Fundamentals of laparoscopic surgery (FLS) manual skills assessment: Surgeon vs nonsurgeon raters

Deborah M. Rooney*, Byron F. Santos, Eric Hungness

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


Objective: The American Board of Surgery has recently started requiring completion of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) fundamentals of laparoscopic surgery (FLS) program for board certification in general surgery. Although most SAGES Testing Centers utilize nonsurgeons as FLS proctors, the effectiveness of using nonsurgeons as FLS proctors has not been evaluated. Methods: Surgeons and nonsurgeons attending FLS proctor training workshops were studied. Participants reviewed training materials before course attendance. Subjects watched a videotaped FLS performance containing 9 "critical" errors, which participants were asked to identify. This assessment was repeated after hands-on training. Results: Thirteen surgeon and 17 nonsurgeon subjects participated. At baseline, surgeons detected 66% of errors, vs 65% for nonsurgeons, with no statistical difference between groups. Analysis of individual tasks also showed no difference between groups, except for intracorporeal knot-tying (p = 0.049). Both groups improved after training (p < 0.01), with surgeons detecting 81% of errors vs 83% for nonsurgeons (no difference in overall or task-specific ratings). Conclusions: This study suggests that trained nonsurgeons may be as effective as surgeon proctors in detecting errors associated with the FLS manual test. This finding supports the utility of using trained nonsurgeons as FLS proctors as surgical training programs face increasing economic constraints.

Original languageEnglish (US)
Pages (from-to)588-592
Number of pages5
JournalJournal of Surgical Education
Issue number5
StatePublished - Sep 1 2012


  • FLS
  • assessment
  • fundamentals of laparoscopic surgery
  • surgery
  • technical skills

ASJC Scopus subject areas

  • Surgery
  • Education


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