DEVELOPMENT OF A PROFICIENCY-BASED SKILLS PROGRAM FOR FES™ COMPETENCY: DETERMINING EXPERT PERFORMANCE CRITERIA ON THE SIMBIONIX GI ENDOSCOPY- FUNDAMENTAL SKILLS MODULES
Cheyenne C. Sonntag*1, David Morrell1, Katelin A. Mirkin1, John M. Levenick1, Jennifer Maranki1, Emmanuelle Williams1, Abraham Mathew1, David B. Stewart2, Vamsi V. Alli1, Eric Pauli1
1General Surgery, Penn State Health Milton S. Hershey Medical Center, Hummelstown, PA; 2University of Arizona Medical Center, Tuscon, AZ
Introduction: Passing the Fundamentals of Endoscopic Surgery (FES™) is a requirement for certification eligibility by the American Board of Surgery for all general surgery graduates. There is a need for evidence-based options for endoscopy training that will prepare trainees to pass FES™ technical skills examination. The purpose of this study is to establish expert performance criteria on FES™ training modules to set minimum proficiency levels for trainees.
Methods: Expert performance criteria were established for the 9 currently available Simbionix GI Endoscopy-Fundamental Skills Modules by expert endoscopists. Modules included: Basic Scope Manipulation; Endoscopic Navigation; Mucosal Evaluation (Basic, Advanced I, II); Retroflexion (Basic, Advanced); Task Targeting with Tool (Basic, Advanced), and Loop Reduction. Demographic information and annual case experience was collected. Each expert demonstrated baseline passage of the FES™ exam skills portion. Experts performed five repetitions for each module and mean scores were calculated. Performance metrics included speed and precision as reported by the module software. Minimum standard of skill proficiency for trainees were then set at one standard deviation from the mean expert score for each module.
Results: Six expert endoscopists (4 male, mean age 40 years, 6 right handed) were recruited for study participation, with five experts completing each module five times. Experts reported on average 408 (range 100-800) upper and 251 (range 5-500) lower endoscopy procedures annually. Mean expert scores for each module and establishment of minimum standard of skill proficiency for trainees were calculated (Table 1 & 2).
Conclusion: There remains a clear need to define and validate a hands-on technical skills training program that promotes endoscopic skills competency and passage of the technical skills portion of the FES™ exam. Establishing expert performance criteria on FES™ training modules is the first step in development of a proficiency-based skills program. Future and ongoing work aims to assess construct validity of the program.
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