Jazzin' It Up: Ideas for Implementing FLS into your Residency Curriculum

Disclosures Dr. Auguste is paid editor for Springer publishing Dr.Page-Ramsey is a paid author for McGraw-Hill Dr. Page-Ramsey is a paid clinical trainer for Merck Drs. Auguste, Kaufman, and Page-Ramsey are oral board examiners for the American Board of Obstetrics and Gynecology (ABOG)

Objectives Know the requirement for Fundamentals of Laparoscopic Surgery (FLS) certification for residents who desire board certification after 2020. Know the required components for FLS certification. Gain ideas for incorporating FLS certification into residency training.

SPR *NOT a requirement from CREOG nor ACGME

Why FLS? SPR

Components of FLS SPR

https://www.sages.org/projects/fls/ SPR

Task 1: Peg Transfer Move all 6 from one side to the other and back Must transfer the ring between hands each time Maximum time is 300 seconds LK

Task 2: Precision Cutting Cut circle out of gauze Only have to cut top layer Maximum time is 300 seconds LK

Task 3: Ligating Loop Ligate appendage Cut suture Maximum time is 180 seconds LK

Task 4: Suture with Extracorporeal Knot Place suture through dots Tie 3 extracorporeal knots Cut suture Maximum time is 420 seconds LK

Task 5: Suture with Intracorporeal Knot Place suture through dots Tie 3 intracorporeal knots Cut suture Maximum time is 600 seconds LK

Costs and Supplies of FLS? TA

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Breakout Session -begin worksheet What barriers have you identified? (assign groups) SPACE COST EQUIPMENT TIMING TIME KB

This slide will show the worksheet and QR code https://drive.google.com/open?id=1OHUqCCXbyqxgKiR3zsc09sq3-XOXM4Oy KB

Integration into UF Jacksonville Ob/Gyn Curriculum PGY 2 (GYN and ONC rotations) and PGY 3* (UROGYN) Staffed in classroom with 3 towers ~3 hour sessions weekly practice for the manual dexterity portion l learn all five required skills practice skills for time and accuracy Creation of a study guide Faculty determines the resident’s readiness for simulated timed tests using proctored exam with true FLS equipment and disposables (purchased one full set with cart). If able to complete all skills accurately and in an appropriate time, will sign up for exam. Nearest sites: Tampa; Miami, Atlanta, Charleston, Fort Gordon KB

MedStar Simulation Curriculum Monthly simulation labs Separate PGY 1 & 2 labs from PGY 3 &4 Both GYN and OB stations FLS practice is a monthly GYN station FLS is a proctored station FLS Wars between General Surgery and OBGYN FLS Olympics within OBGYN End of the year prizes for Gold, Silver, Bronze (Starbucks cards) TA

SUNY Upstate Medical University OBGYN Approach to FLS NO FLS testing center within 4 hour radius-plan for current PGY 2 & 3 to be tested on site this July Department Sim center- purchased 2 FLS boxes, practice on low tech boxes as well PGY 2-3 sign up via Google Calendar for daily access to sim boxes, low tech are on L&D-Attg in Sim area supervises tasks Additional time Sim Fridays-PGY 1-4 MIS rotation (PGY-3), Research (3) , REI (3), Family Planning (2) rotation all with dedicated practice time-80 hrs LK

University of Texas Health Science Center at San Antonio Solution Dedicated time during the urogynecology rotation Met w surgical education director Determined 12-20 hours adequate for skills practice Scheduled ½ day/week for 8 week block (32 hours) Chose PGY-3 year because they already have basic skills Modules and Practice Department purchased 2 trainers 24 hr access via keycode lock Training sheets w goals and times (faster than required) Uninterrupted Same equipment used in testing center Certified testing center last week of rotation SPR

Breakout Session Curriculum Planning Complete your worksheet How can you implement a program at your institution? SPR

Breakout Session Curriculum Planning (worksheet) How much time? When in your curriculum? What equipment do you have? What do you need? What space do you need? What would be the cost for the equipment and materials? KB

Breakout Session Curriculum Planning (worksheet) How much time? When in your curriculum? What equipment do you have? What do you need? What space do you need? What would be the cost for the equipment and materials? SPR

Breakout Session Curriculum Planning (worksheet) How much time? When in your curriculum? What equipment do you have? What do you need? What space do you need? What would be the cost for the equipment and materials? TA

Breakout Session Curriculum Planning (worksheet) How much time? When in your curriculum? What equipment do you have? What do you need? What space do you need? What would be the cost for the equipment and materials? KB

Breakout Session Curriculum Planning (worksheet) How much time? When in your curriculum? What equipment do you have? What do you need? What space do you need? What would be the cost for the equipment and materials? TA

Questions? Sarah M. Page-Ramsey, MD Kelly Best, MD Tamika Auguste, MD University of Texas Health Science Center at San Antonio University of Florida at Jacksonville Kelly.best@jax.ufl.edu pageramsey@uthscsa.edu Tamika Auguste, MD Leah Kaufman, MD State University of New York – Upstate MedStar Washington Hospital Center / Georgetown University kaufmale@upstate.edu Tamika.c.auguste@medstar.net SPR