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Abstract
FLS (Fundamentals in Laparoscopic Surgery) is a test and a curriculum to test and teach laparoscopic surgery skills. Our aim for this systematic review was to examine validity evidence supporting or refuting FLS specifically as a high-stakes summative assessment tool in gynecology. We systematically searched for studies on FLS as an assessment tool in gynecology on January 30, 2019. We organized validity evidence for cognitive and manual skills portions based on validity elements of current validity framework. From 1,971 citations identified 9 studies were included involving 319 participants. For the cognitive portion of the test, results were mixed in five studies in relationship with other variables category. For the manual portion of the test, most of the studies focused on relationships with other variables validity element with mixed findings. Concerning findings in the manual skills portion were the lack of transferability of skills to the operating room, limited mixed evidence for improvement in operating room performance, and worse performance by OBGYNs compared to other specialties. We were not able to find evidence supporting content, response process or consequences validity elements in either the cognitive or the manual skills portions of the test. Validity evidence was mixed in relation with other variables category, but other validity evidence was lacking. Given the high-stakes use of this assessment, we suggest requiring further evidence and/or re-evaluating utilization of this test.
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