Operative Performance Rating System (OPRS)
Operative Performance Rating System (OPRS)
PARTIAL MASTECTOMY WITH AXILLARY MANAGEMENT/BREAST BIOPSY
|Evaluator: | |Resident: | |
|Resident Level: | |Program: | |
|Date of Procedure: |
| |
|Time Procedure Was Completed: |
| |
| |
|Date Assessment Was Completed: |
| |
|Time Assessment Was Initiated: |
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| |
Please rate this resident's performance during this operative procedure. For most criteria, the caption above each checkbox provides descriptive anchors for 3 of the 5 points on the rating scale. "NA" (not applicable) should only be selected when the resident did not perform that part of the procedure.
Case Difficulty
|1 |2 |3 |
| | | |
|Straightforward anatomy, no related prior |Intermediate difficulty |Abnormal anatomy, extensive pathology, related |
|surgeries or treatment | |prior surgeries or treatment (for example |
| | |radiation), or obesity |
|☐ |☐ |☐ |
Degree of Prompting or Direction
|1 |2 |3 |
| | | |
|Minimal direction by attending. Resident |Some direction by attending. Resident performs|Substantial direction by attending. Resident |
|performs all steps and directs the surgical |all steps but the attending provides |performs all steps but the attending provides |
|team independently with minimum or no |occasional direction to the resident and /or |constant direction to the resident and |
|direction from the attending, to either the |to the surgical team. |surgical team. |
|resident or to the surgical team. | | |
|☐ |☐ |☐ |
Procedure-Specific Criteria
Planning of Incision
|5 |4 |3 |2 |1 | |
|Excellent |Very Good |Good |Fair |Poor |NA |
|Excellent planning of | |Understands most | |Poor incision planning | |
|incision (use of wire, | |principles in planning | | | |
|if utilized) | |incision | | | |
Margins of Excision
|5 |4 |3 |2 |1 | |
|Excellent |Very Good |Good |Fair |Poor |NA |
|Excellent technique in | |Adequate margins of | |Inappropriate margins | |
|assuring appropriate | |excision | |and/or lesion entered | |
|margins of excision | | | |during dissection | |
Sentinel Lymph Node Mapping
|5 |4 |3 |2 |1 | |
|Excellent |Very Good |Good |Fair |Poor |NA |
|Rapid and efficient SLN| |Utilized scintigraphy | |Poor knowledge and | |
|mapping | |to identify SLN(s) but | |technique in SLN | |
| | |with some | |mapping | |
| | |inefficiencies | | | |
Anatomic Dissection of Borders
|5 |4 |3 |2 |1 | |
|Excellent |Very Good |Good |Fair |Poor |NA |
|Rapid Level | |Hesitant dissection, | |Poor dissection and | |
|1-2 dissection; | |but adequate | |inadequate | |
|excellent | |identification of | |identification of | |
|identification of | |borders | |borders | |
|borders | | | | | |
Identification of Nerves
|5 |4 |3 |2 |1 | |
|Excellent |Very Good |Good |Fair |Poor |NA |
|Clearly identified and | |Some unprompted nerve | |Failed to clearly | |
|preserved nerves during| |identification and | |identify nerves | |
|dissection | |preservation | | | |
Suturing Technique
|5 |4 |3 |2 |1 | |
|Excellent |Very Good |Good |Fair |Poor |NA |
|Excellent suture | |Satisfactory suture | |Poor suture placement | |
|placement, appropriate | |placement, occasional | |and knot tying | |
|tension and constant | |failures in providing | |technique | |
|square knots | |square knots | | | |
General Criteria
Instrument Handling
|5 |4 |3 |2 |1 | |
|Excellent |Very Good |Good |Fair |Poor |NA |
|Fluid movements with | |Competent use of | |Tentative or awkward | |
|instruments consistently | |instruments, | |movements, often did | |
|using appropriate force, | |occasionally appeared | |not visualize tips of | |
|keeping tips in view, and| |awkward or did not | |instrument or clips | |
|placing clips securely | |visualize instrument | |poorly placed | |
| | |tips | | | |
Respect for Tissue
|5 |4 |3 |2 |1 | |
|Excellent |Very Good |Good |Fair |Poor |NA |
|Consistently handled | |Careful tissue handling, | |Frequent unnecessary | |
|tissue carefully | |occasional inadvertent | |tissue force or damage by| |
|(appropriately), minimal | |damage | |inappropriate instrument | |
|tissue damage | | | |use | |
|Clear economy of motion, | |Efficient time and | |Many unnecessary moves | |
|and maximum efficiency | |motion, some unnecessary | | | |
| | |moves | | | |
Operation Flow
|5 |4 |3 |2 |1 | |
|Excellent |Very Good |Good |Fair |Poor |NA |
|Obviously planned course | |Some forward planning, | |Frequent lack of forward | |
|of operation and | |reasonable procedure | |progression; frequently | |
|anticipation of next | |progression | |stopped operating and | |
|steps | | | |seemed unsure of next move | |
Overall Performance
Rating of 4 or higher indicates technically proficient performance (i.e., resident is ready to perform operation independently, assuming resident consistently performs at this level)
|5 |4 |3 |2 |1 | |
|Excellent |Very Good |Good |Fair |Poor |NA |
|☐ |
Please indicate the strengths in this resident’s performance:
| |
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