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. 2021 Jun 11;35(12):3192–3201. doi: 10.1038/s41433-021-01599-7

Table 1.

Modified rating scale for assessment of operative performance.

Rating of operative performance (based on Reznick and Vassiliou)
Assessed skill Grading
1 2 3
Time and motion Unnecessary moves Efficient time and/or motion, with some unnecessary moves Clear economy of movement with maximum efficiency
Instrument/robot handling Repeated, tentative and/or awkward moves Competent use of instruments but occasional stiffness and/or awkward moves Fluid movement with instruments and no awkwardness
Knowledge of instrument/robotic procedure Incorrect use of instruments; uncontrolled and/or unsafe movement with robot Knows how to use instruments appropriately; some familiarity with robotics procedure Confident use of instruments and knowledge of robotics procedure
Flow of procedure Frequently pauses while operating and/or unsure of next steps Demonstrates some forward planning with reasonable progression of procedure Obvious advanced planning with effortless flow from one step to the next
Use of assistant/alternate steps Consistently makes inappropriate use of assistant and/or alternate modules Appropriate use of assistance and/or alternate modules most of the time Strategic use of assistance/alternate steps to best advantage all the time
Risk mitigation Inappropriate anticipation and/or unable to respond to simulated emergencies Appropriate recognition of a simulated emergency but has some hesitancy in response Appropriate recognition of a simulated emergency and use of appropriate modules
Autonomy Unable to complete entire task, even with verbal guidance Completes tasks safely with moderate guidance Completes task independently without prompting
Force sensitivity Aggressive movements, tears tissue, and/or injures structures Occasional uncontrolled movements, but able to recognize and respond accordingly Applies appropriate tension, no injury to tissues/structures