Development of a train-to-proficiency curriculum for the technical skills component of the fundamentals of endoscopic surgery exam

Susan Gearhart, Michael Marohn, Saowanee Ngamruengphong, Gina Adrales, Oluwafemi Owodunni, Kim Duncan, Emil Petrusa, Pamela Lipsett

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Background: The demonstration of competency in endoscopy is required prior to obtaining American Board of Surgery Certification. To demonstrate competency, the resident must pass a national high-stakes cognitive test and a technical skills exam on a virtual reality simulator. The purpose of this preliminary study was to design a proficiency-based endoscopy simulation curriculum to meet this competency requirement. Methods: This is a mixed methods prospective cohort study at a single academic medical institution. Prior to taking the national exam, surgery residents were required to participate in a skills lab and demonstrate proficiency on 10 simulation tasks. Proficiency was based on time and percent of objects targeted/mucosa seen. Simulation practice time, number of task repetitions to proficiency, and prior endoscopic experience were recorded. Resident’s self-reported confidence scores in endoscopic skills prior to and following simulation lab training were obtained. Results: From January 1, 2016 through August 1, 2017, 20 surgical residents (8 PGY2, 8 PGY3, 4 PGY4) completed both a faculty-supervised endoscopy skills lab and independent learning with train-to-proficiency simulation tasks. Median overall simulator time per resident was 306 min (IQR: 247–405 min). Median overall time to proficiency in all tasks was 235 min (IQR: 208–283 min). The median time to proficiency decreased with increasing PGY status (r = 0.4, P = 0.05). There was no correlation between prior real-time endoscopic experience and time to proficiency. Reported confidence in endoscopic skills increased significantly from mean of 5.75 prior to 7.30 following the faculty-supervised endoscopy skills lab (P = 0.0002). All 20 residents passed the national exam. Conclusions: In this preliminary study, a train-to-proficiency curriculum in endoscopy improved surgical resident’s confidence in their endoscopic skills and 100% of residents passed the FES technical skills test on their first attempt. Our findings also indicate that uniform proficiency was not achieved by real-time experience alone.

Original languageEnglish (US)
Pages (from-to)3070-3075
Number of pages6
JournalSurgical endoscopy
Issue number7
StatePublished - Jul 1 2018


  • Endoscopy
  • FES
  • Proficiency-based training
  • Simulation

ASJC Scopus subject areas

  • Surgery


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