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Establishing Proficiency Benchmarks on a VR Simulator to Prepare Residents for the FES Examination

Daniel A Hashimoto, MD, MS1, Brenna W Casey, MD2, Emil Petrusa, PhD1, Christina Valle1, Denise W Gee, MD1. 1Department of Surgery, Massachusetts General Hospital, 2Division of Gastroenterology, Massachusetts General Hospital

Introduction: The Fundamentals of Endoscopic Surgery (FES) program, created by the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), is a test of knowledge and skill in flexible gastrointestinal endoscopy. The skill portion of the examination involves five tasks that assess the following skills: scope navigation, loop reduction, mucosal inspection, retroflexion, and targeting. Beginning in 2017, graduating general surgery residents will be required to pass the FES examination as part of the Flexible Endoscopy Mandate of the American Board of Surgery. This project aimed to identify proficiency benchmarks on currently available modules on the GI Mentor virtual reality simulator that could help to prepare residents for the FES technical skills exam.

Methods: Experienced endoscopists (>100 career colonoscopies) and inexperienced endoscopists (<50 career colonoscopies) were recruited to participate. Experienced endoscopists took the FES technical skills exam, and those who passed were asked to review six GI Mentor modules identified by two FES-certified surgeons as reflecting the skills tested in the exam. All recruited endoscopists were then asked to perform each of the selected modules twice. Median performance was compared between the two groups, and metrics that reflected significant differences between experienced and inexperienced endoscopists were selected as benchmarks. Alpha was set at 0.05.

Results: Five experienced endoscopists and nine inexperienced endoscopists participated. All experienced endoscopists agreed that the six selected modules reflected the skills tested in FES. Construct valid metrics were identified for six modules, and proficiency benchmarks were established as the median experienced endoscopist performance for each significant metric (Table 1).

Conclusion: The GI Mentor has practice modules that can distinguish experienced endoscopists who have passed FES from inexperienced endoscopists. These benchmarks can be utilized to establish a proficiency-based VR curriculum.

Table 1. Proficiency benchmarks (defined as median experienced endoscopist performance) for GI Mentor modules compared to performance of inexperienced endoscopists


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 78139

Program Number: S089

Presentation Session: SAGES Got Talent : Resident & Fellow Scientific Session

Presentation Type: ResFel

97

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