Design of a proficiency-based skills training curriculum for the fundamentals of laparoscopic surgery.

Currently, no optimal curriculum exists for the Fundamentals of Laparoscopic Surgery (FLS) manual skills training program. The objective was to create a proficiency-based training curriculum that would allow both successful completion of the FLS manual skills exam and improved performance in the operating room. Two experienced laparoscopic surgeons performed 5 consecutive repetitions of all 5 FLS tasks. The mean performance times for both subjects were determined. Error parameters for each task were also recorded and used to establish a maximum allowable error parameter for each task. These data were used to create both error- and time-based proficiency levels for each task based on the importance of the task and the amount of resources consumed when practicing the task. This type of objective proficiency level was determined for each of the 5 FLS tasks. We have developed a proficiency-based training curriculum for the psychomotor skills portion of FLS. Work is under way to evaluate and validate this curricular design.