Lindsay Wenger, MD, Cory Richardson, MD, Shawn Tsuda, MD, FACS. University of Nevada School of Medicine.
Introduction: The Fundamentals of Laparoscopic Surgery (FLS) program was developed by the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) in 1997 with the goal of teaching surgeons the fundamental knowledge, judgment, and technical skills specific to laparoscopic surgery. This single academic institution observational study aimed to assess the effectiveness of a biannual FLS training curriculum on PGY 1-5 proficiency levels, with a focus on a single FLS task (PEG transfer). Previous studies have shown that obtaining expert FLS proficiency correlates with retaining this proficiency in the future.
Methods and Materials: PGY 1-5 residents (n=17) at an academic general surgery residency program performed two separate timed PEG transfer tasks biannually. Participants were monitored by FLS certified examiners and standard FLS instructions, rules, and time penalties applied. Residents were expected to meet or exceed standards set by SAGES and FLS in consecutive timed PEG transfer trials (proficiency time: 48 seconds).
Results: Seventeen residents participated in the study ranging from PGY 1-5. Participants showed proficiency if they could complete the PEG transfer task in less than 48 seconds on two consecutive trials. None of the PGY-1 or PGY-2 residents completed two consecutive trials within the stated proficiency time during the one hour session, while 100% of the PGY 3-5 residents showed proficiency in the PEG transfer task. No participant of any PGY level went over the time limit of 300 seconds.
Conclusion: A biannual training session for FLS retains expert proficiency by PGY levels 3-5. Previous reports from our institution demonstrated that 95% of the residents did not practice this task between mandatory biannual sessions. This suggests that in combination with standard residency training, a biannual FLS proficiency based sessions confers retained expert skills by PGY 3-5. As the FLS certification exam is generally taken by PGY 4 and 5 residents and is now a requirement for board certification, general surgery residents that participate in biannual training sessions will likely retain expert proficiency and achieve FLS certification.
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