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Background: The purpose of this study was to examine the effectiveness of the SAGES flexible endoscopy course in improving fellows' attitudes, confidence, and skills related to implementing endoscopy in practice.Methods: Fellows participated in a 2-day course consisting of case presentations, expert panels, and hands-on laboratory training. Before and after the course, fellows completed a questionnaire assessing demographics, experiences in residency, practice plans, plans to implement flexible endoscopy in practice, and level of confidence performing 15 endoscopic procedures. Half of the fellows were randomly assigned to complete pre- and post-skills testing using a previously validated endoscopic targeting model.Results: Fifty-four fellows (90 %; age 33.5 ± 2.8; 58 % male) completed the pre- and post-questionnaire. All MIS fellowship types were represented. Almost half (48 %) reported none or very little flexible endoscopy in their current fellowship. The average prior case volume among those completing an ACGME-approved residency (42/54) was 76 upper and 75 lower endoscopies with one-third reporting no experience in therapeutic EGD (33 %) or polypectomy (31 %). Intentions to implement flexible endoscopy in practice significantly improved after the course overall (3.72 ± .85-3.92 ± .69, p < 0.05; 1 = never; 5 = very frequently). Prior to the course, 39 % of fellows reported plans to use endoscopy in practice "occasionally" or "rarely." After, this decreased to 28 with 72 % planning to implement "frequently" or "very frequently." Mean levels of confidence performing all 15 endoscopic tasks improved significantly after the course. Skills performance for the 27 fellows improved significantly as well; participants decreased their time to perform the targeting task by 40 % (222.3 ± 119.8-133.0 ± 70.1 s; p < 0.001) and decreased errors by 49 % (2.9 ± 1.7-1.5 ± 1.5; p < 0.001).Conclusions: These results indicate that the SAGES flexible endoscopy course increases fellow confidence to implement endoscopic techniques, expands the ways in which they plan to include endoscopy in practice, and enhances their endoscopic skills. [ABSTRACT FROM AUTHOR]

Background: The aim of this prospective study was to evaluate and compare operative performance and technical improvement of surgical trainees learning open gastrectomy using an objective structured stepwise assessment tool of operative skills (SATOS) previously validated for open surgery., Study Design: Thirty residents in general surgery performed 2 open partial gastrectomy training events on a porcine model. Earlier instruction was provided for the critical operative steps, with additional intraoperative instruction when required. Performance was assessed by postgraduate year (PGY) according to operative time, technical skills using a 23-step objective structured tool, and error rate., Results: There were 11 PGY-3, 11 PGY-4, and 8 PGY-5 residents. At the initial assessment, performance significantly differentiated the 3 PGY grades according to technical skills and error rate. At the second assessment, all 3 PGY classes were still significantly differentiable by technical skills, with no difference in error rate. Comparing performances, residents improved operative time (p < 0.001), technical skills (p < 0.001), and error rate (p = 0.019) over the 2 training events., Conclusions: SATOS demonstrated relevant and accurate objective assessment of trainees' operative skills and improvement for open gastrectomy in a porcine model. This tool may be useful to standardize instruction, to expose weaknesses of trainees, and to determine minimal technical standards in residency programs., (Copyright © 2010 American College of Surgeons. Published by Elsevier Inc. All rights reserved.)