaron mejoras en métricas de simulación y procesos, mientras que la transferencia a la competencia quirúrgica independiente y a mejores resultados clínicos fue inconsistente. Conclusiones. La integración de la cirugía robótica en la GME sigue limitada por inequidades en el acceso y una infraestructura curricular e institucional inconsistente.
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