Table 1.
Direct observation of procedural skills (DOPS) form
| Procedure | Endotracheal intubation | |
|---|---|---|
| Patient details | ||
| Degree of difficulty | Low | Time taken for procedure |
| Moderate | ||
| High | ||
| Reason for difficulty | Time taken for feedback | |
| Time pressure | Elective | Number of times procedure previously completed by student |
| Emergency | ||
| Observation | ||
| Knowledge | Demonstrates relevant basic science/clinical knowledge and understanding of the procedure including indications, contraindications, anatomy, technique, side effects and complications | |
| Airway anatomy | ||
| Airway evaluation | ||
| Mallampati classification | ||
| Endotracheal tube | ||
| Indications/contraindications | ||
| Consent | Explains procedure to the patient and obtains valid and adequate informed consent | |
| Preparation | Prepares OR appropriately for procedure | |
| Ensures assisting staff are present | ||
| Checks machine | ||
| Monitors | ||
| Prepares drugs | ||
| Keeps appropriate size laryngoscope/tube/airway/LMA | ||
| Suction | ||
| Vigilance | Demonstrates situational awareness through constant clinical and electronic monitoring. | |
| Maintains focus on the patient and avoids distraction | ||
| Identify SpO2 based on tone modulation | ||
| Look for EtCO2 curve | ||
| Looks for chest expansion | ||
| Infection control | Demonstrates aseptic/clean technique | |
| Standard (universal) precautions | ||
| Use of gloves | ||
| Technical ability | Demonstrates manual dexterity and confidence | |
| Able to perform mask ventilation | ||
| Keeps position of the head correctly | ||
| Introduction of DL scope into the oral cavity/LMA | ||
| Correct procedural sequence with minimal hesitation and unnecessary actions | ||
| Patient interaction | Provides reassurance and checks for discomfort, concerns and complications | |
| Insight | Ability to identify difficulty | |
| Ask for extra aids for intubation (bougie, stylet, McCoy, External laryngeal manipulation) | ||
| Knows when to seek assistance | ||
| Abandon procedure or arrange alternative care to prevent harm to patient | ||
| Documentation/post procedure management | Confirm tube position by auscultation/EtCO2 | |
| Fixing tube appropriately | ||
| Start IPPV | ||
| Check ventilator setting | ||
| Start appropriate FGF and inhalational agent | ||
| Documents the episode including problems and complications; arranges and documents plans for post procedural care | ||
| Team interaction | Provides clear and concise instructions to assisting staff/paramedics | |
| Conveys relevant information concerning the patient | ||
| Explains the plans to team members | ||
| Overall feedback | ||
| What was done well | ||
| Areas that need improvement | ||
| Trainee reflection | ||
| Trainee comments | ||
| Trainee action plan | ||
| Outcome | ||
| DOPS Score (1 to 9) | ||
| Competence | Need constant supervision and assistance | |
| Needs minimal assistance | ||
| Can perform independently | ||
| Date of assessment | ||
| Trainee name | ||
| Trainee email | ||
| Assessor name | ||
| Assessor email | ||
OR: Operation room, LMA: Laryngeal mask airway, SpO2: Oxygen saturation, EtCO2: End-tidal carbon dioxide, DLscope: Direct laryngoscope, IPPV: Intermittent positive pressure ventilation, FGF: Fresh gas flow