Procedural assessment

Assessment by direct observation of procedural skills is an important source of constructive feedback.

The direct observation of procedural skills (DOPS) is an assessment focusing on observing and assessing a candidate’s performance of a procedure.

What is this for?

  • This a structured rating proforma for assessing a trainee’s performance during a real-life procedure.  It can be used for any procedure, from flexible bronchoscopy to thoracocentesis.  It is intended to function as a formative assessment, but a series of high ratings in a procedure could be used by the trainee and supervisor to act as a summative assessment, demonstrating the trainee’s competence in this procedure.

Why bother with a form?

  • It documents the areas which need development.
  • It forces the supervisor to confront these areas with the trainee.
  • It acts as a permanent record of progress (or possibly lack of progress) and can be used as more robust evidence of competence, especially if more than one supervisor is involved.

Is it going to take a lot of time?

  • Filling in the form takes a minute or two.  The debrief with the trainee, somewhere private, takes a few minutes more, but this is a valuable part of the training process: if the trainee is not yet ready to practice unsupervised, it is important to discuss what needs improving.  How else will they get better?

Do I have to send the form to someone?

  • The trainee needs a copy.  If you are the trainee’s main educational supervisor, then you need a copy as well.  If not, then you should send it to the supervisor.  It is just a tool to be used in training.


There is a brief learning module available on giving constructive feedback.


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Please be very careful about filling out the form and pay special attention to the following pitfalls:

  • End-aversion bias: Many people are generally reluctant to use the extremes of the scale, which causes responses to clump together in the middle (also called central tendency bias). Avoid giving everyone a grade of 1 – give 0 if it is bad and 2 if it is good.
  • Positive skew: Tendency to rate people on the good end. An example is teachers who were asked to rate their students – 31% were rated as the best fifth, while only 5% were rated as the worst fifth! Avoid giving all grades 1 or 2, making the scale dichotomous and significantly less accurate.
  • Halo: Tendency to allow one’s general assessment of the test subject to influence all the sub-questions. If a person makes a perfect bronchoscopy but forgets the 7th segment, he should only have the grade 1 of Right Lower Lobe. Evaluate one thing at a time without taking into account the overall impression.

In general the Assessment Form can be completed on an ongoing basis.

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