Elif Bilgic1, Pepa Kaneva1, Allan Okrainec2, Eric M Ritter3, Steven D Schwaitzberg4, Melina C Vassiliou1. 1McGill University, 2University of Toronto, 3Uniformed Services University, 4University of Buffalo
Introduction: The Fundamentals of Laparoscopic Surgery® (FLS) certification exam assesses both cognitive and manual skills, and has been administered for over a decade. The purpose of this study is to report results over the past 9 years of testing in order to identify patterns and evaluate the need to update content or scoring practices. This is a quality initiative of the SAGES FLS committee with the goal of keeping the exam current and relevant to the changing clinical environment.
Methods: A representative sample of FLS exam data from 2008- 2016 was analyzed. The de-identified data included demographics and scores for the cognitive and manual tests. Standard descriptive statistics were used to compare trends over the years, scores for different levels of training, and to assess the pass/fail rate.
Results: A total of 7232 FLS tests were analyzed (64% male, 6.4% junior (PGY 1-2), 84% senior(PGY3-5), 2.9% fellows(PGY6), and 6.7% attending surgeons(PGY7)). Specialties included 93% general surgery(GS), 6.2% gynecology, and 0.9% urology. The correlation between cognitive and manual scores was 0.09. For the cognitive exam, there was an increase in scores over the years (Mean 453.1 (2008-2011) compared to 520.3 (2012-2016)), and the most junior residents scored lowest. For the manual skills, there was no difference in scores over the years, and junior residents and fellows scored highest. Failure rates and patterns by level of training are shown in Table 1. The odds ratio of PGY3+ passing was 1.8 (CI 1.2-2.8) times higher than a PGY1-2. The internal consistency between tasks on the manual skills exam was 0.73. If any one of the tasks was removed, the Cronbach’s alpha dropped to between 0.65-0.71, depending on the task being removed.
Conclusion: The cognitive and manual components of FLS test different aspects of laparoscopy. Both FLS components demonstrate evidence for reliability and validity. More experienced trainees have a higher likelihood of passing the exam and tend to perform better on the cognitive skills. Each component of the manual skills contributes to the exam and should continue to be part of the test.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 79418
Program Number: S063
Presentation Session: Education, Simulation and Assessment
Presentation Type: Podium