Potential Fundamentals of Endoscopic Surgery exam curriculum successful, study claims

An abstract published in examined a potential curriculum for the soon-to-be-implemented Fundamentals of Endoscopic Surgery exam.

Matthew Ritter, MD, an associate professor for Bethesda, Md.-based Uniformed Services University, and colleagues developed a simulation-based mastery learning curriculum for the FES exam using an endoscopy training system.

The exam currently has no curriculum. Estimates predict a 40 percent failure rate. The exam is mandatory starting in 2018.

Eleven endoscopists from multiple institutions consisting of several specialties participated in the curriculum development. All eleven performed three trials of five different aspects including:

  • Scope manipulation
  • Tool targeting
  • Retroflexion
  • Loop reduction
  • Mucosal inspection

Researchers used their performance to set a standard for the simulation-based mastery learning curriculum. Four trainees then completed the curriculum.

Here's what they found:

1. The experienced endoscopists had approximately 11.2 years of experience and performed approximately 328 endoscopies over the past year. Six of them had completed the FES (mean 83.5). Eight had Global Assessment of Gastrointestinal Skill Scores of mean 19.6 on 20 point scale.

2. All 11 endoscopists needed to perform each of the three tasks twice to advance to the next task.

3. Pilot trainees needed 29.5 +/­ 3.7 training trials distributed over 2.75 +/­ 0.5 training sessions to complete the curriculum.

4. Despite earning passing Fundamentals of Endoscopic Surgery baseline scores, all trainees improved after training.

Researchers concluded, "This SBML curriculum developed using a multi­specialty/institutional standard setting approach resulted in a feasible curriculum producing improved FES scores even in a group of high performers."

Researchers recommend testing the curriculum with novice endoscopists.

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