Advertisement

Proficiency-based preparation significantly improves FES certification performance

  • Angela A. Guzzetta
  • Joshua J. Weis
  • Sara A. Hennessy
  • Ross E. Willis
  • Victor WilcoxJr.
  • Brian J. Dunkin
  • Deborah C. Hogg
  • Daniel J. Scott
Article

Abstract

Background

The Fundamentals of Endoscopic Surgery (FES) certification has recently been mandated by the American Board of Surgery but best methods for preparing for the exam are lacking. Our previous work demonstrated a 40% pass rate for PGY5 residents in our program. The purpose of this study was to determine the effectiveness of a proficiency-based skills and cognitive curriculum for FES certification.

Methods

Residents who agreed to participate (n = 15) underwent an orientation session, followed by skills pre-testing using three previously described models (Trus, Operation targeting task, and Kyoto) as well as the actual FES skills exam (vouchers provided by the FES committee). Participants then trained to proficiency on all three models for the skills curriculum and completed the FES online didactic material for the cognitive curriculum. Finally, participants post-tested on the models and took the actual FES certification exam. Values are mean ± SD; p < 0.05 was considered significant.

Results

Of 15 residents who participated, 8 (53%) passed the FES skills exam at baseline. Participants required 2.7 ± 1.3 h to achieve proficiency on the models and approximately 3 h to complete the cognitive curriculum. At post-test, 14 (93%, vs. pre-test 53%, p = 0.041) passed the FES skills exam. 14 (93%) passed the FES cognitive exam and 13/15 (87%) passed both the skills and cognitive exam and achieved FES certification.

Conclusions

Our traditional clinical endoscopy curricula were not sufficient for senior residents to pass the FES exam. Implementation of a proficiency-based flexible endoscopy curriculum using bench-top models and the FES online materials was feasible and effective for the majority of learners. Importantly, with a modest amount of additional training, 87% of our trainees were able to pass the FES examination, which represents a significant improvement for our program. We expect that additional refinements of this curriculum may yield even better results for preparing future residents for the FES examination.

Keywords

Fundamentals of Endoscopic Surgery Resident endoscopy training Endoscopy simulation FES 

Notes

Acknowledgements

The authors gratefully acknowledge the funding provided by the Society of American Gastrointestinal and Endoscopic Surgeons in the form of discounted test vouchers.

Compliance with ethical standards

Disclosures

Drs. Angela A. Guzzetta, Joshua J. Weis, Sara A. Hennessy, Ross E. Willis, Victor Wilcox Jr., Brian J. Dunkin, Deborah C. Hogg, and Daniel J. Scott have no conflicts of interest or financial ties to disclose.

Supplementary material

464_2018_6190_MOESM1_ESM.pdf (1.6 mb)
Supplementary material 1 (PDF 1664 KB)

References

  1. 1.
    Halverson AL, Hughes TG, Borgstrom DC, Sachdeva AK, DaRosa DA, Hoyt DB (2013) What surgical skills rural surgeons need to master. J Am Coll Surg 217(5):919–923CrossRefPubMedGoogle Scholar
  2. 2.
    Zuckerman R, Doty B, Bark K, Heneghan S (2007) Rural versus non-rural differences in surgeon performed endoscopy: results of a national survey. Am Surg 73(9):903–905PubMedGoogle Scholar
  3. 3.
    Pearl J, Fellinger E, Dunkin B et al (2016) Guidelines for privileging and credentialing physicians in gastrointestinal endoscopy. Surg Endosc 30(8):3184–3190CrossRefPubMedGoogle Scholar
  4. 4.
    Flexible Endoscopy Curriculum. 2015. Accessed 22 Feb 2017Google Scholar
  5. 5.
    Fundamentals of Endoscopic Surgery 2016. Accessed 22 Feb 2016, 2017Google Scholar
  6. 6.
    SCORE Curriculum Outline. 2016. Accessed 22 Feb 2017Google Scholar
  7. 7.
    Gardner AK, Scott DJ, Willis RE et al (2017) Is current surgery resident and GI fellow training adequate to pass FES? Surg Endosc 31(1):352–358CrossRefPubMedGoogle Scholar
  8. 8.
    Van Sickle KR, Buck L, Willis R et al (2011) A multicenter, simulation-based skills training collaborative using shared GI Mentor II systems: results from the Texas Association of Surgical Skills Laboratories (TASSL) flexible endoscopy curriculum. Surg Endosc 25(9):2980–2986CrossRefPubMedGoogle Scholar
  9. 9.
    SAGES STEP (Surgeons Training Endoscopic Proficiency) Application. https://www.sages.org/projects/step/. Accessed 2 Oct 2017
  10. 10.
    Snyder CW, Vandromme MJ, Tyra SL, Hawn MT (2009) Proficiency-based laparoscopic and endoscopic training with virtual reality simulators: a comparison of proctored and independent approaches. J Surg Educ 66(4):201–207CrossRefPubMedGoogle Scholar
  11. 11.
    Basic Endoscopic Skills. University of Texas Southwestern Simulation Videos 2016, 2017Google Scholar
  12. 12.
    Wilcox V Jr, Trus T, Salas N, Martinez J, Dunkin BJ (2014) A proficiency-based skills training curriculum for the SAGES surgical training for endoscopic proficiency (STEP) program. J Surg Educ 71(3):282–288CrossRefPubMedGoogle Scholar
  13. 13.
    Epstein RM, Hundert EM (2002) Defining and assessing professional competence. JAMA 287(2):226–235CrossRefPubMedGoogle Scholar
  14. 14.
    Batalden P, Leach D, Swing S, Dreyfus H, Dreyfus S (2002) General competencies and accreditation in graduate medical education. Health Aff 21(5):103–111CrossRefGoogle Scholar
  15. 15.
    Leung WC (2002) Competency based medical training: review. BMJ 325(7366):693–696CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Pugh CM, DaRosa DA, Glenn D, Bell RH Jr (2007) A comparison of faculty and resident perception of resident learning needs in the operating room. J Surg Educ 64(5):250–255CrossRefPubMedGoogle Scholar
  17. 17.
    Spalding LR, Hardin CD (1999) Unconscious unease and self-handicapping: behavioral consequences of individual differences in implicit and explicit self-esteem. Psychol Sci 10(6):535–539CrossRefGoogle Scholar
  18. 18.
    Koch AD, Buzink SN, Heemskerk J et al (2008) Expert and construct validity of the Simbionix GI Mentor II endoscopy simulator for colonoscopy. Surg Endosc 22(1):158–162CrossRefPubMedGoogle Scholar
  19. 19.
    Fayez R, Feldman LS, Kaneva P, Fried GM (2010) Testing the construct validity of the Simbionix GI Mentor II virtual reality colonoscopy simulator metrics: module matters. Surg Endosc 24(5):1060–1065CrossRefPubMedGoogle Scholar
  20. 20.
    Felsher JJ, Olesevich M, Farres H et al (2005) Validation of a flexible endoscopy simulator. Am J Surg 189(4):497–500CrossRefPubMedGoogle Scholar
  21. 21.
    Cohen J, Cohen SA, Vora KC et al (2006) Multicenter, randomized, controlled trial of virtual-reality simulator training in acquisition of competency in colonoscopy. Gastrointest Endosc 64(3):361–368CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Angela A. Guzzetta
    • 1
  • Joshua J. Weis
    • 1
  • Sara A. Hennessy
    • 1
  • Ross E. Willis
    • 2
  • Victor WilcoxJr.
    • 3
  • Brian J. Dunkin
    • 3
  • Deborah C. Hogg
    • 1
  • Daniel J. Scott
    • 1
  1. 1.University of Texas Southwestern Medical Center at DallasDallasUSA
  2. 2.University of Texas Health Sciences Center at San AntonioSan AntonioUSA
  3. 3.Houston Methodist HospitalHoustonUSA

Personalised recommendations