Implementing FLS Training Protocol for Minimally Invasive GYN Surgery Training

Abstract

Study Objective The number of minimally invasive surgeries required for residents has increased alongside the requirement of passing the Fundamentals of Laparoscopic Surgery (FLS) program for board certification in Obstetrics and Gynecology (OBGYN) programs. Simulation training has been proposed as a method to increase the proficiency of training surgeons; however, no gynecologic simulation models have been validated. We hypothesized that 24-hour access to the FLS trainer would improve the residents’ times to complete the standardized FLS tasks and improve first time pass rates, and that increased training time would increase resident confidence. Design We performed an observational prospective study. Each resident was timed on the FLS tasks and surveyed to assess confidence each quarter. We compared first time pass rates of the FLS exam for residents who took the exam prior to having access to the trainer to the first-time pass rates of the residents who did have access to the trainer. Setting N/A. Patients or Participants 20 residents were enrolled. During the study period, 1 resident left the program. Interventions N/A. Measurements and Main Results There was no statistical significance between first time pass rates for the FLS exam. Paired t-test was used and found no significant differences in timed task completion or survey question. Conclusion Voluntary simulation-based training was not an effective way to improve gynecologic surgical skills during this study. We suspect this to be a result of lack of defined structure, limited free time, and challenges due to the COVID 19 pandemic. There were low compliance rates of the residents using the FLS trainer and no significant improvement in the time required to finish the standardized FLS tasks, first time pass rates on the FLS exam, or resident confidence levels measured by survey results. More research is needed to evaluate barriers to simulation training to improve minimally invasive surgical skills The number of minimally invasive surgeries required for residents has increased alongside the requirement of passing the Fundamentals of Laparoscopic Surgery (FLS) program for board certification in Obstetrics and Gynecology (OBGYN) programs. Simulation training has been proposed as a method to increase the proficiency of training surgeons; however, no gynecologic simulation models have been validated. We hypothesized that 24-hour access to the FLS trainer would improve the residents’ times to complete the standardized FLS tasks and improve first time pass rates, and that increased training time would increase resident confidence. We performed an observational prospective study. Each resident was timed on the FLS tasks and surveyed to assess confidence each quarter. We compared first time pass rates of the FLS exam for residents who took the exam prior to having access to the trainer to the first-time pass rates of the residents who did have access to the trainer. N/A. 20 residents were enrolled. During the study period, 1 resident left the program. N/A. There was no statistical significance between first time pass rates for the FLS exam. Paired t-test was used and found no significant differences in timed task completion or survey question. Voluntary simulation-based training was not an effective way to improve gynecologic surgical skills during this study. We suspect this to be a result of lack of defined structure, limited free time, and challenges due to the COVID 19 pandemic. There were low compliance rates of the residents using the FLS trainer and no significant improvement in the time required to finish the standardized FLS tasks, first time pass rates on the FLS exam, or resident confidence levels measured by survey results. More research is needed to evaluate barriers to simulation training to improve minimally invasive surgical skills