University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Blvd., Dallas, TX, 75390-9092, USA.
University of Texas Health Sciences Center at San Antonio, San Antonio, TX, USA.
Surg Endosc. 2018 Nov;32(11):4451-4457. doi: 10.1007/s00464-018-6190-4. Epub 2018 Apr 11.
The Fundamentals of Endoscopic Surgery (FES) certification has recently been mandated by the American Board of Surgery but best methods for preparing for the exam are lacking. Our previous work demonstrated a 40% pass rate for PGY5 residents in our program. The purpose of this study was to determine the effectiveness of a proficiency-based skills and cognitive curriculum for FES certification.
Residents who agreed to participate (n = 15) underwent an orientation session, followed by skills pre-testing using three previously described models (Trus, Operation targeting task, and Kyoto) as well as the actual FES skills exam (vouchers provided by the FES committee). Participants then trained to proficiency on all three models for the skills curriculum and completed the FES online didactic material for the cognitive curriculum. Finally, participants post-tested on the models and took the actual FES certification exam. Values are mean ± SD; p < 0.05 was considered significant.
Of 15 residents who participated, 8 (53%) passed the FES skills exam at baseline. Participants required 2.7 ± 1.3 h to achieve proficiency on the models and approximately 3 h to complete the cognitive curriculum. At post-test, 14 (93%, vs. pre-test 53%, p = 0.041) passed the FES skills exam. 14 (93%) passed the FES cognitive exam and 13/15 (87%) passed both the skills and cognitive exam and achieved FES certification.
Our traditional clinical endoscopy curricula were not sufficient for senior residents to pass the FES exam. Implementation of a proficiency-based flexible endoscopy curriculum using bench-top models and the FES online materials was feasible and effective for the majority of learners. Importantly, with a modest amount of additional training, 87% of our trainees were able to pass the FES examination, which represents a significant improvement for our program. We expect that additional refinements of this curriculum may yield even better results for preparing future residents for the FES examination.
美国外科委员会最近要求外科住院医师必须通过内镜外科技能基础（FES）认证，但目前缺乏准备该考试的最佳方法。我们之前的研究表明，我们项目中 5 年级住院医师的通过率为 40%。本研究旨在确定基于熟练程度的技能和认知课程对 FES 认证的有效性。
同意参加的住院医师（n=15）参加了一个介绍会，然后使用之前描述的三种模型（Trus、Operation targeting task 和 Kyoto）进行技能预测试，并进行了实际的 FES 技能考试（由 FES 委员会提供的代金券）。然后，参与者在所有三个模型上进行技能课程培训，直到达到熟练程度，并完成 FES 在线教学材料的认知课程。最后，参与者在模型上进行后测并参加实际的 FES 认证考试。数值为平均值±标准差；p<0.05 被认为具有统计学意义。
在 15 名参加的住院医师中，有 8 名（53%）在基线时通过了 FES 技能考试。参与者需要 2.7±1.3 小时才能在模型上达到熟练程度，大约需要 3 小时才能完成认知课程。在后测中，14 名（93%，前测为 53%，p=0.041）通过了 FES 技能考试。14 名（93%）通过了 FES 认知考试，13/15（87%）名通过了技能和认知考试并获得了 FES 认证。
我们传统的临床内镜课程不足以让高级住院医师通过 FES 考试。使用台式模型和 FES 在线材料实施基于熟练程度的灵活内镜课程对大多数学习者来说是可行且有效的。重要的是，通过少量额外的培训，我们的 87%的受训者能够通过 FES 考试，这对我们的项目来说是一个重大的改进。我们预计，对该课程的进一步改进可能会为未来的住院医师准备 FES 考试带来更好的结果。
