OPEN INGUINAL HERNIA
Evaluator:
Subject:
Status:
Program:
Please rate this resident's performance during this operative procedure. The caption
above each item provides descriptive anchors for 3 of the 5 points on the rating scale.
"N/A" (Not applicable) should only be selected when the resident did not perform that
part of the procedure.
Patient Location
MMC Inpatient
O
St. John’s Inpatient
MMC Outpatient
(23 hour )
O
O
St John’s Outpatient
(23 hour )
O
Hospital Medical Record Number
Date of Procedure
MM/DD/YY
OPRS Case Difficulty
Indicate the difficulty of the case:
1
Straightforward anatomy, no
related prior surgeries or
treatment
O
2
Intermediate difficulty
O
3
Abnormal anatomy, extensive
pathology, related prior surgeries
or treatment (for example
radiation), or obesity
O
1
Degree of Prompting or Direction
1
2
Substantial direction by
attending. Resident
performs all steps but
the attending provides
constant direction to the
resident and surgical
team.
3
Some direction by
attending. Resident
performs all steps but
the attending provides
occasional direction to
the resident and /or to
the surgical team.
O
Minimal direction by
attending. Resident
performs all steps and
directs the surgical team
independently with
minimum or no direction
from the attending, to
either the resident or to
the surgical team.
O
O
Procedure Specific Criteria
Identification of Ilioinguinal Nerve
5
Excellent
4
Very Good
Clearly
identified and
protected
nerve during
procedure
O
3
Good
2
Fair
Some attempt
to protect and
identify nerve.
O
O
1
Poor
NA
Did not identify
or protect
nerve until
prompted
O
O
O
2
Fair
1
Poor
NA
Identification of Indirect Hernia Sac
5
Excellent
4
Very Good
Meticulous
search for
indirect sac,
with careful
and efficient
dissection; with
high ligation of
sac if present
O
3
Good
Some attempt
to identify an
indirect sac
(neck), some
inefficiency in
sac dissection
O
O
Did not
specifically
search for
indirect sac
(neck) and / or
poor dissection
of sac
O
O
O
2
Identification of Anatomic Landmarks for Mesh Placement
5
Excellent
4
Very Good
Accurately
identifies
medial, lateral
landmarks,
without
prompting for
attachment of
mesh in region
of deep ring
and / or
inguinal floor
3
Good
2
Fair
Identifies
landmarks after
some
prompting
O
O
1
Poor
NA
Did not identify
landmarks,
until prompted
or directed to
do so
O
O
O
O
Mesh Insertion
5
4
3
2
1
Excellent
Very Good
Good
Fair
Poor
Excellent
securing of
mesh
w/consistently
appropriate
tissue bites,
and
appropriate
tension
O
Good
placement of
sutures to
secure mesh
w/only
occasional
inaccurate
bites
O
O
NA
Demonstrated
inconsistency
in accurate
placement of
mesh sutures,
redundancy of
mesh or too
much tension
O
O
O
General Criteria
Instrument Handling
5
Excellent
4
Very Good
Fluid
movements
with
instruments,
no stiffness or
awkwardness
O
3
Good
2
Fair
Competent
use of
instruments
occasionally
appeared
awkward
O
O
1
Poor
NA
Tentative or
awkward
movements or
inappropriate
instrument
use.
O
O
O
3
Respect for Tissue
5
4
3
2
1
Excellent
Very Good
Good
Fair
Poor
Consistently
handled tissue
appropriately,
minimal tissue
damage
Careful tissue
handling,
occasional
inadvertent
tissue damage
O
O
NA
Frequent
unnecessary
tissue force or
damage by
inappropriate
instrument use
O
O
O
O
Time and Motion
5
Excellent
4
Very Good
Clear economy
of motion, and
maximum
efficiency
3
Good
2
Fair
1
Poor
Efficient time &
motion, some
unnecessary
moves
O
O
NA
Many
unnecessary
moves
O
O
O
O
Operation Flow
5
Excellent
4
Very Good
Obviously
planned course
of operation, and
anticipation of
next steps
O
3
Good
2
Fair
Some forward
planning,
reasonable
procedure
progression
O
O
1
Poor
NA
Frequently
stopped
operating and
seemed unsure
of next move
O
O
O
4
Overall Performance
5
Excellent
4
Very Good
3
Good
2
Fair
1
Poor
NA
O
O
O
O
O
O
Please indicate the weaknesses in this resident’s performance:
Please indicate the strengths in this resident’s performance:
5