title: The model for Fundamentals of Endovascular Surgery (FEVS) successfully defines the competent endovascular surgeon.
abstract: OBJECTIVE
  Fundamental skills testing is now required for certification in general surgery. No model for assessing fundamental endovascular skills exists. Our objective was to develop a model that tests the fundamental endovascular skills and differentiates competent from noncompetent performance.
  
  
  METHODS
  The Fundamentals of Endovascular Surgery model was developed in silicon and virtual-reality versions. Twenty individuals (with a range of experience) performed four tasks on each model in three separate sessions. Tasks on the silicon model were performed under fluoroscopic guidance, and electromagnetic tracking captured motion metrics for catheter tip position. Image processing captured tool tip position and motion on the virtual model. Performance was evaluated using a global rating scale, blinded video assessment of error metrics, and catheter tip movement and position. Motion analysis was based on derivations of speed and position that define proficiency of movement (spectral arc length, duration of submovement, and number of submovements).
  
  
  RESULTS
  Performance was significantly different between competent and noncompetent interventionalists for the three performance measures of motion metrics, error metrics, and global rating scale. The mean error metric score was 6.83 for noncompetent individuals and 2.51 for the competent group (P < .0001). Median global rating scores were 2.25 for the noncompetent group and 4.75 for the competent users (P < .0001).
  
  
  CONCLUSIONS
  The Fundamentals of Endovascular Surgery model successfully differentiates competent and noncompetent performance of fundamental endovascular skills based on a series of objective performance measures. This model could serve as a platform for skills testing for all trainees.
authors.affiliation: Methodist DeBakey Heart & Vascular Center, Department of Cardiovascular Surgery, Houston Methodist Hospital, Houston, Tex. Electronic address: caduran@houstonmethodist.org.
authors.forename: Cassidy
authors.initials: C
authors.lastname: Duran
authors.affiliation: Department of Mechanical Engineering, Mechatronics and Haptics Interfaces Laboratory, Rice University, Houston, Tex.
authors.forename: Sean
authors.initials: S
authors.lastname: Estrada
authors.affiliation: Department of Mechanical Engineering, Mechatronics and Haptics Interfaces Laboratory, Rice University, Houston, Tex.
authors.forename: Marcia
authors.initials: M
authors.lastname: O'Malley
authors.affiliation: Department of Vascular Surgery, Louisiana State University School of Medicine, New Orleans, La.
authors.forename: Malachi G
authors.initials: MG
authors.lastname: Sheahan
authors.affiliation: Department of Surgery, University of South Florida, Tampa, Fla.
authors.forename: Murray L
authors.initials: ML
authors.lastname: Shames
authors.affiliation: Department of Vascular Surgery, Stanford University School of Medicine, Stanford, Calif.
authors.forename: Jason T
authors.initials: JT
authors.lastname: Lee
authors.affiliation: Methodist DeBakey Heart & Vascular Center, Department of Cardiovascular Surgery, Houston Methodist Hospital, Houston, Tex.
authors.forename: Jean
authors.initials: J
authors.lastname: Bismuth
mesh_terms: D000328:Adult; D002568:Certification / Q000592:standards*; D002983:Clinical Competence; D004502:Education, Medical, Continuing; D057510:Endovascular Procedures / Q000592:standards*; D005260:Female; D013502:General Surgery / Q000193:education* / Q000592:standards*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D017145:Models, Educational; D012371:Robotics / Q000592:standards*; D013647:Task Performance and Analysis