Successful Fundamentals of Laparoscopic Surgery (fls) Testing for Practicing Surgeons in the Middle East

Brian J Dunkin, MD, Victor Wilcox, MD, Hani Lababidi, MD, Bandar Al Harthi, MD, Jalal Al Froukh, Mohammad Al Ammar, Alan Okrainec, MD, Steve Schwaitzberg, MD

The Methodist Hospital and King Fahad Medical City

INTRODUCTION FLS testing provides a baseline measurement of knowledge and skill in laparoscopic surgery. The success of this program in North America has created demand for expansion to international sites. Cultural and language barriers have sometimes impeded this expansion. This study describes a successful process for bringing FLS testing to the Kingdom of Saudi Arabia.

METHODS An approved US FLS testing center collaborated with the Center for Research, Education and Simulation Enhanced Training (CRESENT) in King Fahad Medical City, Riyadh, Saudi Arabia to organize two courses in basic laparoscopy. Prior to the courses, arrangements were made to ensure equipment, supplies, and computer resources would be available. Course participants were identified by CRESENT and registered by the US test center to receive test vouchers and on-line FLS content access. The US course director prepared all materials for the program and arrived on-site beforehand to coordinate logistics with the CRESENT team. Local laparoscopic surgeons were identified to be champions for the course and assist in its administration and expert proctors were brought-in from the US and Canada. All testing was done by official FLS test proctors and test material was managed by the US testing center. On course day one participants had ½ day of didactic presentations (content mirrored FLS on-line material) and ½ day hands-on skills training using the FLS technical skills proficiency-based training curriculum. Baseline measures of technical skill were recorded. On day 2 participants had an abbreviated didactic review and were allowed to continue to rehearse their hands-on skills with expert proctor guidance until they felt prepared to take the FLS test. All participants completed a post-test survey.

RESULTS Thirty six practicing surgeons and 3 surgery residents from Saudi Arabia registered for the courses (25 general, 2 thoracic, 2 pediatric, 5 urology, 5 gynecology). Thirty six completed the courses and took the FLS exam. Baseline measurements predicted that 24% would have passed the FLS skills test at the beginning of the course. Available official FLS test results from the first course (second course test results pending) show that 17 of 19 (89%) passed the skills test, while 18/19 (95%) passed the written. Post course evaluations revealed that 93% felt the program met or exceeded expectations (100% for non general surgery specialties); 100% strongly agreed that it provided knowledge and skill to implement in their practice and would enhance patient care; 100% agreed or strongly agreed that the CRESENT facility was conducive to learning and all stated that the pace of the program was “just right”.

CONCLUSIONS This program demonstrates that there are no cultural or language barriers to FLS testing in Saudi Arabia. It also proves the success of a concentrated two-day course in preparing international surgeons to take the FLS exam with a pass rate for this mixed specialty group exceeding that published for practicing general surgeons in the US (13% failure rate; Surg Endosc. 2012 Jul 7). This experience should serve as a foundation for expanding FLS testing in the Middle East.

Session: Poster Presentation

Program Number: P187

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