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Proficiency-based Preparation Significantly Improves Fes Certification Performance

Angela A Guzzetta, MD1, Aimee K Gardner, PhD1, Ross E Willis, PhD2, Victor Wilcox, MD3, Brian J Dunkin, MD3, Deborah C Hogg, BS1, Lauren Scott, BS1, Sara A Hennessy, MD1, Daniel J Scott, MD1. 1University of Texas Southwestern Medical School, 2University of Texas Health Science Center at San Antonio, 3Houston Methodist Hospital

Introduction: The Fundamentals of Endoscopic Surgery (FES) certification has recently been mandated by the American Board of Surgery but best methods for preparing for the exam are lacking. Our previous work demonstrated a 68% pass rate for 28 PGY5 residents at six programs using only existing endoscopy curricula, including a disappointing 30% pass rate at our institution. The purpose of this study was to determine the effectiveness of a proficiency-based skills and cognitive curriculum for FES certification.

Methods: All PGY4-5 general surgery residents (n=19) from the University of Texas Southwestern Medical Center were invited to participate in this IRB approved study. All residents had completed all previously established curricular components, including a dedicated, clinical flexible endoscopy rotation. Experts from three institutions designed a new flexible endoscopy curriculum. Residents who agreed to participate (n=17) underwent an orientation session, followed by skills pre-testing using 3 previously described models (Truss, MITIE Targeting Task, and Kyoto) as well as the actual FES skills exam (vouchers were provided by the FES committee). Participants then trained to proficiency on all 3 models for the skills curriculum and completed the FES online didactic material for the cognitive curriculum. Finally, participants post-tested on the models and took the actual FES certification exam. Values are mean ± SD; p<0.05 significant.

Results: Of 15 residents who completed the entire curriculum, 8 (53%) passed the FES skills exam at baseline; 2.7 ± 1.3 hours were required to achieve proficiency on the models and approximately 3 hours for the didactics. At post-test, 14 (93%, p=0.035 vs. pre-test) passed the FES skills exam and 14 (93%) passed the FES cognitive exam, with 13/15 (87%) achieving FES certification. Feedback from the learners was quite positive, with uniform encouragement to incorporate this curriculum into our program.

Conclusions: Traditional endoscopy curricula may not be sufficient for senior residents to pass the FES exam. Implementation of a proficiency-based flexible endoscopy curriculum using bench-top models and the FES online materials was feasible and effective for the majority of learners. Importantly, with a modest amount of additional training, 87% of our trainees were able to pass the FES examination, which represents a significant improvement for our program and surpasses the national resident pass rate of 77%. We are confident that implementing this proficiency based skills and cognitive curriculum will prepare future residents for the FES examination.


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

Abstract ID: 79424

Program Number: S061

Presentation Session: Education, Simulation and Assessment

Presentation Type: Podium

41

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