| Self-Assessment of Skills/Tasks | Not Confident | Somewhat Confident | Completely Confident | ||
| 1 | 2 | 3 | 4 | 5 | |
| Describe how to locate and confirm a bladder injury | □ | □ | □ | □ | □ |
| Describe the basic steps in performing a repair of an injury to the bladder dome | □ | □ | □ | □ | □ |
| Describe the basic steps in performing a repair of an injury to the bladder trigone | □ | □ | □ | □ | □ |
| Describe the postoperative management after cystotomy repair | □ | □ | □ | □ | □ |
| Describe risk factors for cystotomy during gynecologic surgery | □ | □ | □ | □ | □ |