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 New Zealand

Direct Observation of Procedural Skills

The RACP Direct Observation of Procedural Skills is an evidence-based assessment that aims to guide trainee learning and achievement of competency. The trainee performs a procedure on a real patient in the workplace and is observed by an experienced and knowledgeable assessor who reviews the trainee’s performance against a structured checklist. The assessor provides feedback to the trainee, which allows the trainee, the assessor and the trainee’s supervisor to collaboratively identify learning needs and plan future learning opportunities.

By observing a skill, broken into components, in a structured manner, feedback can be focused on the various composite parts of a procedure. Feedback on each component of the trainee’s performance can be of greater value to the trainee than feedback on their overall performance, as areas for improvement and focus for future learning are more easily identified and the importance of considering the procedure as comprised of a number of crucial components is emphasised.

Direct Observation of Procedural Skills Information Sheet 

Direct Observation of Procedural Skills Rating Form

Direct Observation of Procedural Skills Workflow

What procedures will the trainee be assessed on?
Each Advanced Training Committee has identified a list of procedures from their Advanced Training Curriculum that are suitable for one or more Direct Observation of Procedural Skills. Suitable procedures are central to practice in each specialty and complex enough to warrant observation and feedback across a number of assessment domains.

How is the trainee assessed?
While observing the trainee performing the chosen procedure, the assessor uses the RACP Direct Observation of Procedural Skills Rating Form to rate the trainee across up to ten assessment domains, including:

  • understanding of indications, anatomy and technique
  • pre-procedure preparation
  • technical ability
  • post-procedure management
  • professionalism

For each of the domains observed, assessors rate the trainee on a nine-point scale according to what they would expect of a trainee in that particular year of training. Assessors mark ‘not observed’ for any domains not observed during that particular Direct Observation of Procedural Skills encounter.

What other information is available about the Direct Observation of Procedural Skills?
Specialty-specific Assessment Guides are being developed by each Advanced Training Committee and are intended to be used in conjunction with the RACP Direct Observation of Procedural Skills Rating Form. Within each Assessment Guide, observable behaviours are listed for each domain of assessment on the RACP Direct Observation of Procedural Skills Rating Form. These behaviours are considered to be markers of satisfactory performance of the procedure. Rather than a set of definitive criteria, the behaviours should be used as a guide to help assessors discriminate between ratings.

The Direct Observation of Procedural Skills Workflow details the process of the assessment, including the roles and responsibilities of the trainee, assessor and supervisor.