Performance assessment tool:
DIRECT OBSERVATION OF
PROCEDURAL SKILLS FOR MAJOR
PROCEDURALISTS
DM1224173
May 2013
Objective
The objective of this tool is to assess the doctor’s procedural skills by direct observation of major
surgical techniques.
This module is designed only to assess the quality of the doctor’s procedural performance. If you do
find clearly inadequate performance in other domains of practice, and these have implications for
patient safety, please record details.
Instructions for using the assessment tool
This is a generic assessment tool designed for assessments of different branches of medicine where
procedures are carried out. Some items may not apply to the type of practice you are assessing: if
so, write “n/a” for not applicable, in the marking column.
If you aware of already approved standards for these areas in the branch of medicine you are
assessing, please discuss this with the Council’s Medical Adviser as they can be incorporated into the
assessment.
Although a number of criteria are provided for you to check, not all are equally important, and
failure on one, or even several criteria does not necessarily require remedial education. The checklist
is provided to assist you to assess the practice, but in the end the decision as to whether the doctor
is meeting the required standard of competence is a matter of the professional, informed judgement
of the Performance Assessment Committee (PAC).
What is direct observation of procedural skills (DOPS)?
If procedural skills are in question, doctors should be adequately assessed for competence in the
practical procedures that they undertake. DOPS is a method that has been designed specifically for
the assessment of procedural skills.
How should it work?
Please ensure that patients are aware that DOPS is being carried out (formal consent should be
obtained by the doctor well in advance). The encounters should be representative of the
proceduralist’s work. You should complete one checklist for each procedure observed, and should
observe at least three procedures.
DM1224173
May 2013
Doctor’s name
Assessor’s name
Branch of medicine
Clinical setting
Theatre
Department
Other (specify)
Procedure
Number of times
procedure
performed by doctor
prior to this
Complexity of case
Low
ICU
Average
Please assess and mark (√) the following areas in relation to
what you expect, given the doctor’s experience
Ensure that it is the correct patient and that they have
provided informed consent
Prepares for procedure according to an agreed protocol
Demonstrates good asepsis technique, and safe use of
instruments/sharps
Performs technical aspects competently. Shows respect for
tissue, identifies correct tissue planes
Demonstrates manual dexterity required to carry out
procedure
Adapts procedure to accommodation patient and/or
unexpected events
Is aware of own limitations and seeks assistance when
appropriate. Has insight.
Maintains calm demeanour, regardless of circumstances
Treats all members of the surgical team with respect
Completes required documentation (written or dictated)
Analyses their own clinical performance for continuous
improvement. Self-critical
Overall ability to perform whole procedure
U
B
S
AS
N/A
Emergency
High
U
B
S
AS
N/A
Unsatisfactory or potentially dangerous
Borderline. Marginal or needs attention
Satisfactory
Above satisfactory – demonstrating a significant higher level of skill than expected
Not observed or Not applicable
Overall ability to perform whole procedure:
Suggestions for development:
DM1224173
May 2013
Other comments:
Agreed action:
DM1224173
May 2013
Doctor’s name
Assessor’s name
Branch of medicine
Clinical setting
Theatre
Department
Other (specify)
Procedure
Number of times
procedure
performed by doctor
prior to this
Complexity of case
Low
ICU
Average
Please assess and mark (√) the following areas in relation to
what you expect, given the doctor’s experience
Ensure that it is the correct patient and that they have
provided informed consent
Prepares for procedure according to an agreed protocol
Demonstrates good asepsis technique, and safe use of
instruments/sharps
Performs technical aspects competently. Shows respect for
tissue, identifies correct tissue planes
Demonstrates manual dexterity required to carry out
procedure
Adapts procedure to accommodation patient and/or
unexpected events
Is aware of own limitations and seeks assistance when
appropriate. Has insight.
Maintains calm demeanour, regardless of circumstances
Treats all members of the surgical team with respect
Completes required documentation (written or dictated)
Analyses their own clinical performance for continuous
improvement. Self-critical
Overall ability to perform whole procedure
U
B
S
AS
N/A
Emergency
High
U
B
S
AS
N/A
Unsatisfactory or potentially dangerous
Borderline. Marginal or needs attention
Satisfactory
Above satisfactory – demonstrating a significant higher level of skill than expected
Not observed or Not applicable
Overall ability to perform whole procedure:
Suggestions for development:
DM1224173
May 2013
Other comments:
Agreed action:
DM1224173
May 2013
Doctor’s name
Assessor’s name
Branch of medicine
Clinical setting
Theatre
Department
Other (specify)
Procedure
Number of times
procedure
performed by doctor
prior to this
Complexity of case
Low
ICU
Average
Please assess and mark (√) the following areas in relation to
what you expect, given the doctor’s experience
Ensure that it is the correct patient and that they have
provided informed consent
Prepares for procedure according to an agreed protocol
Demonstrates good asepsis technique, and safe use of
instruments/sharps
Performs technical aspects competently. Shows respect for
tissue, identifies correct tissue planes
Demonstrates manual dexterity required to carry out
procedure
Adapts procedure to accommodation patient and/or
unexpected events
Is aware of own limitations and seeks assistance when
appropriate. Has insight.
Maintains calm demeanour, regardless of circumstances
Treats all members of the surgical team with respect
Completes required documentation (written or dictated)
Analyses their own clinical performance for continuous
improvement. Self-critical
Overall ability to perform whole procedure
U
B
S
AS
N/A
Emergency
High
U
B
S
AS
N/A
Unsatisfactory or potentially dangerous
Borderline. Marginal or needs attention
Satisfactory
Above satisfactory – demonstrating a significant higher level of skill than expected
Not observed or Not applicable
Overall ability to perform whole procedure:
Suggestions for development:
DM1224173
May 2013
Other comments:
Agreed action:
DM1224173
May 2013
Doctor’s name
Assessor’s name
Branch of medicine
Clinical setting
Theatre
Department
Other (specify)
Procedure
Number of times
procedure
performed by doctor
prior to this
Complexity of case
Low
ICU
Average
Please assess and mark (√) the following areas in relation to
what you expect, given the doctor’s experience
Ensure that it is the correct patient and that they have
provided informed consent
Prepares for procedure according to an agreed protocol
Demonstrates good asepsis technique, and safe use of
instruments/sharps
Performs technical aspects competently. Shows respect for
tissue, identifies correct tissue planes
Demonstrates manual dexterity required to carry out
procedure
Adapts procedure to accommodation patient and/or
unexpected events
Is aware of own limitations and seeks assistance when
appropriate. Has insight.
Maintains calm demeanour, regardless of circumstances
Treats all members of the surgical team with respect
Completes required documentation (written or dictated)
Analyses their own clinical performance for continuous
improvement. Self-critical
Overall ability to perform whole procedure
U
B
S
AS
N/A
Emergency
High
U
B
S
AS
N/A
Unsatisfactory or potentially dangerous
Borderline. Marginal or needs attention
Satisfactory
Above satisfactory – demonstrating a significant higher level of skill than expected
Not observed or Not applicable
Overall ability to perform whole procedure:
Suggestions for development:
DM1224173
May 2013
Other comments:
Agreed action:
DM1224173
May 2013