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Erschienen in: Surgical Endoscopy 11/2013

01.11.2013

Feasibility of remote administration of the Fundamentals of Laparoscopic Surgery (FLS) skills test

verfasst von: Allan Okrainec, Melina Vassiliou, Andrew Kapoor, Kristen Pitzul, Oscar Henao, Pepa Kaneva, Timothy Jackson, E. Matt Ritter

Erschienen in: Surgical Endoscopy | Ausgabe 11/2013

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Abstract

Background

Fundamentals of Laparoscopic Surgery (FLS) certification testing currently is offered at accredited test centers or at select surgical conferences. Maintaining these test centers requires considerable investment in human and financial resources. Additionally, it can be challenging for individuals outside North America to become FLS certified. The objective of this pilot study was to assess the feasibility of remotely administering and scoring the FLS examination using live videoconferencing compared with standard onsite testing.

Methods

This parallel mixed-methods study used both FLS scoring data and participant feedback to determine the barriers to feasibility of remote proctoring for the FLS examination. Participants were tested at two accredited FLS testing centers. An official FLS proctor administered and scored the FLS exam remotely while another onsite proctor provided a live score of participants’ performance. Participant feedback was collected during testing. Interrater reliabilities of onsite and remote FLS scoring data were compared using intraclass correlation coefficients (ICCs). Participant feedback was analyzed using modified grounded theory to identify themes for barriers to feasibility.

Results

The scores of the remote and onsite proctors showed excellent interrater reliability in the total FLS (ICC 0.995, CI [0.985–0.998]). Several barriers led to critical errors in remote scoring, but most were accompanied by a solution incorporated into the study protocol. The most common barrier was the chain of custody for exam accessories.

Conclusion

The results of this pilot study suggest that remote administration of the FLS has the potential to decrease costs without altering test-taker scores or exam validity. Further research is required to validate protocols for remote and onsite proctors and to direct execution of these protocols in a controlled environment identical to current FLS test administration.
Literatur
2.
Zurück zum Zitat Derossis AM, Fried GM, Abrahamowicz M, Sigman HH, Barkun JS, Meakins JL (1998) Development of a model for training and evaluation of laparoscopic skills. Am J Surg 175:482–487PubMedCrossRef Derossis AM, Fried GM, Abrahamowicz M, Sigman HH, Barkun JS, Meakins JL (1998) Development of a model for training and evaluation of laparoscopic skills. Am J Surg 175:482–487PubMedCrossRef
3.
Zurück zum Zitat Peters JH, Fried GM, Swanstrom LL, Soper NJ, Sillin LF, Schirmer B, Hoffman K (2004) Development and validation of a comprehensive program of education and assessment of the basic fundamentals of laparoscopic surgery. Surgery 135:21–27PubMedCrossRef Peters JH, Fried GM, Swanstrom LL, Soper NJ, Sillin LF, Schirmer B, Hoffman K (2004) Development and validation of a comprehensive program of education and assessment of the basic fundamentals of laparoscopic surgery. Surgery 135:21–27PubMedCrossRef
4.
Zurück zum Zitat Derossis AM, Bothwell J, Sigman HH, Fried GM (1998) The effect of practice on performance in a laparoscopic simulator. Surg Endosc 12:1117–1120PubMedCrossRef Derossis AM, Bothwell J, Sigman HH, Fried GM (1998) The effect of practice on performance in a laparoscopic simulator. Surg Endosc 12:1117–1120PubMedCrossRef
5.
Zurück zum Zitat Fried GM, Feldman LS, Vassiliou MC, Fraser SA, Stanbridge D, Ghitulescu G, Andrew CG (2004) Proving the value of simulation in laparoscopic surgery. Ann Surg 240:518–525PubMedCrossRef Fried GM, Feldman LS, Vassiliou MC, Fraser SA, Stanbridge D, Ghitulescu G, Andrew CG (2004) Proving the value of simulation in laparoscopic surgery. Ann Surg 240:518–525PubMedCrossRef
6.
Zurück zum Zitat Vassiliou MC, Ghitulescu GA, Feldman LS, Stanbridge D, Leffondré K, Sigman HH, Fried GM (2006) The MISTELS program for measure technical skill in laparoscopic surgery: evidence for reliability. Surg Endosc 20:744–747PubMedCrossRef Vassiliou MC, Ghitulescu GA, Feldman LS, Stanbridge D, Leffondré K, Sigman HH, Fried GM (2006) The MISTELS program for measure technical skill in laparoscopic surgery: evidence for reliability. Surg Endosc 20:744–747PubMedCrossRef
7.
Zurück zum Zitat McCluney AL, Vassiliou MC, Kaneva PA, Cao J, Stanbridge DD, Feldman LS, Fried GM (2007) FLS simulator performance predicts intraoperative laparoscopic skill. Surg Endosc 21:1991–1995PubMedCrossRef McCluney AL, Vassiliou MC, Kaneva PA, Cao J, Stanbridge DD, Feldman LS, Fried GM (2007) FLS simulator performance predicts intraoperative laparoscopic skill. Surg Endosc 21:1991–1995PubMedCrossRef
8.
Zurück zum Zitat Vassiliou MC, Ghitulescu GA, Feldman LS, Stanbridge D, Leffondré K, Sigman HH, Fried GM (2010) Fundamentals of Laparoscopic Surgery simulator training to proficiency improves laparoscopic performance in the operating room: a randomized controlled trial. Am J Surg 199:115–120PubMedCrossRef Vassiliou MC, Ghitulescu GA, Feldman LS, Stanbridge D, Leffondré K, Sigman HH, Fried GM (2010) Fundamentals of Laparoscopic Surgery simulator training to proficiency improves laparoscopic performance in the operating room: a randomized controlled trial. Am J Surg 199:115–120PubMedCrossRef
9.
Zurück zum Zitat Soper NJ, Fried GM (2008) The Fundamentals of Laparoscopic Surgery: its time has come. Bull Am Coll Surg 93:30–32PubMed Soper NJ, Fried GM (2008) The Fundamentals of Laparoscopic Surgery: its time has come. Bull Am Coll Surg 93:30–32PubMed
10.
Zurück zum Zitat Okrainec A, Henao O, Azzie G (2009) Telesimulation: an effective method for teaching the Fundamentals of Laparoscopic Surgery in resource-restricted countries. Surg Endosc 24:417–422PubMedCrossRef Okrainec A, Henao O, Azzie G (2009) Telesimulation: an effective method for teaching the Fundamentals of Laparoscopic Surgery in resource-restricted countries. Surg Endosc 24:417–422PubMedCrossRef
11.
12.
Zurück zum Zitat Anvari M (2007) Telesurgery: remote knowledge translation in clinical surgery. World J Surg 31:1545–1550PubMedCrossRef Anvari M (2007) Telesurgery: remote knowledge translation in clinical surgery. World J Surg 31:1545–1550PubMedCrossRef
13.
Zurück zum Zitat Hiatt JR, Shabot MM, Phillips EH, Haines RF, Grant TL (1996) Telesurgery: acceptability of compressed video for remote surgical proctoring. Arch Surg 131:396–401PubMedCrossRef Hiatt JR, Shabot MM, Phillips EH, Haines RF, Grant TL (1996) Telesurgery: acceptability of compressed video for remote surgical proctoring. Arch Surg 131:396–401PubMedCrossRef
14.
Zurück zum Zitat Anvari M (2007) Remote telepresence surgery: the Canadian experience. Surg Endosc 21:537–541PubMedCrossRef Anvari M (2007) Remote telepresence surgery: the Canadian experience. Surg Endosc 21:537–541PubMedCrossRef
15.
Zurück zum Zitat Anvari M (2007) Impact of information technology on human resources in healthcare. Healthc Q 10:84–88PubMedCrossRef Anvari M (2007) Impact of information technology on human resources in healthcare. Healthc Q 10:84–88PubMedCrossRef
16.
Zurück zum Zitat Latifi R, Peck K, Satava R, Anvari M (2004) Telepresence and telementoring in surgery. Stud Health Technol Inform 104:200–206PubMed Latifi R, Peck K, Satava R, Anvari M (2004) Telepresence and telementoring in surgery. Stud Health Technol Inform 104:200–206PubMed
17.
Zurück zum Zitat Schlachta CM, Lefebvre KL, Sorsdahl AK, Jayaraman S (2010) Mentoring and telementoring leads to effective incorporation of laparoscopic colon surgery. Surg Endosc 24:841–844PubMedCrossRef Schlachta CM, Lefebvre KL, Sorsdahl AK, Jayaraman S (2010) Mentoring and telementoring leads to effective incorporation of laparoscopic colon surgery. Surg Endosc 24:841–844PubMedCrossRef
Metadaten
Titel
Feasibility of remote administration of the Fundamentals of Laparoscopic Surgery (FLS) skills test
verfasst von
Allan Okrainec
Melina Vassiliou
Andrew Kapoor
Kristen Pitzul
Oscar Henao
Pepa Kaneva
Timothy Jackson
E. Matt Ritter
Publikationsdatum
01.11.2013
Verlag
Springer US
Erschienen in
Surgical Endoscopy / Ausgabe 11/2013
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-013-3048-7

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