TY - JOUR
T1 - Simulation-based mastery learning significantly reduces gender differences on the Fundamentals of Endoscopic Surgery performance exam
AU - Ritter, E. Matthew
AU - Lineberry, Matthew
AU - Hashimoto, Daniel A.
AU - Gee, Denise
AU - Guzzetta, Angela A.
AU - Scott, Daniel J.
AU - Gardner, Aimee K.
N1 - Funding Information:
Disclosures Dr. Gardner reports personal fees and other from Surg-Wise, outside the submitted work. Dr. Ritter reports grants from Henry M. Jackson Foundation for the Advancement of Military Medicine, outside the submitted work; and ETS Simulation platform developed through a Collaborative Research and Development Agreement between the Uniformed Services University, Henry M. Jackson Foundation, Limbs and Things LLC, and Kyoto Kagaku Inc. Dr. Scott reports grants from Ethicon Endosurgery, grants from Karl Storz Endoscopy, grants from Covidien, personal fees from Accelerated Technologies Inc, outside the submitted work. Dr’s Lineberry, Hashimoto, Gee, and Guzzetta have no conflict of interest or financial ties to disclose.
Publisher Copyright:
© 2018, This is a U.S. government work and its text is not subject to copyright protection in the United States; however, its text may be subject to foreign copyright protection.
Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2018/12/1
Y1 - 2018/12/1
N2 - Background: Analysis of the Fundamentals of Endoscopic Surgery (FES) performance exam showed higher scores for men than women. Gender differences have been reduced with task-specific practice. We assessed the effect of simulation-based mastery learning (SBML) on FES performance exam differences by gender. Methods: Forty-seven surgical trainees [29 men (m), 18 women (w)] completed a SBML curriculum and were assessed by FES. Fourteen trained on the GI Mentor 2, 18 on the Endoscopy Training System, and 15 using the Surgical Training for Endoscopic Proficiency curriculum. Performance of male and female trainees was compared. Results: On the pre-training assessment, there were large differences between genders in FES pass rates (m 77%, w 15%, p < 0.001), total scores (m 69 ± 11, w 50 ± 12; p < 0.001), and in four of five FES sub-task scores (Navigation, m 73 ± 19, w 55 ± 22, p = 0.02; Loop reduction, m 34 ± 29, w 14 ± 22, p = 0.02; Retroflexion, m 81 ± 17, w 47 ± 27, p < 0.001; Targeting, m 89 ± 10, w 66 ± 23, p = 0.002). No differences were discernible post training (Pass rate, m 100%, w 94%, p = 0.4; Total score, m 77 ± 8, w 72 ± 12, p = 0.2; Navigation, m 91 ± 13, w 80 ± 13, p = 0.009; Loop reduction, m 49 ± 26, w 46 ± 36, p = 0.7; Retroflexion, m 82 ± 18, w 81 ± 15, p = 0.9; Targeting, m 92 ± 15, w 86 ± 12, p = 0.12). Time needed to complete curricula was not discernably different by gender (m 3.8 ± 1.7 h, w 5.0 ± 2.6 h, p = 0.17). Conclusions: Gender-based differences are nearly eliminated through task-specific SBML training. This lends further evidence to the validity argument for the FES performance exam as a measure of basic endoscopic skills.
AB - Background: Analysis of the Fundamentals of Endoscopic Surgery (FES) performance exam showed higher scores for men than women. Gender differences have been reduced with task-specific practice. We assessed the effect of simulation-based mastery learning (SBML) on FES performance exam differences by gender. Methods: Forty-seven surgical trainees [29 men (m), 18 women (w)] completed a SBML curriculum and were assessed by FES. Fourteen trained on the GI Mentor 2, 18 on the Endoscopy Training System, and 15 using the Surgical Training for Endoscopic Proficiency curriculum. Performance of male and female trainees was compared. Results: On the pre-training assessment, there were large differences between genders in FES pass rates (m 77%, w 15%, p < 0.001), total scores (m 69 ± 11, w 50 ± 12; p < 0.001), and in four of five FES sub-task scores (Navigation, m 73 ± 19, w 55 ± 22, p = 0.02; Loop reduction, m 34 ± 29, w 14 ± 22, p = 0.02; Retroflexion, m 81 ± 17, w 47 ± 27, p < 0.001; Targeting, m 89 ± 10, w 66 ± 23, p = 0.002). No differences were discernible post training (Pass rate, m 100%, w 94%, p = 0.4; Total score, m 77 ± 8, w 72 ± 12, p = 0.2; Navigation, m 91 ± 13, w 80 ± 13, p = 0.009; Loop reduction, m 49 ± 26, w 46 ± 36, p = 0.7; Retroflexion, m 82 ± 18, w 81 ± 15, p = 0.9; Targeting, m 92 ± 15, w 86 ± 12, p = 0.12). Time needed to complete curricula was not discernably different by gender (m 3.8 ± 1.7 h, w 5.0 ± 2.6 h, p = 0.17). Conclusions: Gender-based differences are nearly eliminated through task-specific SBML training. This lends further evidence to the validity argument for the FES performance exam as a measure of basic endoscopic skills.
KW - Endoscopy
KW - Fundamentals of Endoscopic Surgery
KW - Gender differences
KW - Mastery learning
KW - Simulation
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U2 - 10.1007/s00464-018-6313-y
DO - 10.1007/s00464-018-6313-y
M3 - Article
C2 - 30014324
AN - SCOPUS:85049962987
SN - 0930-2794
VL - 32
SP - 5006
EP - 5011
JO - Surgical endoscopy
JF - Surgical endoscopy
IS - 12
ER -