Proposed Template for Rating Forms



Operative Performance Rating System (OPRS)

LAPAROSCOPIC APPENDECTOMY

|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

|1 |2 |3 |4 |5 |

| | | | | |

|Straightforward anatomy, no related prior | |Intermediate difficulty | |Abnormal anatomy, extensive pathology, |

|surgeries or treatment | | | |related prior surgeries or treatment |

| | | | |(for example radiation), or obesity |

Degree of Prompting or Direction

|Substantial Direction |2 |Some Direction |4 |Minimal Direction |

|1 | |3 | |5 |

| | | | | |

|Unable to direct team, use/choose | |Actively assists and anticipates own and| |Performs all steps and directs team with|

|instruments, or anticipate next steps as | |attending’s needs, performs basic steps | |minimal direction from attending to |

|surgeon or as first assistant without | |with occasional attending direction to | |either resident or team, i.e., |

|constant attending prompting | |resident and/or surgical team. Somewhat | |anticipates needs, sets up exposure for |

| | |hesitant and slow to anticipate or | |self and assistant, transitions fluently|

| | |recognize aberrant anatomy, unexpected | |between steps, gives clear direction to |

| | |findings, and/or “slowing down” moments | |first assistant, maintains situation |

| | | | |awareness, calmly recovers from error |

| | | | |and recognizes when to seek help/advice |

|☐ |☐ |☐ |☐ |☐ |

Procedure-Specific Criteria

Please assess performance and indicate the degree of prompting for each item. The assessment score for each item may differ from the prompting score for that item.

Incision / Port Placement

|Poor |Fair |Good |Very Good 4 |Excellent | |

|1 |2 |3 | |5 |NA |

|Poor choice of port | |Functional but somewhat | |Safe, efficient and | |

|position; unsafe technique | |awkward port | |optimal positioning of| |

|in insertion or removal | |positioning; generally safe | |ports for procedure, | |

| | |technique; some difficulty | |and anatomy | |

| | |inserting ports | | | |

|Substantial Direction | |Some | |Minimal Direction |NA |

|1 |2 |Direction |4 |5 | |

| | |3 | | | |

Exposure

|Poor |Fair |Good |Very Good 4 |Excellent | |

|1 |2 |3 | |5 |NA |

|Poor/inadequate | |Adequate establishment and | |Optimizes exposure, | |

|pneumoperitoneum, camera | |maintenance of | |efficiently directs | |

|angle and retraction with | |pneumoperitoneum, camera | |retraction and camera to | |

|frequent loss of exposure  | |angle and retraction but | |maintain exposure and | |

| | |with occasional loss of | |pneumoperitoneum | |

| | |exposure | | | |

|Substantial Direction | |Some | |Minimal Direction |NA |

|1 |2 |Direction |4 |5 | |

| | |3 | | | |

Appendix Dissection

|Poor |Fair |Good |Very Good 4 |Excellent | |

|1 |2 |3 | |5 |NA |

|Dissection of appendix | |Adequate but inefficient | |Expedient and efficient | |

|inadequate for safe staple | |dissection; some bleeding | |location of appendix and | |

|placement | |during creation of | |creation of mesoappendix | |

| | |mesoappendix window | |window close to cecum | |

|Substantial Direction | |Some | |Minimal Direction |NA |

|1 |2 |Direction |4 |5 | |

| | |3 | | | |

Appendix Division

|Poor |Fair |Good |Very Good 4 |Excellent | |

|1 |2 |3 | |5 |NA |

|Dissection of appendix | |Adequate but inefficient | |Safe and secure staple | |

|inadequate to place staples| |dissection; stapled | |placement across base of | |

|and divide safely; multiple| |securely but spacing not | |appendix and mesoappendix | |

|attempts to place staples | |ideal | |with clean division of | |

| | | | |appendix | |

|Substantial Direction | |Some | |Minimal Direction |NA |

|1 |2 |Direction |4 |5 | |

| | |3 | | | |

Appendix Removal

|Poor |Fair |Good |Very Good 4 |Excellent | |

|1 |2 |3 | |5 |NA |

|Inadequate division of | |Inefficient placement of | |Efficient placement of | |

|appendix or mesoappendix | |appendix within bag; some | |appendix within bag and | |

|(multiple attempts); did | |contamination | |removal from field without| |

|not cleanly remove | | | |spillage or contamination | |

|appendix; or caused | | | | | |

|spillage or contamination | | | | | |

|Substantial Direction | |Some | |Minimal Direction |NA |

|1 |2 |Direction |4 |5 | |

| | |3 | | | |

General Criteria

Instrument Handling

|Poor |Fair |Good |Very Good 4 |Excellent | |

|1 |2 |3 | |5 |NA |

|Tentative or awkward | |Competent use of | |Fluid movements with | |

|movements, often did not | |instruments, | |instruments consistently| |

|visualize tips of | |occasionally appeared | |using appropriate force,| |

|instrument or clips poorly | |awkward or did not | |keeping tips in view, | |

|placed | |visualize instrument | |and placing clips | |

| | |tips | |securely | |

Respect for Tissue

|Poor |Fair |Good |Very Good 4 |Excellent | |

|1 |2 |3 | |5 |NA |

|Frequent unnecessary | |Careful tissue handling, | |Consistently handled | |

|tissue force or damage by| |occasional inadvertent | |tissue carefully | |

|inappropriate instrument | |damage | |(appropriately), minimal | |

|use | | | |tissue damage | |

Time and Motion

|Poor |Fair |Good |Very Good 4 |Excellent | |

|1 |2 |3 | |5 |NA |

|Many unnecessary moves | |Efficient time and | |Clear economy of motion, | |

| | |motion, some unnecessary | |and maximum efficiency | |

| | |moves | | | |

Operation Flow

|Poor |Fair |Good |Very Good 4 |Excellent | |

|1 |2 |3 | |5 |NA |

|Frequent lack of forward | |Some forward planning, | |Obviously planned course | |

|progression; frequently | |reasonable procedure | |of operation and | |

|stopped operating and | |progression | |anticipation of next steps| |

|seemed unsure of next move | | | | | |

Overall Performance (not included in calculation of mean score)

Rating of very good or higher indicates technically proficient performance (i.e., resident is ready to perform operation independently, assuming resident consistently performs at this level)

|Poor |Fair |Good |Very Good |Excellent |

|☐ |☐ |☐ |☐ |☐ |

Please indicate the weaknesses in this resident’s performance:

| |

Please indicate the strengths in this resident’s performance:

| |

-----------------------

Published with permission of Southern Illinois University Department of Surgery

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download