Respect for tissue

1

Frequently used unnecessary force on tissue or caused damage by inappropriate use of instruments

2

3

Careful handling of tissue but occasionally caused inadvertent damage

4

5

Consistently handled tissues appropriately with minimal damage

Time and motion

1

Many unnecessary moves

2

3

Efficient time/motion but some unnecessary moves

4

5

Economy of movement and maximum efficiency

Instrument handling

1

Repeatedly makes tentative or awkward moves with instruments

2

3

Competent use of instruments although occasionally appeared stiff or awkward

4

5

Fluid moves with instruments and no awkwardness

Knowledge of instruments

1

Frequently asked for the wrong instrument or used an inappropriate instrument

2

3

Knew the names of most instruments and used appropriate instrument for the task

4

5

Obviously familiar with the instruments required and their names

Flow of operation and forward planning

1

Frequently stopped operating or needed to discuss next move

2

3

Demonstrate ability for forward planning with steady progression of operative procedure

4

5

Obviously planned course of operation with effortless flow from one move to the next

Knowledge of specific procedure

1

Deficient knowledge. Needed specific instruction at most operative steps

2

3

Knew all important aspects of the operation

4

5

Demonstrated familiarity with all aspects of the operation

Overall score (out of 30)

Overall, should this resident

PASS

FAIL