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

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

2. 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)

3. 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.

4. SPR *NOT a requirement from CREOG nor ACGME

5. Why FLS? SPR

6. Components of FLS SPR

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

8. 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

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

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

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

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

13. Costs and Supplies of FLS? TA

14. TA

15. TA

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

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

18. 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

19. 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

20. 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

21. 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

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

23. 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

24. 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

25. 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

26. 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

27. 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

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