Vol.:(0123456789) 1 3 Surgical Endoscopy https://doi.org/10.1007/s00464-017-6018-7 Development of a train-to-profciency curriculum for the technical skills component of the fundamentals of endoscopic surgery exam Susan Gearhart 1,5  · Michael Marohn 1  · Saowanee Ngamruengphong 2  · Gina Adrales 1  · Oluwafemi Owodunni 1  · Kim Duncan 3  · Emil Petrusa 4  · Pamela Lipsett 1 Received: 25 November 2017 / Accepted: 19 December 2017 © Springer Science+Business Media, LLC, part of Springer Nature 2018 Abstract Background The demonstration of competency in endoscopy is required prior to obtaining American Board of Surgery Certifcation. To demonstrate competency, the resident must pass a national high-stakes cognitive test and a technical skills exam on a virtual reality simulator. The purpose of this preliminary study was to design a profciency-based endoscopy simulation curriculum to meet this competency requirement. Methods This is a mixed methods prospective cohort study at a single academic medical institution. Prior to taking the national exam, surgery residents were required to participate in a skills lab and demonstrate profciency on 10 simulation tasks. Profciency was based on time and percent of objects targeted/mucosa seen. Simulation practice time, number of task repetitions to profciency, and prior endoscopic experience were recorded. Resident’s self-reported confdence scores in endoscopic skills prior to and following simulation lab training were obtained. Results From January 1, 2016 through August 1, 2017, 20 surgical residents (8 PGY2, 8 PGY3, 4 PGY4) completed both a faculty-supervised endoscopy skills lab and independent learning with train-to-profciency simulation tasks. Median overall simulator time per resident was 306 min (IQR: 247–405 min). Median overall time to profciency in all tasks was 235 min (IQR: 208–283 min). The median time to profciency decreased with increasing PGY status (r = 0.4, P = 0.05). There was no correlation between prior real-time endoscopic experience and time to profciency. Reported confdence in endoscopic skills increased signifcantly from mean of 5.75 prior to 7.30 following the faculty-supervised endoscopy skills lab (P = 0.0002). All 20 residents passed the national exam. Conclusions In this preliminary study, a train-to-profciency curriculum in endoscopy improved surgical resident’s confdence in their endoscopic skills and 100% of residents passed the FES technical skills test on their frst attempt. Our fndings also indicate that uniform profciency was not achieved by real-time experience alone. Keywords FES · Simulation · Profciency-based training · Endoscopy In 2018, demonstration of competency in surgical endoscopy will be required in order to obtain American Board of Sur- gery (ABS) Certifcation. This is a new educational goal of which the objectives have been outlined in the Fundamentals and Other Interventional Techniques This work was presented at the Surgery Education Week Meeting April 18–22, 2017 in San Diego, CA. * Susan Gearhart Sdemees1@jhmi.edu 1 Department of Surgery, Johns Hopkins Medical Institutions, Baltimore, MD 21286, USA 2 Department of Gastroenterology, Johns Hopkins Medical Institutions, Baltimore, MD 21286, USA 3 The Center for Innovation in Graduate Biomedical Education, Johns Hopkins University, Baltimore, MD 21286, USA 4 Department of Surgery, MGH Learning Lab, Massachusetts General Hospital, Boston, MA 02114, USA 5 Johns Hopkins Bayview Medical Center, 4940 Eastern Avenue, Baltimore, MD 21224, USA