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

The Essentials in Minimally Invasive Gynecologic Surgery (EMIGS) is a new assessment employed by the American Board of Obstetrics and Gynecology to evaluate physicians' surgical skills for certification. The program assesses the minimal laparoscopic skills needed to qualify for the certifying exam. We aimed to use checklist assessments to predict performance on the Running Stitch task of EMIGS. We strove to develop and evaluate a novel metric to predict competency in the EMIGS Running Stitch task. Secondly, to assess resident PGY year, prior laparoscopic suturing experience, and prior laparoscopic simulation experience correlation with passage.

A novel task specific checklist was developed by expert teaching surgeons to assess the Running Stitch task of EMIG. The checklist was tested for inter-rater reliability.

Residency programs at 4 participating academic centers.

Seventy-one participants completed 97 videotaped trials Interventions participants completed a pre-study survey prior to each video-taped laparoscopic skills session (one to 4 sessions over 4 months of study). The video and the completed EMIGS task Penrose were evaluated both by the study team with checklists and later by EMIGs.

The 2 scores were correlated using linear regression and Bland-Altman plots for agreement. 53% of trials received a passing score by AAGL. AAGL and study team checklist scores were moderately correlated (0.73) however study team metrics consistently overrated performance. Laparoscopic case numbers and PGY level correlated with passing score.

Scoring using our novel metric correlated with passing scores but overrated performance. This tool may aid educators in assessment during resident preparation for the EMIGS skills exam, but metrics for grading of this examination remain poorly understood.