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The American Board of Surgery flexible endoscopy curriculum prepares individuals to pass the fundamentals of endoscopic surgery manual skills test

  • 2022 SAGES Oral
  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

The American Board of Surgery (ABS) has required Fundamentals of Endoscopic Surgery (FES) certification for general surgery applicants since 2018. Flexible Endoscopy Curriculum (FEC) completion is recommended prior to taking the FES exam. The objective of the study was to determine if FEC completion prepares individuals to pass the FES manual skills test.

Methods

Participants included first-attempt FES examinees from June 2014 to February 2019. De-identified data were reviewed, Self-reported data included gender, PGY, glove size, upper (UE) and lower (LE) endoscopy experience, simulation training time, and participation in an endoscopy rotation (ER). FES skills exam performance was reported by FES staff. Those completing all vs. none of the FEC were compared.

Results

Of 2023 participants identified, 809 (40.0%) reported completion of all FEC components, 1053 (52.1%) completed of some, and 161 (8.0%) completed none. Men and candidates taking FES later in residency were more likely to complete all FEC requirements (p = 0.002, p < 0.001). FES pass rates were higher for those who completed all FEC components compared to those who completed none (88.4% vs 72.7%, p < 0.001). On logistic regression analysis, completion of all components (OR 2.3, 95% CI 1.5–3.7, p < 0.001) and male gender (OR 3.1, 95% CI 1.7–5.7, p < 0.001) were predictors of passing, while glove size (OR 1.5, 95% CI 1.0–2.5, p = 0.08), simulator time (OR 1.1, 95% CI 0.9–1.4, p = 0.37) and PGY were not (OR 1.1, 95% CI 0.9–1.4, p = 0.38). On multivariate analysis controlling for glove size and gender, completion of all FEC components was still associated with a higher likelihood of passing the FES skills exam (OR 1.6, 95% CI 1.2–2.1, p < 0.001).

Conclusions

Completion of FEC is strongly associated with passing the FES skills test. This study supports the ABS recommendation for completion of FEC prior to taking the FES skills test.

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References

  1. Halverson AL et al (2013) What surgical skills rural surgeons need to master. J Am Coll Surg 217(5):919–923

    Article  PubMed  Google Scholar 

  2. Decker MR et al (2014) Specialization and the current practices of general surgeons. J Am Coll Surg 218(1):8–15

    Article  PubMed  Google Scholar 

  3. Zuckerman R et al (2007) Rural versus non-rural differences in surgeon performed endoscopy: results of a national survey. Am Surg 73(9):903–905

    Article  PubMed  Google Scholar 

  4. Undurraga Perl V et al (2015) Does surgery residency prepare residents to work at critical access hospitals? Am J Surg 209(5):828–32 (discussion 832-3)

    Article  PubMed  Google Scholar 

  5. Surgery, T.A.B.O. Flexible endoscopy curriculum for general surgery residents

  6. Poulose BK et al (2014) Fundamentals of Endoscopic Surgery cognitive examination: development and validity evidence. Surg Endosc 28(2):631–638

    Article  PubMed  Google Scholar 

  7. Vassiliou MC et al (2014) Fundamentals of endoscopic surgery: creation and validation of the hands-on test. Surg Endosc 28(3):704–711

    Article  PubMed  Google Scholar 

  8. Mueller CL et al (2014) Colonoscopy performance correlates with scores on the FES™ manual skills test. Surg Endosc 28(11):3081–3085

    Article  CAS  PubMed  Google Scholar 

  9. Lineberry M et al (2020) The Fundamentals of Endoscopic Surgery (FES) skills test: factors associated with first-attempt scores and pass rate. Surg Endosc 34(8):3633–3643

    Article  PubMed  Google Scholar 

  10. Sages, Sages fundamentals of endoscopic surgery (FES) required by American Board of Surgery. In: FES elevates the standards and training for minimally invasive surgery

  11. Gardner AK et al (2017) Is current surgery resident and GI fellow training adequate to pass FES? Surg Endosc 31(1):352–358

    Article  PubMed  Google Scholar 

  12. Weis JJ et al (2020) Are you better off than you were 4 years ago? Measuring the impact of the ABS flexible endoscopy curriculum. Surg Endosc 34(9):4110–4114

    Article  PubMed  Google Scholar 

  13. Lineberry M, Matthew Ritter E (2017) Psychometric properties of the Fundamentals of Endoscopic Surgery (FES) skills examination. Surg Endosc 31(12):5219–5227

    Article  PubMed  Google Scholar 

  14. Ritter EM, Dyke C, Marks JM (2020) Fact or fiction? Practice on a simulator is not required to pass the Fundamentals of Endoscopic Surgery (FES)TM skills exam. J Surg Educ 77(6):e229–e236

    Article  PubMed  Google Scholar 

  15. Ritter EM et al (2018) Simulation-based mastery learning for endoscopy using the endoscopy training system: a strategy to improve endoscopic skills and prepare for the fundamentals of endoscopic surgery (FES) manual skills exam. Surg Endosc 32(1):413–420

    Article  PubMed  Google Scholar 

  16. Ritter EM et al (2018) Simulation-based mastery learning significantly reduces gender differences on the Fundamentals of Endoscopic Surgery performance exam. Surg Endosc 32(12):5006–5011

    Article  PubMed  Google Scholar 

  17. Gearhart S et al (2018) Development of a train-to-proficiency curriculum for the technical skills component of the fundamentals of endoscopic surgery exam. Surg Endosc 32(7):3070–3075

    Article  PubMed  Google Scholar 

  18. Cohen DL et al (2008) The perception of gastroenterology fellows towards the relationship between hand size and endoscopic training. Dig Dis Sci 53(7):1902–1909

    Article  PubMed  Google Scholar 

  19. Austin K et al (2019) Musculoskeletal injuries are commonly reported among gastroenterology trainees: results of a National Survey. Dig Dis Sci 64(6):1439–1447

    Article  PubMed  Google Scholar 

  20. Shergill AK, McQuaid KR (2019) Ergonomic endoscopy: an oxymoron or realistic goal? Gastrointest Endosc 90(6):966–970

    Article  PubMed  Google Scholar 

  21. Voyer D, Voyer S, Bryden MP (1995) Magnitude of sex differences in spatial abilities: a meta-analysis and consideration of critical variables. Psychol Bull 117(2):250

    Article  CAS  PubMed  Google Scholar 

  22. Meyerson SL et al (2017) The effect of gender on resident autonomy in the operating room. J Surg Educ 74(6):e111–e118

    Article  PubMed  Google Scholar 

  23. Meyerson SL et al (2019) The effect of gender on operative autonomy in general surgery residents. Surgery 166(5):738–743

    Article  PubMed  Google Scholar 

  24. Hoops H et al (2019) Resident autonomy in the operating room: does gender matter? Am J Surg 217(2):301–305

    Article  PubMed  Google Scholar 

  25. Cooney CM et al (2021) An analysis of gender bias in plastic surgery resident assessment. J Grad Med Educ 13(4):500–506

    Article  PubMed  PubMed Central  Google Scholar 

  26. Kass SJ, Ahlers RH, Dugger M (1998) Eliminating gender differences through practice in an applied visual spatial task. Hum Perform 11(4):337–349

    Article  Google Scholar 

  27. Yu JX et al (2021) Gender disparities in advanced endoscopy fellowship. Endosc Int Open 9(3):E338–E342

    Article  PubMed  PubMed Central  Google Scholar 

  28. Weis JJ et al (2020) FES exam outcomes in year two of a proficiency-based endoscopic skills curriculum. Surg Endosc 34(2):961–966

    Article  PubMed  Google Scholar 

  29. Collings AT et al (2022) Assessment of chief resident practice readiness in a porcine lab: a 4-year experience. J Surg Educ 9(3):783–790

    Article  Google Scholar 

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Acknowledgements

We would like to acknowledge Jessica Mischna, Sarah Colon, Christelle Menetrier, and Vanessa Pryor from the SAGES Fundamentals Program for their assistance in providing the de-identified data.

Funding

This work was not funded by grants or industry.

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Authors and Affiliations

  1. Department of Surgery, Indiana University School of Medicine, 545 Barnhill Drive, Emerson Hall 129, Indianapolis, IN, 46202, USA

    Dominique L. Doster, Amelia T. Collings, Dimitrios Stefanidis & E. Matthew Ritter

Authors
  1. Dominique L. Doster
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  2. Amelia T. Collings
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  3. Dimitrios Stefanidis
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  4. E. Matthew Ritter
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Corresponding author

Correspondence to E. Matthew Ritter.

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Disclosures

E. Matthew Ritter, M.D., M.H.P.E is a consultant for Boston Scientific and receives royalties from the Henry M. Jackson Foundation for the Advancement of Military Medicine related to the development and sale of a flexible endoscopy simulator. Neither is related to this work or the FES program. Dimitrios Stefanidis, M.D., Ph.D. receives support from Intuitive and Beckton Dickinson. None of the above disclosures is related to this work. Dominique Doster, M.D. and Amelia Collings, M.D. have no conflicts of interest or financial ties to disclose.

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Doster, D.L., Collings, A.T., Stefanidis, D. et al. The American Board of Surgery flexible endoscopy curriculum prepares individuals to pass the fundamentals of endoscopic surgery manual skills test. Surg Endosc 37, 4010–4017 (2023). https://doi.org/10.1007/s00464-022-09559-2

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