The FES Program was designed to teach and assess the physiology, anatomy, fundamental knowledge and technical skills required to practice flexible endoscopic procedures of the gastrointestinal (GI) tract. The FES Program is comprised of an interactive, web-based, multimedia-enhanced, didactic curriculum component and a two-part, validated assessment made up of:
- A web-based multiple-choice exam for evaluating cognitive knowledge and judgment.
- A virtual reality platform to evaluate fundamental technical and psychomotor skills.
FES establishes a standard set of didactic information and manual skills serving as a basic curriculum to guide surgical residents, fellows, and practicing surgeons in the performance of basic endoscopic surgery. By mastering the curriculum and the honing of skills in this inanimate modality, it is expected that surgical residents and surgeons will initiate and carry out their performance of endoscopy more effectively, with greater skill and greater safety, and with lower complication rates. The specific aim of FES is that the knowledge and skills gained by those who master the FES curriculum will improve the quality and safety of surgical care delivered to their patients.
The SAGES FES curriculum has been developed to establish a validated, core endoscopic curriculum for surgical and gastroenterological trainees. The curriculum includes 13 web-based, interactive, cognitive content chapters covering basic diagnostic and therapeutic endoscopy, using rich text, images, and illustrations. Extensive peer review for content and accuracy by surgeons and gastroenterologists has been included in chapter development.
The cognitive test includes 80 questions assessing the understanding and application of the fundamentals of endoscopy with as much emphasis as possible on clinical judgment or intra-operative decision-making. Detailed psychometric analysis has been part of the preparation and standard setting process for the cognitive exam.
The manual skills test consists of five simulation exercises that incorporate and represent most of the psychomotor skills necessary for basic endoscopic surgery. The skills assessment modules have been developed after a process of rigorous cognitive task analysis and deconstructive effort and utilizes a Surgical Science virtual reality platform. The skills incorporated in this element include bimanual navigation, loop reduction, targeting, mucosal evaluation, and retroflexion.
At the conclusion of this activity, participants will be able to:
- Understand indications and contraindications for basic endoscopic procedures (competence)
- Recognize common pathological findings and apply appropriate diagnostic and therapeutic interventions (performance)
- Recognize and manage common complications related to basic endoscopic procedures (competence)
- Describe appropriate patient preparation (competence)
- Identify and discuss available diagnostic and therapeutic alternatives (competence)
- Demonstrate improved motor skills and dexterity that form the fundamental basis for the performance of upper and lower endoscopy:
- Demonstrate the process of endoscope navigation, tip deflection, and torque (performance)
- Demonstrate the technique of colonoscope loop reduction (performance)
- Demonstrate the technique for retroflexion (performance)
- Demonstrate the ability to adequately evaluate the mucosa and the skill to target lesions endoscopically (performance)
- Helps to address case-mix inequalities in a residency program
- Permits learning of flexible gastrointestinal endoscopy techniques in a safe environment without putting patients at risk
- Refreshes techniques for endoscopic surgeons returning to practice after an extended absence
FES candidates are:
- Junior and senior surgical residents and fellows enrolled in an accredited program of surgical education
- Board eligible/certified practicing surgeons
- Residents and fellows in an accredited internal medicine or other program that teaches endoscopic procedures
- Board eligible/certified practicing gastroenterologists and other physicians who perform endoscopic procedures