Joshua J Weis, Lauren Busato, BS, Daniel J Scott, MD, Sara A Hennessy, MD. University of Texas Southwestern Medical Center at Dallas
Background: Fundamentals of Endoscopic Surgery (FES) certification is required to sit for the American Board of Surgery (ABS) Qualifying Exam. Our previous work demonstrated a 40% FES pass rate for our residents with standard clinical endoscopy training. After implementing a proficiency-based simulation curriculum championed by an MIS/Bariatric fellow, our FES pass rate increased to 87%. The purpose of this study was to monitor the success of our curriculum in its second year. We also hypothesized that residents who took the FES exam within 30 days of their clinical endoscopy rotation would have superior pass rates to residents who waited longer.
Methods: PGY4 residents (N=12) underwent flexible endoscopy training including a one month clinical rotation plus proficiency-based simulation training using bench-top models (Truss, MITE Targeting Task) and a virtual reality task on the GI Mentor, supervised by non-physician proctors. Residents that passed FES on their first attempt were compared to residents that did not pass based on number of endoscopies logged, hours spent practicing on simulators, and time elapsed between completing their endoscopy rotation and taking the FES exam. The Mann-Whitney U test and Fisher’s exact test were used to evaluate for differences with α<0.05 considered significant.
Results: Nine residents (75%) passed FES on their first attempt. Residents waited a median of 62 days (IQR 3-111) after their endoscopy rotation to take the FES exam. Overall, 80% of residents who tested within 30 days of their endoscopy rotation (n=5) passed FES while 71% of residents who waited longer (n=7) passed FES (p=non-significant). Residents logged a median of 83 endoscopies (IQR 77-92) and spent a median of 5.5 hours on simulators (IQR 2.75-10) before taking the FES exam. Residents that passed FES were not significantly different from residents who did not pass based on number of endoscopies logged or hours spent practicing on simulators.
Conclusions: FES pass rates decreased during the second year of our curriculum. We hypothesize that our learners received less coaching during simulation in the absence of a physician champion. Based on other literature, our trainees would benefit from higher volumes of endoscopy and/or a more robust proficiency-based simulation curriculum. In our small sample, scheduling the FES exam in the month following the endoscopy rotation did not significantly improve pass rates.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 87378
Program Number: S113
Presentation Session: Residents/Fellows Session
Presentation Type: ResFel