Direct Observation of Procedural Skills (DOPS)

Competence in 19 of the 24 practical skills (PS) listed in the OST curriculum, and in laser surgery skills (SS14, SS15 and SS16) is assessed using a modified version of the F2 DOPS rating scale. [PS2 (refraction) is assessed by a formal College examination (refraction certificate) and by a bespoke CRS (CRSret).]

How a practical procedure is taught will be determined by the individual trainer and informed by an appropriate training the trainers course. When trainees have the opportunity to perform the procedure themselves they must do so under appropriate supervision. The supervisor will be able to complete a DOPS at the end of the procedure. If there are aspects of the procedure that are not performed satisfactorily the completed DOPS will act as a guide for training and inform the next attempt. It is expected that for some of the more complex practical procedures e.g. PS3 ‘Drugs’, a trainee will require assessment on more than one occasion (their portfolio will reflect this). Where possible a trainee will arrange to have at least 2 satisfactory DOPS for each of the relevant Learning Outcomes. Where opportunities to perform a procedure are scarce e.g. PS16 ‘Corneal glue’, it may be appropriate for the portfolio to contain only one DOPS. The ultimate decision as to how many are appropriate will be the responsibility of the ARCP panel.

Where appropriate it is useful for initial DOPS to be completed using any simulators that are available e.g. in a clinical skills centre. The DOPS form must make it clear that the assessment has been carried out using a simulator.

Trainees should also maintain a logbook of procedures performed with reflective comments where appropriate as part of their portfolio.

Where a trainee has an opportunity to perform a practical procedure that is not included in the curriculum e.g. as part of sub-specialty training, she/he is encouraged to ask the trainer to complete a DOPS for inclusion in the portfolio.

The following practical skills Learning Outcomes are assessed by DOPS:

Learning Outcome ( LO) DOPS , DOPSBi		Target Year (TYA)*	Comments
PS11	Ocular surface FB	1	DOPS can be assessed by an appropriately trained nurse or senior OST
PS22	Ocular irrigation	1
PS8	Lacrimal function	2	Tear production/tear drainage may need to be assessed separately with different DOPS
PS10	Corneal scrape	2	.
PS13	Removal of sutures	2	DOPS can be completed by an appropriately trained nurse
PS18	Perform/teach lid hygiene	2	DOPS can be completed by an appropriately trained nurse
PS5	Local anaesthesia	3	May require several DOPS for different LA techniques
PS14	Fit a bandage contact lens	3	DOPS can be completed by an appropriately trained nurse
SS14	Laser to the lens capsule	3
SS15	Laser for raised intraocular pressure	3 (annual review)	May require several DOPS for different laser therapies
SS16	Laser for retinal problems	3 (annual review)	May require several DOPS for different laser therapies
PS6	Diathermy	7	May be incorporated with a surgical OSATS
PS3	Intraocular/periocular drugs	7	May require several DOPS for different LA techniques
PS7	Cryotherapy	7	May be incorporated with a surgical OSATS
PS9	Paracentesis	7	May be incorporated with a surgical OSATS
PS12	Punctal occlusion	7	.
PS15	Botulinum toxin injection	7	May require several DOPS for different techniques/indications
PS16	Corneal glue	7	.
PS17	Ultrasonography	7	.
PS19	Aqueous/vitreous	7	.
PS23	Prepare biopsy	7	.
PS24	Forced duction test	7	.
PS25	Biometry skills	1, 7	DOPSBi must be assessed by an appropriately trained consultant, senior Trust Grade or senior OST (OST4 and above)

* The TYA represents the latest year that a trainee should normally achieve the specified LO. Trainees are encouraged to seek assessment using DOPS when an opportunity arises and not wait until the target year.

By completion of training a trainee’s portfolio may contain around 60 satisfactory DOPS forms.