The purpose of the CEX, DOPS and PBA tools is to encourage trainee practice within a supported environment, followed by a developmental conversation (feedback) to identify elements of good practice and areas for development. Such development should be discussed in terms of follow-up actions that will extend the trainee's technical proficiency and clinical skills.
The following clips demonstrate the versatility of surgical practice. An operation can be divided into several stages all of which can be used to develop trainees at differing levels of competence as well as developing teaching and training skills in the more senior trainees. The clips also demonstrate the use of DOPS and PBAs within a surgical team.
PBA/DOPS
Here a consultant is asked to provide feedback to two trainees on their DOPS (insertion of a catheter) and a PBA (laparoscopic port insertion) before the procedure begins, and so this is trainee-triggered. It is also possible that a list is designated as a training list and therefore all cases can be used in this way. It is important that trainees or trainers request that such tools be used prior to the procedure. DOPS, PBAs and CEXs are all observational tools and so if the observer is not aware that they are required to observe and provide feedback until after the event the quality of the observation and feedback will be compromised. Note that the consultant requested that the forms be available for her to use whilst observing and providing feedback to the trainees. This is to guide her in her evaluation and also to record comments for the trainees to document subsequently on the ISCP web-based forms.
The following clips are the discussions that occur in the coffee room after completing a laparoscopic cholecystectomy for a FY2, CTI and ST3.