Integrating Direct Observation of Procedural Skills as a workplace‑based assessment tool for residents working in an...

Direct Observation of Procedural Skills (DOPS) is a workplace-based assessment tool where the student is directly observed by the assessor during the procedure in an actual clinical situation, followed by immediate feedback.

To introduce DOPS as an assessment tool for ultrasound-guided central venous catheter insertion by residents (registrars) working in an intensive care unit.

A mixed-methods study design was used for assessment (two sessions) using a pre-validated DOPS checklist for scoring 25 residents. Feedback was obtained from faculty members and residents after the second session using an anonymous questionnaire, and the satisfaction index was calculated for each item.

With the implementation of DOPS, a significant improvement in the second session score in comparison with the first session was observed (p<0.001). This improvement can be attributed to use of the DOPS checklist, deconstruction of steps and provision of immediate constructive feedback, which helped to cover all the aspects of the procedure in a systematic manner. The overall perception of the residents as assessed by the feedback questionnaire was satisfactory, with most of them feeling that the assessment by DOPS was unbiased and that constructive feedback positively impacted on their learning process, making it more engaging and interesting. The satisfaction index for all the items was ≥88%. Faculty members were also satisfied with DOPS as a formative assessment tool.

DOPS promotes active and deep learning with effective assessment methods. It can improve teaching and training if there is commitment from all stakeholders and a supportive organisation.

What the study adds. This study demonstrates that Direct Observation of Procedural Skills (DOPS) can be effectively implemented as a formative workplace-based assessment (WBPA) tool for residents (registrars) performing ultrasound-guided central venous catheter insertion in an intensive care unit. Use of DOPS with structured feedback using the Pendleton model led to significant improvement in procedural competence and confidence. Both residents and faculty members perceived DOPS as an objective, valid and engaging method of assessment.Implications of the findings. The study indicates that introducing DOPS as a WPBA tool is an effective and engaging way to encourage residents to adopt correct practices of procedural skills, as reflected by the largely positive responses from both the residents and faculty members. The implications of this project will be the educational and quality assurance impact of DOPS implementation in resident training.