TABLE VI.

P-Score Assessment Tool

Level	Description
Novice	Attending surgeon provides maximum assistance Demonstrates knowledge of anatomy Demonstrates basic operative skills (e.g., incision, excision, and wound closure) Positions the patient First assists and observes
Low intermediate	Attending surgeon provides significant assistance and direction Performs the approach with minimal assistance Identifies anatomical landmarks Identifies most of the critical steps Demonstrates proficiency with the component technical skills Demonstrates an increasing ability to perform different key parts of the operation with attending assistance Demonstrates room setup and equipment management
High intermediate	Attending provides modest assistance and direction Capable of performing the approach Familiar with anatomic landmarks Identifies and is capable of performing almost all the critical steps Demonstrates proficiency with the component technical skills Attending assistance required for the most challenging portions of the procedure
Supervision-only competent	Attending surgeon not required to provide active assistance Knows steps and transitions easily Able to direct and assist a more junior resident Aware of environment and can manage patient safety and coordinate the operative team Capable of performing the procedure in practice independently
Advanced expertise-proficient	Performance matches that of the advanced surgeon Capable of performing complex procedures independently Capable of independent management of intraoperative complications