Maintaining proficiency after Fundamentals of Laparoscopic Surgery training: A 1-year analysis of skill retention for surgery residents

Background. The purpose of this study was to determine performance retention after initial and ongoing Fundamentals of Laparoscopic Surgery (FLS) skills, training. Methods. Surgery residents (postgraduate year [PGY] 1-5; n = 91) initially underwent proficiency-based training during a 2-month period for all 5 FLS tasks. Subsequently, available residents (PGY 2-5; n = 44) were enrolled in a follow-up curriculum for Task 4 and 5, with retention testing at 6.5 +/- 1.0 months (Retention 1) and 12.5 +/- 1.3 months (Retention 2), followed by mandatory retraining if needed. Results. Forty-two residents participated in the follow-up curriculum. For Task 4, retraining was required for 55% of trainees after Retention 1 and for 40% after Retention 2 testing. For Task 5, retraining was required for 86% of trainees after Retention 1 and for 48% after Retention 2 testing. Compared with posttest performance, skill retention was 86% and 96% for Task 4 and 87% and 96% for Task 5 at Retentions 1 and 2, respectively. Conclusion. A modest decrement in performance was detected at 6.5 months, but a small amount Of additional structured practice reinforced skill acquisition and minimized skill loss at 12.5 months. In addition to clinical experience, trainees may benefit from ongoing FLS simulator training to optimally maintain proficiency. (Surgery 2009;146:387-93.)