|
| Please rate the trainee's performance on the following scale. |
|
| Respect for tissue | 1 | 2 | 3 | 4 | 5 |
|
| | Frequently used unnecessary force on tissues or caused damage by inappropriate instrument use | | Careful handling of tissue, but occasional inadvertent damage | | Consistently handled tissues appropriately with minimal damage |
|
| Time in motion | 1 | 2 | 3 | 4 | 5 |
|
| | Many unnecessary moves | | Efficient time and motion, but some unnecessary moves | | Clear economy of movement and maximum efficiency |
|
| Instrument handling | 1 | 2 | 3 | 4 | 5 |
|
| | Repeatedly makes tentative or awkward moves with instruments | | Competent use of instruments, but occasionally awkward | | Fluid movements |
|
| Elliptical excision skill* | 1 | 2 | 3 | 4 | 5 |
|
| | Lacks knowledge of design parameters
(<2 mmor >10 mm margins);
angles very different than 30°;
length-width ratio very different than 3-4 : 1 | | Adequate 2 to 10 mm margins;
angles at ends of ellipse slightly different than 30°;
length-width ratio slightly different than 3-4 : 1 | | Adequate 2 to 10 mm margins;
30° angles at both ends;
length-width ratio 3-4 : 1 |
|
| Suture training** | 1 | 2 | 3 | 4 | 5 |
|
| | Awkward and unsure with poor knot tying, and inability to maintain tension | | Competent suturing with good knot placement and appropriate tension | | Excellent suture control with correct suture placement and tension |
|
| Flow of operation | 1 | 2 | 3 | 4 | 5 |
|
| | Frequently stopped operating, seemed unsure of next move | | Demonstrated some forward planning and reasonable progression of procedure | | Obviously planned operation |
|
| Knowledge of procedure | 1 | 2 | 3 | 4 | 5 |
|
| | Inefficient knowledge of procedure.
Looked unsure and hesitant | | Knew all important steps of procedure | | Demonstrated familiarity of all steps of procedure |
|
| Final product | 1 | 2 | 3 | 4 | 5 |
|
| | Final product of unacceptable quality | | Final product of average quality | | Final product of superior quality |
|
| Overall performance | 1 | 2 | 3 | 4 | 5 |
|
| | Very poor | | Competent | | Very good |
|
| Maximum total score (40) | | | | | |
|
| Total score ( ) | | | | | |
|
