Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York (Dr. Lerner); Department of Obstetrics and Gynecology, Mayo Clinic, Jacksonville, Florida (Dr. DeStephano); Department of Obstetrics and Gynecology, University of Connecticut Health Center, Farmington, Connecticut (Dr. Ulrich); Department of Obstetrics & Gynecology, Columbia University Medical Center, New York, New York (Dr. Han); Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma (Dr. LeClaire); Department of Gynecology and Obstetrics, Johns Hopkins University, Baltimore, Maryland (Dr. Chen).
Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York (Dr. Lerner); Department of Obstetrics and Gynecology, Mayo Clinic, Jacksonville, Florida (Dr. DeStephano); Department of Obstetrics and Gynecology, University of Connecticut Health Center, Farmington, Connecticut (Dr. Ulrich); Department of Obstetrics & Gynecology, Columbia University Medical Center, New York, New York (Dr. Han); Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma (Dr. LeClaire); Department of Gynecology and Obstetrics, Johns Hopkins University, Baltimore, Maryland (Dr. Chen).
J Minim Invasive Gynecol. 2021 Jul;28(7):1313-1324. doi: 10.1016/j.jmig.2021.04.010. Epub 2021 Apr 22.
The Fundamentals in Laparoscopic Surgery (FLS) examination is designed to test laparoscopic surgery skills. Our aim for this systematic review was to examine validity evidence supporting or refuting the FLS examination specifically as a high-stakes summative assessment tool in gynecology.
The data sources were PubMed, MEDLINE, Embase, and Scopus.
The study eligibility criterion was the subject of the FLS examination as an assessment tool in gynecology. We developed a data extraction tool and assigned articles for screening and extraction to all authors, who then abstracted data independently. Conflicts that arose during the extraction process were resolved by consensus. We organized validity evidence for the cognitive and manual skills portions on the basis of the categories of current validation standards.
TABULATION, INTEGRATION, AND RESULTS: From 1971 citations identified, 9 studies were included, involving 319 participants. For the cognitive portion of the test, the results were mixed in 5 studies in relationships with the other variables category. For the manual portion of the test, most of the studies focused on the relationships with other variables evidence with mixed findings. The concerning findings in the manual skills portion included the lack of transferability of skills to the operating room, limited mixed evidence for improvement in operating room performance, and worse performance by obstetrics and gynecology surgeons compared with other specialties. We did not find supportive content-based, response process, or consequential evidence in either the cognitive or manual skills portion of the test.
Validity evidence for the FLS examination was either mixed, as it pertained to relationships with other variables, or lacking in other important evidence categories. Further evidence is required to justify the use of the FLS examination scores as a high-stakes summative assessment.
腹腔镜手术基础（FLS）考试旨在测试腹腔镜手术技能。我们的目的是对 FLS 考试作为妇产科高风险总结性评估工具的有效性证据进行审查，以支持或反驳该考试。
数据来源为 PubMed、MEDLINE、Embase 和 Scopus。
研究入选标准是 FLS 考试作为妇产科评估工具的主题。我们开发了一个数据提取工具，并将所有文章分配给所有作者进行筛选和提取，然后由作者独立提取数据。在提取过程中出现的冲突通过协商解决。我们根据现行验证标准的类别，对认知和手动技能部分的有效性证据进行了组织。
列表、综合和结果：从 1971 个引文确定中，纳入了 9 项研究，涉及 319 名参与者。对于测试的认知部分，5 项研究的结果与其他变量类别存在关联，结果不一。对于测试的手动部分，大多数研究都集中在与其他变量的关系证据上，结果不一。在手动技能部分令人担忧的发现包括技能向手术室转移的能力有限、在手术室性能提高方面的混合证据有限、以及与其他专业相比妇产科医生的表现更差。我们在测试的认知或手动技能部分都没有发现支持内容基础、反应过程或后果的证据。
FLS 考试的有效性证据要么是混合的，因为它与其他变量有关，要么在其他重要证据类别中缺乏。需要进一步的证据来证明使用 FLS 考试成绩作为高风险总结性评估的合理性。
