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THE FUNDAMENTALS OF ENDOSCOPIC SURGERY (FES) EXAM: TRAINEE PREPARATION, PERFORMANCE AND PERCEPTIONS AT A SINGLE INSTITUTION

Jacqueline J Blank, MD, Theresa B Krausert, BA, Lisa R Olson, BS, Matthew I Goldblatt, MD, Brian D Lewis, MD, Philip N Redlich, MD, PhD, Robert Treat, PhD, Andrew S Kastenmeier, MD. Medical College of Wisconsin

INTRODUCTION: Graduating general surgery residents are required to pass the FES exam in order to sit for the ABS qualifying exam. Trainees and surgery educators are interested in defining the most effective methods of exam preparation. Our aim is to define trainee perceptions, performance, and the most effective preparation methods regarding the FES exam.

METHODS: General surgery residents from a single institution who completed the FES exam were identified. All participated in a dedicated flexible endoscopy rotation, and all had access to an endoscopy simulator. Some trainees participated in an endoscopy curriculum. De-identified exam results were obtained. Residents were surveyed regarding the quality of available preparation methods, the difficulty of the exam, and the need for additional preparation materials. Descriptive statistics were used to evaluate the cohort, and a Kruskal-Wallis test was employed to determine differences in scores based on dedicated curricular instruction.

RESULTS: A total of 26 trainees took the FES exam with a first time pass rate of 96.2% compared to the national average of 79.9%. Nineteen (73.1%) participated in an endoscopy curriculum; however, scores for the written and skills exams did not differ significantly between groups (547 [IQR 539-562.5] vs 516 [484.5-547], p=0.1484; 535.5 [468.5-571] vs. 519 [464.75-575], p=0.9514). Surveys were completed by 21 (80.7%) trainees. Regarding the written exam, 90.5% felt there were appropriate preparation resources, exam difficulty was rated as 5.5 on a 10-point Likert scale, and 85.7% felt it was a fair assessment of endoscopy knowledge. Regarding the skills exam, 95.2% felt there were appropriate preparation resources, exam difficulty was rated as 7, and 71% felt it was a fair assessment of endoscopy skill. Trainees spent a median of 3 hours per week for 2 weeks in dedicated preparation for the written exam, and 3 hours per week for 1 week for the skills exam. The most effective written exam preparation included online FES modules, the endoscopy clinical rotation, and an exam preparation session with faculty. The most effective skills exam preparation methods were independent simulator practice, the endoscopy clinical rotation, and an exam preparation session with a faculty member. The most difficult skill components were reported as loop reduction and retroflexion.

CONCLUSIONS: A clinical endoscopy rotation, a method for independent skills practice, and faculty-mediated exam instruction appear to be effective exam preparation methods. When these are present, trainees report minimal need for dedicated exam preparation time prior to taking the FES exam.


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

Abstract ID: 95433

Program Number: S007

Presentation Session: Education

Presentation Type: Podium

96

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