Conducting the Directly Observed Procedural Skills (DOPS)

A DOPS involves a registrar being observed by an assessor while performing a procedural skill. DOPS are opportunistic, completed on real patients during the course of normal work in an approved training facility.

The assessor rates the registrars performance and provides structured feedback after the completion of the procedure.

The required DOPS are selected skills taken from the procedural components of the Core Skills . A DOPS must be completed by an assessor observing the registrar performing the procedure on a real patient in the workplace. They cannot be assessed in simulation or at SDAW. However, if some aspects of the core skill list are not applicable to the particular patient that a DOPS is performed on (e.g. if a wound being sutured does not require debridement) then these aspects can be assessed by discussion after the case. Documentation is on the DOPS form as well as signing off the core skill checklist.

Completed DOPS allow the core skills list to be also signed off as complete. The remaining core skills that could be used as DOPS should be completed in the same way as other core skills sign off.

Requirements

• Basic phase of training
  • A minimum of 2 DOPS must be completed. These must include Local anaesthetics, including ring block and Suturing, including wound debridement
  •  Additional DOPS can be completed for credit during this phase.
• Advanced phase of training
  • Incision and drainage of abscesses
  • Reduction of digital dislocation
  • Reduction of shoulder dislocation and collar and cuff
  • Relocation of pulled elbow and radial head subluxation
  • Removal of corneal and conjuctival foreign bodies
  • Plus one from the following:
    • Diagnostic arthocentesis of the knee
    • Doppler ultrasound for foetal heartbeat
    • Removal of cutaneous foreign bodies
    • Wound management
    • Nail trephine, nail removal and nail bed repair

Completing a DOPS

• The registrar introduces themselves to the patient, explains their the role and that of the assessor, gaining consent from the patient.
• The assessor observes the registrar completing the procedure and rates their performance relative to the standard expected of a new FRNZCUC.
• The assessor can intervene or give advice to ensure safe patient care.

Assessment and Feedback

• The assessor bases the assessment on their direct observation of the registrar performing the procedure
• A rating is made of the technical skill performing the procedure as well as aspects including correct indications and contraindications, gaining consent, communication and post procedure advice.
• Structured feedback is provided to the registrar about their performance and opportunities for improvement.
• If aspects of the core skill are not applicable to the particular patient that a DOPS is performed on (e.g. if a wound being sutured does not require debridement) then these aspects can be assessed by discussion after the case.

Reporting and Documentation

The DOPS Form is completed and uploaded to UCCIS