title: Colonoscopy performance correlates with scores on the FES™ manual skills test.
abstract: BACKGROUND
  Achieving proficiency in flexible endoscopy is a major priority for general surgery training programs. The Fundamentals of Endoscopic Surgery (FES™) is a high-stakes examination of the knowledge and skills required to perform flexible endoscopy. The objective of this study was to establish additional evidence for the validity of the FES™ hands-on test as a measure of flexible endoscopy skills by correlating clinical colonoscopy performance with FES™ score.
  
  
  METHODS
  Participants included FES™-naïve general surgery residents, gastroenterology fellows at all levels of training and attending physicians who regularly perform colonoscopy. Each participant completed a live colonoscopy and the FES™ hands-on test within 2 weeks. Performance on live colonoscopy was measured using the Global Assessment of Gastrointestinal Endoscopic Skills-Colonoscopy (GAGES-C, maximum score 20), and performance on the FES™ hands-on test was assessed by the simulator's computerized scoring system. The clinical assessor was blinded to simulator performance. Scores were compared using Pearson's correlation coefficient.
  
  
  RESULTS
  A total of 24 participants were enrolled (mean age 30; 54 % male) with a broad range of endoscopy experience; 17 % reported no experience, 54 % had <25 previous colonoscopies; and 21 % had >100. The FES™ and GAGES scores reflected the broad range of endoscopy experience of the study group (FES™ score range 32-105; GAGES score range 5-20). Pearson's correlation coefficient between GAGES-C scores and FES™ hands-on test scores was 0.78 (0.54-0.90, p < 0.0001). All eight participants with GAGES-C score >15/20 achieved a passing score on the FES™ hands-on test.
  
  
  CONCLUSIONS
  There is a strong correlation between clinical colonoscopy performance and scores achieved on the FES™ hands-on test. These data support the validity of FES™ as a measure of colonoscopy skills.
authors.affiliation: Steinberg-Bernstein Centre for Minimally Invasive Surgery, McGill University Health Centre, Montreal, QC, Canada, carmen.mueller@mcgill.ca.
authors.forename: C L
authors.initials: CL
authors.lastname: Mueller
authors.forename: P
authors.initials: P
authors.lastname: Kaneva
authors.forename: G M
authors.initials: GM
authors.lastname: Fried
authors.forename: L S
authors.initials: LS
authors.lastname: Feldman
authors.forename: M C
authors.initials: MC
authors.lastname: Vassiliou
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003113:Colonoscopy; D003198:Computer Simulation; D016099:Endoscopy, Gastrointestinal / Q000193:education*; D005260:Female; D005762:Gastroenterology / Q000193:education; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D055815:Young Adult