Early implementation of Fundamentals of Endoscopic Surgery training using a simulation-based mastery learning...

Area of Science:

• Medical Education
• Surgical Training
• Gastroenterology

Background:

• The American Board of Surgery mandated flexible endoscopy training in 2014.
• A dedicated endoscopy rotation and simulation curriculum were implemented for postgraduate year 2 (PGY2) surgical residents.
• This study evaluates the outcomes of the implemented simulation-based curriculum.

Purpose of the Study:

• To assess the effectiveness of a simulation-based endoscopy curriculum for surgical residents.
• To evaluate resident performance on Fundamentals of Endoscopic Surgery (FES) skills.
• To compare outcomes with clinical experience benchmarks.

Main Methods:

• Implemented a clinical endoscopy and simulation-based rotation starting in 2015.
• Utilized the Endoscopy Training System (ETS) for mastery learning curriculum since 2016.
• Evaluated success based on first-time FES pass rates, training time, and comparison to benchmarks.

Main Results:

• 97% first-time pass rate for residents completing the ETS curriculum versus 67% for those who did not (P=.01).
• Residents completing ETS had higher FES scores (472 vs. 389, P<.01) and specific task scores.
• PGY2 residents with minimal clinical experience achieved high pass rates (92%) and scores, comparable to PGY5s.

Conclusions:

• Early implementation of simulation-based flexible endoscopy training enhances FES performance.
• The curriculum requires minimal time (<10 hours) and offers a high return on investment.
• Simulation training enables residents to achieve proficiency comparable to extensive clinical experience.