Validation of an Essentials in Minimally Invasive Gynecology Running Stitch Task Checklist

Area of Science:

• Minimally Invasive Gynecologic Surgery
• Surgical Skills Assessment
• Medical Education Technology

Background:

• The American Board of Obstetrics and Gynecology utilizes the Essentials in Minimally Invasive Gynecologic Surgery (EMIGS) assessment for physician certification.
• The EMIGS program evaluates essential laparoscopic skills required for the certifying examination.
• This study focuses on the EMIGS Running Stitch task, a key component of the assessment.

Purpose of the Study:

• To develop and evaluate a novel checklist metric for predicting competency in the EMIGS Running Stitch task.
• To assess the correlation between resident PGY year, prior laparoscopic suturing experience, and simulation experience with performance on the EMIGS Running Stitch task.

Main Methods:

• A task-specific checklist was developed by expert surgeons and tested for inter-rater reliability.
• Seventy-one participants from four academic centers completed 97 videotaped trials over four months.
• Video recordings and completed EMIGS tasks were evaluated using the novel checklist and by EMIGS examiners; scores were correlated using linear regression and Bland-Altman plots.

Main Results:

• 53% of trials achieved a passing score as determined by the American Association of Gynecologic Laparoscopists (AAGL).
• The study team's checklist scores showed moderate correlation (0.73) with AAGL scores but consistently overrated performance.
• Higher laparoscopic case numbers and postgraduate year (PGY) level correlated with achieving a passing score.

Conclusions:

• The novel checklist metric demonstrated correlation with passing scores for the EMIGS Running Stitch task but requires refinement due to overrating performance.
• This tool may assist educators in resident preparation for the EMIGS skills examination.
• Further research is needed to understand the grading metrics for the EMIGS examination more thoroughly.