Advancing Evidence, Elevating Standards: New Validity Data Strengthens EMIGS

The AAGL continues to lead the field in advancing evidence-based surgical education with the publication of new validity evidence supporting the Essentials in Minimally Invasive Gynecologic Surgery (EMIGS) program. This latest study, published in the American Journal of Obstetrics and Gynecology1, represents a critical step forward in reinforcing EMIGS as a rigorously developed, standardized assessment for training and testing in minimally invasive gynecologic surgery (MIGS). 

Building on the foundational work of Munro et al.2,3, which established the face and construct validity of EMIGS through pilot and multi-institutional trials, this new investigation provides additional, contemporary validity evidence aligned with modern psychometric frameworks. 

Specifically, the study demonstrates a strong correlation between EMIGS performance and the Global Operative Assessment of Laparoscopic Skills (GOALS)—a widely validated, independent measure of surgical skill. Participants who passed EMIGS consistently achieved GOALS scores of at least 3 across key domains including depth perception, bimanual dexterity, efficiency, and tissue handling, underscoring that EMIGS performance reflects real-world competence. 

Importantly, the study further confirms that more experienced surgeons—ranging from senior residents to fellowship-trained MIGS specialists—demonstrate superior performance on EMIGS tasks, completing them more efficiently and with fewer errors. These findings reinforce EMIGS as a meaningful, discriminative, and high-stakes assessment tool capable of differentiating levels of surgical expertise. 

This work represents not a culmination, but a continuation of the AAGL’s unwavering commitment to rigorous educational research. The EMIGS Research Subcommittee arm of the EMIGS Steering Committee has prioritized continuous evaluation and refinement of the program to ensure it meets the highest standards of validity, reliability, and educational impact. This philosophy reflects a broader commitment: just as we practice evidence-based medicine, we must also practice evidence-based surgical education. 

A key driver of this progress has been the AAGL’s substantial investment in the EMIGS program and a generous $80,000 EMIGS research grant that is distributed annually to competitive applicants. The grant continues to support investigators dedicated to advancing surgical education science and has already yielded additional scholarly contributions, including presentations at major international meetings: 

• Lerner V, Frost A, King CR, Katz A, Moawad NS, Levy B, Bar-El L, Long JB. Validity Evidence for EMIGS Laparoscopic Skills. Presented at the Society of Gynecologic Surgeons Annual Clinical Meeting, Rancho Mirage, CA, March 2025. 

• Chen G, Levy B, Moawad NS. Validity Evidence for EMIGS Laparoscopic Skills. E-poster presentation at the International Urogynecological Association (IUGA) 24th Annual Meeting, Singapore, June 2024. 

These efforts highlight a growing and robust body of literature supporting EMIGS and reflect a collaborative, multi-institutional commitment to excellence.

As EMIGS continues to evolve, future research will focus on downstream outcomes—examining how performance translates into operative safety, efficiency, and patient outcomes. This next phase of research will be essential in solidifying EMIGS as not only a measure of competency, but a driver of improved surgical care. 

The message is clear: EMIGS is not static. It is a dynamic, evidence-driven program—continuously refined, rigorously tested, and firmly positioned at the forefront of surgical education. Through sustained investment, collaborative research, and an uncompromising commitment to excellence, the AAGL is shaping the future of MIGS training—ensuring that the next generation of surgeons is not only competent, but exceptional. 

REFERENCES: 

1. Grace Chen CC, Bar-El L, Long JB, Frost A, King CR, Katz A, Moawad NS, Levy B, Wu H, Lerner V; Validity Evidence for the Essentials in Minimally Invasive Gynecologic Surgery (EMIGS) Laparoscopic Skills: Correlation with the Global Operative Assessment of Laparoscopic Skills (GOAL S)., American Journal of Obstetrics and Gynecology (2026), doi: https://doi.org/10.1016/j.ajog.2026.02.040.
2. Munro MG, Advincula AP, Banks EH, Auguste TC, Chahine EB, Grace Chen CC, Curlin HL, Jorgensen EM, Kim JH, King CR, Lucas J, Milad MP, Mourad J, Siedhoff MT, Solnik MJ, Destephano CC, Thayn K; Essentials in Minimally Invasive Gynecology (EMIG) Steering Committee. Essentials in Minimally Invasive Gynecology Manual Skills Construct Validation Trial. Obstet Gynecol. 2020 Jul;136(1):83-96. doi: 10.1097/AOG.0000000000003936. PMID: 32541289; PMCID: PMC7316146. https://pubmed.ncbi.nlm.nih.gov/32541289/ 
3. Munro MG, Brown AN, Saadat S, Gomez N, Howard D, Kahn B, Stockwell E, Advincula AP, Volker W, Thayn K; EMIG Steering Committee. Essentials in Minimally Invasive Gynecology Manual Skills Pilot Validation Trial. J Minim Invasive Gynecol. 2020 Feb;27(2):518-534. doi: 10.1016/j.jmig.2019.04.018. Epub 2019 Apr 26. PMID: 31034978. https://pubmed.ncbi.nlm.nih.gov/31034978/