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Updated: Feb 6, 2026

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The FES Test: Are We Ready?

Yazan Aljamal1, Humza Saleem2, Nicholas Prabhakar2

  • 1Mayo Clinic Multidisciplinary Simulation Center, Mayo Clinic College of Medicine and Science, Rochester, Minnesota; Department of General Surgery, Mayo Clinic, Rochester, Minnesota.

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General surgery residents initially struggled with colonoscopy simulation. Hands-on training significantly improved performance, with 96% achieving task completion, highlighting the need for simulation-based curricula.

Keywords:
FESInterpersonal and Communication SkillsMedical KnowledgePractice-Based Learning and ImprovementSystems-Based Practicecolonoscopyeducationendoscopysimulationsurgery

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Area of Science:

  • Medical Simulation
  • Surgical Education
  • Gastrointestinal Endoscopy

Background:

  • The Fundamentals of Endoscopic Surgery (FES) skills test uses a costly computer-based simulator.
  • General surgery residents often lack prior experience with this simulator.
  • Assessing baseline endoscopic skills is crucial for curriculum development.

Purpose of the Study:

  • Evaluate general surgery residents' baseline colonoscopy skills using a simulator.
  • Develop a simulation-based endoscopy curriculum.
  • Define performance-based assessment criteria for endoscopic proficiency.

Main Methods:

  • General surgery residents underwent colonoscopy skills assessment on a computer-based endoscopy simulator (CBES).
  • Tasks involved ileal intubation within 5 minutes, minimizing pain and complications.
  • Residents were assessed pre- and post-intervention (voluntary hands-on session).

Main Results:

  • Initially, few residents across PGY levels successfully intubated the ileum.
  • Post-intervention, residents attending a voluntary hands-on session showed significantly improved task completion (96% vs. 64%).
  • Prior simulator experience was the strongest predictor of successful colonoscopy task completion.

Conclusions:

  • General surgery residents require structured training for simulator-based endoscopic assessments.
  • Simulation-based curricula and hands-on sessions enhance trainee proficiency.
  • This approach can better prepare residents for the FES hands-on skills test.