FLS Test is Transferable to ProMIS Simulator

INTRODUCTION: The McGill Inanimate System for Training and Evaluation of Laparoscopic Skills (MISTELS) is comprised of five tasks with an objective scoring system, and has been incorporated by SAGES in their Fundamentals of Laparoscopic Surgery (FLS) program. MISTELS has high inter-rater and test-retest reliability and correlates with operative skill. However, the FLS program is labor intensive, requiring a trained proctor. The ProMIS simulator allows for assessment of physical tasks (instrument path length and instrument smoothness) through instrument tracking technology. We hypothesized that the FLS scores obtained in the ProMIS simulator as well as ProMIS metrics would correlate with standard FLS scoring. METHODS: Twenty general surgery residents (13 junior and 7 senior) had baseline laparoscopic skills assessed using MISTELS in the standard FLS and ProMIS simulators (pre-test). Nine junior and 4 senior residents had a post-test after four weeks of training. Tasks were scored by FLS and ProMIS metrics. Total path length (TP) and total smoothness (TS) were calculated by adding the path lengths and smoothness of each individual task. ANOVA was used to compare the mean (SD) of total and individual task scores for pre- and post-tests in the FLS and ProMIS simulators. Student’s t-test was used to compare ProMIS metrics. Pearson’s correlations were calculated for standard FLS scores in relation to ProMIS FLS scores, TP and TS. Significance was defined as p < 0.01. RESULTS: All residents showed statistically significant improvement in post-test total and individual task FLS scores on either the FLS or ProMIS simulator. 100% and 88% of residents achieved passing post-test scores on the FLS and ProMIS simulator, compared to 30% and 29.2% on the pre-test. There was no difference in junior and senior resident post-test scores (87.6 vs 79.1). ProMIS path length and smoothness were significantly reduced across all tasks (range 14-68%). Total ProMIS FLS scores (0.729), TP (-0.753) and TS (-0.769) significantly correlated with total standard FLS simulator scores. All residents with TP < 4000mm or TS < 6000 achieved a passing total FLS score. CONCLUSIONS: All surgical residents achieved a passing FLS score after a 4-week laparoscopic skills curriculum. FLS tasks are transferable to the ProMIS simulator with traditional FLS scoring and intrinsic ProMIS metrics being good measurement tools. A ProMIS total path length

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Program Number: P174

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