FLS and FES: Comprehensive models of training and assessment

The Fundamentals of Laparoscopic surgery (FLS) is a validated program for the teaching and evaluation of the basic knowledge and skills required to perform laparoscopic surgery. The educational component includes didactic, Web-based material and a simple, affordable physical simulator with specific tasks and a recommended curriculum. FLS certification requires passing a written multiple-choice examination and a proctored manual skills examination in the FLS simulator. The metrics for the FLS program have been rigorously validated to meet the highest educational standards, and certification is now a requirement for the American Board of Surgery. This article summarizes the validation process and the FLS-related research that has been done to date. The Fundamentals of Endoscopic Surgery is a program modeled after FLS with a similar mission for flexible endoscopy. It is currently in the final stages of development and will be launched in April 2010. The program also includes learning and assessment components, and is undergoing the same meticulous validation process as FLS. These programs serve as models for the creation of simulation-based tools to teach skills and assess competence with the intention of optimizing patient safety and the quality of surgical education.