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Use of Fundamentals of Laparoscopic Surgery Testing to Assess Gynecologic Surgeons: A Retrospective Cohort Study of
Sierra J Seaman1, Elisa M Jorgensen1, Angela C Tramontano1
1Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York Presbyterian Hospital, New York, New York (Dr. Seaman); Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts (Drs. Jorgensen, Mendiola, Ricciotti, and Hur); Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts (Dr. Jones); Institute for Technology Assessment, Massachusetts General Hospital, Boston, Massachusetts (Ms. Tramontano).
Study Objective:
To compare the Fundamentals of Laparoscopic Surgery (FLS) exam scores between obstetrics and gynecology (OBGYN) and general surgery (GS) providers.
Design:
This is a retrospective cohort study at a single institution from July 2007 to May 2018. Categorical and continuous variables were analyzed with χ2 test, t test, and Wilcoxon rank sum test.
Setting:
Beth Israel Deaconess Medical Center (BIDMC), Boston, MA, a tertiary care academic medical center.
Patients:
All providers who took the FLS exam at the Carl J. Shapiro Simulation and Skills Center at BIDMC.
Interventions:
FLS certification.
Measurements And Main Results:
A total of 205 BIDMC trainees and faculty took the FLS exam between July 2007 and May 2018, of which 176 were identified to be OBGYN or GS providers. The FLS certification pass rate was high for both specialties (97.0% OBGYN vs 96.1% sGS, p = .76). When comparing all providers, no significant difference was found in the mean manual skill test scores between surgical specialties (594.9 OBGYN vs 601.0 GS, p = .59); whereas, a significant difference was noted in the mean cognitive scores, with GS providers scoring higher than OBGYN providers (533.8 OBGYN vs 583.4 GS, p <.001). However, when adjusting for several variables in a multivariate linear regression model, surgical specialty was not a predictor for cognitive scores. In the multivariate analysis, age, sex, and test year were predictors for cognitive scores, with higher scores associated with younger age, male sex, and advancing calendar year. None of the variables were significant predictors of manual scores.
Conclusion:
Both OBGYN and GS providers had extremely high FLS pass rates. In the multivariate analysis, surgical specialty was not a predictor for higher FLS test scores for either manual or cognitive test scores. Although OBGYN residency programs offer fewer years of training, OBGYN trainees demonstrate the capacity to perform well on the FLS exam.
