year, residents reported performing 23.4 Æ 17 cases. From 2008-2012, this increased to 38.5 Æ 20 (72% increase, p \0.0001). The proportion of robotic-assisted laparoscopic hysterectomies performed was not speciﬁcally reported. Conclusion: While the overall number of hysterectomies reported by residents has remained stable since 2008, the predominant modes of hysterectomy over the past decade have changed substantially with laparoscopic hysterectomy comprising an increasingly large proportion of resident experience. As laparoscopic hysterectomy has become more common, reported cases of abdominal and vaginal hysterectomies have decreased. These trends have signiﬁcant implications for resident training and suggest that new strategies may be needed to maintain adequate training for residents in open and vaginal techniques. Statistics regarding the percentage of robotic-assisted laparoscopic hysterectomies would also be valuable to analyze the impact of this technology on resident training. 80 Open Communications 5dEducation (2:57 PM d 3:02 PM) Predictors of Successful Surgical Outcome in Laparoscopic Hysterectomy - How To Measure Proﬁciency Twijnstra D, Jansen F-W. Gynaecology, Leiden University Medical Center, Leiden, ZH, Netherlands Study Objective: To estimate, after correction for patient’s factors, to what extent blood loss, operative time, and adverse events are decisive factors for the successful outcome of laparoscopic hysterectomy (LH). Secondly, to what extent a successful outcome can be predicted from surgical experience or other measures of surgical skill? Design: A nationwide multivariate 1-year cohort analysis with gynecologists who perform LH. Intervention: The primary outcomes were blood loss, operative time, and adverse events. The procedures were corrected for multiple covariates in a mixed-effects logistic regression model. Furthermore, all primary outcomes were related to experience and the inﬂuence of individual surgical skills factors. Cumulative summation statistics was applied in order to direct derailing individual performance. Measurements and Main Results: 1.534 LH’s were analyzed for 79 surgeons. The success of the surgical outcome was signiﬁcantly inﬂuenced by uterus weight, body mass index, previous abdominal surgeries and the type of LH. Surgical experience also predicted the successful outcome of laparoscopic hysterectomy with respect to blood loss and adverse events (P=.048 and .036, respectively). A signiﬁcant improvement in surgical outcomes tends to continue up to approximately 125 procedures. Independently from surgical experience, an individual surgical skills factor was identiﬁed as OR’s 1.67 and 3.60 for blood loss and operative time, respectively. Cumulative summation analysis was able to ﬂag derailing individual performance. Conclusion: After adjusting for risk factors, it was shown that an increase in experience positively predicted successful outcome in LH with respect to blood loss and adverse events. However, the independent surgical skills factor shows a large variation in proﬁciency between individuals. The fact that a surgeon has performed many LH’s does not necessarily guarantee good surgical outcome. Continuously proﬁciency curve monitoring, by means of cumulative summation analysis can ﬂag in time derailing performance. 81 Open Communications 5dEducation (3:03 PM d 3:08 PM) Assessing the Utility of the Fundamentals of Laparoscopic Proﬁciency Curriculum in Obstetrics and Gynecology Residents Braun KM, Palladino C, Parnell BA, Ray CB, Evans L. Georgia Regents University, Augusta, Georgia Study Objective: To assess the Fundamentals of Laparoscopic Surgery (FLS) Proﬁciency curriculum as a model to teach and assess basic laparoscopic skills and knowledge in Obstetrics and Gynecology (Ob-Gyn) residents. Design: A pre- and post-test pilot study of the FLS curriculum from August 2012-April 2013. Setting: A single Ob-Gyn residency training program located in an academic medical center in the southeastern US. Patients: All residents in the program (PGY 1-4, n=15). Intervention: The FLS curriculum, a two-part program consisting of ﬁve online modules related to cognitive knowledge in laparoscopic surgery and technical training in ﬁve manual skills (e.g., ligating loop). Residents accessed and studied the online modules at their own pace, and the manual skills training was taught during monthly training sessions with faculty. Residents practiced to attain time and accuracy standards for each task per protocol. Measurements and Main Results: To test the efﬁcacy of the FLS program as a curricular initiative, residents completed a pre- and post-test on the manual skills training and a post-test only on the cognitive knowledge modules. All of the residents completed the manual skills training, while only 27% of the residents completed the online cognitive knowledge modules. The difference between pre- (M=138.02, SD=73.50) and post- test (M=453.13, SD=29.14) manual skills scores was statistically signiﬁcant (t(14)=-17.34, p=.000), with all residents attaining manual skills scores equivalent to FLS certiﬁcation (> 270) at post-test (vs. one resident at pre-test). The mean score on the cognitive knowledge post-test was 82.4, with a 100% pass rate. Conclusion: The results of this study suggest that the FLS Program holds promise as a curricular initiative for developing laparoscopic skills and knowledge in Ob-Gyn residents. However, given the differing participation rates for the manual skills training and the online cognitive knowledge modules, more research is needed to conﬁrm and explain our ﬁndings. 82 Open Communications 5dEducation (3:09 PM d 3:14 PM) The Use of a Multimedia Module to Aid the Informed Consent Process for Gynecological Laparoscopy for Pelvic Pain. A Randomized Control Trial Ellett LC, 1 Maher PJ, 1 Beischer A, 2 Villegas RI, 1 Readman E. 1 1 Department of Endosurgery, Mercy Hospital for Women, Heidelberg, Victoria, Australia; 2 Victorian Orthopaedic Foot and Ankle Clinic, Epworth Private Hospital, Richmond, Victoria, Australia Study Objective: To examine whether watching a multimedia module will improve patient understanding about their operation and the role this may play upon patient anxiety levels. Design: Randomised control trial (Canadian task Force I). Setting: Gynaecology clinic at a tertiary teaching hospital and private urban gynaecology clinic. Patients: 41 women (ages 18 - 55) booked for operative laparoscopy for pelvic pain. Intervention: All patients had routine informed consent and were then randomized to watch the multimedia module (intervention group) or not (control group), the surgeon was blinded to the group the patient was assigned. Subsequently they completed a knowledge questionnaire and the Spielberger short form State Trait Anxiety Inventory (STAI). Six weeks after recruitment patients completed the knowledge questionnaire again to look at retention of the information and the STAI. Measurements and Main Results: The intervention group had improved knowledge scores. Mean score in the control arm 7.9 (SD 2.63) vs 11.3 (SD 1.79) p \0.001 (max score 14) This did not translate into improved knowledge 6 weeks later. Control vs intervention group: mean score 7.43 (SD 1.74) vs 8.55 (SD 2.12). This result was not statistically signiﬁcant p=0.11 Anxiety rates were not higher in the intervention S26 Abstracts / Journal of Minimally Invasive Gynecology 20 (2013) S1–S49