ࡱ> %` Dbjbj"x"x ;@@fffz^9^9^989R:zUM*<*<@<@<@<===hLjLjLjLjLjLjL$NhEQLf=====L@<@<HM@@@=v@<8@<hL@=hL@@N@@<< | y^9>j@4C4 %M0UM@Ql><Q@@"Qf4A==@=====LL?j===UM====zzz0^9zzz^9zzz Operative Performance Rating System (OPRS) PARTIAL MASTECTOMY WITH AXILLARY MANAGEMENT/BREAST BIOPSY Evaluator:Resident: Resident Level: Program:  Date of Procedure: Time Procedure Was Completed: Date Assessment Was Completed: Time Assessment Was Initiated: Please rate this resident's performance during this operative procedure. For most criteria, the caption above each checkbox provides descriptive anchors for 3 of the 5 points on the rating scale. "NA" (not applicable) should only be selected when the resident did not perform that part of the procedure. Case Difficulty 123 Straightforward anatomy, no related prior surgeries or treatment Intermediate difficulty Abnormal anatomy, extensive pathology, related prior surgeries or treatment (for example radiation), or obesity &&& Degree of Prompting or Direction 123 Minimal direction by attending. Resident performs all steps and directs the surgical team independently with minimum or no direction from the attending, to either the resident or to the surgical team.  Some direction by attending. Resident performs all steps but the attending provides occasional direction to the resident and /or to the surgical team.  Substantial direction by attending. Resident performs all steps but the attending provides constant direction to the resident and surgical team. &&& Procedure-Specific Criteria Planning of Incision 5 Excellent4 Very Good3 Good2 Fair1 Poor NAExcellent planning of incision (use of wire, if utilized)Understands most principles in planning incisionPoor incision planning&&&&&&Margins of Excision 5 Excellent4 Very Good3 Good2 Fair1 Poor NAExcellent technique in assuring appropriate margins of excisionAdequate margins of excisionInappropriate margins and/or lesion entered during dissection&&&&&&Sentinel Lymph Node Mapping 5 Excellent4 Very Good3 Good2 Fair1 Poor NARapid and efficient SLN mappingUtilized scintigraphy to identify SLN(s) but with some inefficienciesPoor knowledge and technique in SLN mapping &&&&&&Anatomic Dissection of Borders 5 Excellent4 Very Good3 Good2 Fair1 Poor NARapid Level 1-2 dissection; excellent identification of bordersHesitant dissection, but adequate identification of bordersPoor dissection and inadequate identification of borders&&&&&& Identification of Nerves 5 Excellent4 Very Good3 Good2 Fair1 Poor NAClearly identified and preserved nerves during dissectionSome unprompted nerve identification and preservationFailed to clearly identify nerves&&&&&&Suturing Technique 5 Excellent4 Very Good3 Good2 Fair1 Poor NAExcellent suture placement, appropriate tension and constant square knotsSatisfactory suture placement, occasional failures in providing square knots Poor suture placement and knot tying technique&&&*+]^deoq|~ʹʧsaasO=#h-h `5CJOJQJ^JaJ#h/`h `5CJOJQJ^JaJ#hcIh{t5CJOJQJ^JaJhcIh{tCJOJQJaJ hcIh{tCJOJQJ^JaJ&hcIh{t5CJOJQJ\^JaJ#hmjh-{5CJOJQJ^JaJ hmjhmjCJOJQJ^JaJ#hmjhmj5CJOJQJ^JaJhAn5CJOJQJ^JaJ(h*s5CJOJQJ^JaJmHnHu+epq}~ xx$If]`gdcI:xx$If]:`gdcIxx$If`gdcI:xx$If]:gdcI$]`a$gdo(T$BE&dP]B`Ea$gd>B~J99$xx$If]`gdcIxx$If]gdcIkd$$Ifl\L&Fj t0`'44 lap(ytcI5+ $a$gd `kdT$$Ifl\L&  t0`'44 lap(ytcI_xx$If]_^gdcI/kd$IfK$L$l\~+  t~+44 lap(yt-d$If^gd-K$dxx$If^`gd-K$d$Ifgd-K$     ^ r E F G H K V 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movements, often did not visualize tips of instrument or clips poorly placed&&&&&&Respect for Tissue 5 Excellent4 Very Good3 Good2 Fair1 Poor NAConsistently handled tissue carefully (appropriately), minimal tissue damageCareful tissue handling, occasional inadvertent damageFrequent unnecessary tissue force or damage by inappropriate instrument use Time and Motion 5 Excellent4 Very Good3 Good2 Fair1 Poor NAClear economy of motion, and maximum efficiencyEfficient time and motion, some unnecessary movesMany unnecessary moves &&&&&&Operation Flow 5 Excellent4 Very Good3 Good2 Fair1 Poor NAObviously planned course of operation and anticipation of next stepsSome forward planning, reasonable procedure progressionFrequent lack of forward progression; frequently stopped operating and seemed unsure of next move&&&&&& Overall Performance Rating of 4 or higher indicates technically proficient performance (i.e., resident is ready to perform operation independently, assuming resident consistently performs at this level) 5 Excellent4 Very Good3 Good2 Fair1 Poor NA&&&&&& Please indicate the weaknesses in this resident s performance:  Please indicate the strengths in this resident s performance:      Partial Mastectomy with Axillary Management/Breast Biopsy  Page  PAGE \* MERGEFORMAT 4 Baystate Medical Center Department of Surgery Baystate Medical Center Department of Surgery kd)$$Iflֈ H$<<<<<< t0644 lap<yt-6^bvz$ !d$Ifa$gd-gdU, $da$gd$gd-‚kd*$$IflֈT  C|%D9999 t0%644 lap<yt-LP *tx„ :<>@睈n爵]V h-hn!h-hnB*OJQJ^Jph2h-hn6B*CJOJQJ\]^JaJph)h-hnB*CJOJQJ^JaJph/h-hn5B*CJOJQJ\^JaJph/h-hnB*CJOJQJ\]^JaJph2h-h6B*CJOJQJ\]^JaJph/h-hB*CJOJQJ\]^JaJph‚vx<>@DHLPTX$ !d$If`a$gd-Ff<-$ !d$Ifa$gd-$ !dxx$Ifa$gd- $ !dxx$If]^a$gd- @BDFHJLNPRTVXZʹrX@/h-hnB*CJOJQJ\]^JaJph2h-hn6B*CJOJQJ\]^JaJph'h-hn5B*OJQJ\^Jph#h/`hn5CJOJQJ^JaJ h-hn)h-hnB*CJOJQJ^JaJph0h-hnB*CJOJPJQJ^JaJo(ph/h-hn5B*CJOJQJ\^JaJph3h-hnB*CJOJPJQJ\^JaJo(phXZkdV/$$IflֈT =%/././ t0%6?44 lap<yt-Z…̅Ѕڅ܅$d$Ifa$gd-gdy kd0$$Iflֈg l$AMv t0644 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