Preparing for the Fundamentals of Laparoscopic Surgery Exam: A Survey of Residents in Obstetrics & Gynecology.

OBJECTIVE: To describe the actual work-load and experience for first-time resident test takers preparing to meet the new high stakes cognitive and technical skills testing requirement for board certification in Obstetrics and Gynecology. DESIGN: A retrospective observational study. Participating residents completed a 2 page questionnaire about their preparation for the exam. Results are reported in aggregate. SETTING: This study was conducted at the University of Texas Southwestern Medical Center, an academic medical school affiliated with both a private and public tertiary hospitals. PARTICIPANTS: Residents in obstetrics and gynecology who have completed their Fundamentals of Laparoscopic Surgery (FLS) certification exam between September 1, 2018 and September 31, 2019. Thirty-three PGY-2 and PGY-3 residents completed the survey. RESULTS: Participants spent an average of 6.7 ± 3.1 hours viewing online modules over an average of 3.6 ± 2.1 nonconsecutive days. Utilizing the campus simulation center, residents spent an average of 2.1 ± 2.1 hours on each of the 5 tasks to practice to the established proficiency score. Twenty-two out of 31 residents rated the ligating loop the easiest skill to master and 13/31 residents rated the precision cut the most difficult. The pass rate for the technical skills portion was 100% (33/33 residents) and for the cognitive portion was 93% (31/33 residents). CONCLUSIONS: Our data suggest that residents spent upward of 10 hours practicing to proficiency on the simulation tasks, in addition to time spent watching FLS-provided training videos. The 100% pass rate for the technical skills portion at our program may be impacted by a required technical skills curriculum that residents must complete prior to registering for the FLS exam. Obstetrics and gynecology residents and training programs will benefit from understanding the time and resources required for first-time resident test takers preparing to take the Fundamentals of Laparoscopic Surgery exam.

Introduction to Open Surgical Skills Curriculum: Randomized Trial of Self-Paced vs Group Video Tutorial Viewing.

OBJECTIVE: At our residency program, incoming interns are traditionally taught fundamental open surgical skills like suturing and knot tying in a group setting by viewing 12 instructional videos consecutively followed by individual baseline skill testing. We sought to evaluate if introduction to open surgical skills via self-paced viewing of video tutorials, as opposed to traditional group viewing, results in improved surgical skill acquisition in Obstetrics and Gynecology (OBGYN) interns as measured by higher proficiency score with decreased workload stress and anxiety. DESIGN, SETTING, PARTICIPANTS: A randomized control trial was conducted in which OBGYN PGY-1 residents in 2015 and 2016 (N = 35) were introduced to basic open surgical skills, such as knot tying and suturing, by viewing 12 video tutorials produced at UTSW (https://youtu.be/4w3hyL9muVU) for a surgical skills curriculum. Residents were randomized to 2 groups: group viewing vs self-paced viewing. Performance scores were calculated based on time and accuracy while workload and anxiety were measured by preand post-testing surveys using the National Aeronautics and Space Administration-Task Load Index and Spielberger State-Trait Anxiety Inventory 6 item questionnaires. RESULTS: There was no significant difference in proficiency score between the group vs self-paced viewing in 8 out of 12 tasks using the Wilcoxon signed rank test (p > 0.10). There was no statistically significant differences in workload stress based on the National Aeronautics and Space Administration-Task Load Index questionnaire (p = 0.399) or self-reported anxiety based on the Spielberger State-Trait Anxiety Inventory 6 item questionnaire (p = 0.607). CONCLUSIONS: Contrary to recent educational data suggesting self-paced learning may improve outcomes, viewing instructional videos in a group setting continues to be a time efficient method to introduce basic open surgical skills to incoming OBGYN interns.