Aimee K Gardner1, Aman B Ali2, Matthew Ritter3, Michael B Ujiki4, Brian J Dunkin2. 1University of Texas Southwestern Medical Center, 2Houston Methodist Hospitl, 3Uniform Services University, Walter Reed National Military Medical Center, 4Northshore University Health System
Introduction: There is an increasing amount of work suggesting that existing flexible endoscopy training curricula in surgical residency may be insufficient to ensure uniform pass rates on the Fundamentals of Endoscopic Surgery (FES) examination. The goal of our study is to examine the extent to which task performance on a newly developed Endoscopy Training System (ETS) would predict FES exam scores.
Methods: Fellows attending the 2016 SAGES Flexible Endoscopy Course were invited to complete the FES skills examination, one repetition of three tasks on the ETS (ETS1, scope manipulation; ETS2, targeting; and ETS3, retroflexion), and a questionnaire collecting information on demographics and endoscopic experience. Participants provided an anonymous unique identification number to ensure de-identified data aggregation. Basic descriptives, correlations, and regression analyses were conducted with SPSS version 23.0.
Results: Fifty-eight fellows (age 33.89 ± 3.21; 69% men) completed the ETS stations. The frequency of achieving proficiency levels on the simulation tasks during the first repetition was 23.5% (ETS1), 26.7% (ETS2), and 40% (ETS3). Twenty-eight fellows also took the FES skills examination with an overall pass rate of 60%. ETS1 performance significantly correlated with FES scope manipulation performance (r=.55, p < 0.001), and those who met proficiency on ETS1 were more likely to pass the FES exam compared to those who did not meet proficiency (100% vs. 56.3%, p < 0.05). Performance on ETS2 correlated with ETS1 (r=0.36, p < 0.05), but neither ETS2 nor ETS3 significantly correlated with their respective FES tasks. When all variables were included in a regression equation with upper and lower endoscopic case experience, ETS1 remained a significant predictor of overall FES exam scores (b= 6.17, t(5, 20)=4.051, p < 0.05), above and beyond clinical endoscopic experience.
Conclusions: These data indicate that there is value in using the scope manipulation task on the ETS to predict performance on the FES examination. In this setting, however, we did not find similar results for the tool targeting and retroflexion tasks. Future work should continue to explore how and when these tools can be used to complement efforts for ensuring uniform competency in flexible gastrointestinal endoscopy.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 80924
Program Number: P289
Presentation Session: Poster (Non CME)
Presentation Type: Poster