Authors

1 Department of Ophthalmology, BPS Government Medical College for Women, Khanpur Kalan, Sonepat, Haryana, India

2 Department of Pharmacology, Christian Medical College, Ludhiana, Punjab, India

Abstract

Introduction: Directly observed procedural skills (DOPS) is aunique method for assessment since it tests the trainee’s abilityto apply his knowledge and skills in performing a particularprocedure and provides an assessment of the practical workperformed by the trainee on a ‘real’ patient under supervisionof an experienced faculty. The study aims to make use of DOPSrating for assessment and further improvement in proceduralskills in interns in Ophthalmology rotational posting.
Methods: A prospective study was planned and 15 interns on 2weeks’ rotational posting in the department of Ophthalmologywere included by purposive sampling over a duration of 2months. Four clinical procedural skills were identified and in thesecond week of posting, the interns were assessed by three DOPSencounters at an interval of 2 days for each clinical skill. TheDOPS ratings were analyzed quantitatively using R-statisticalsoftware by repeated measure ANOVA and Banfuroni test.
Results: A total of 180 DOPS were undertaken for 15 internsin 4 core areas of ophthalmic examination. The mean overallDOPS rating for DOPS-1 was 3.70±0.82, DOPS-2, 3.83±1.82and DOPS-3, 4.93±1.65; the difference in DOPS rating betweenthe first and second encounter was not statistically significant(p=0.497), between the second and the third and between the firstand the third were statistically significant (p=0.000 in both cases)using Banfuroni test. The overall difference was also statisticallysignificant (p=0.000) using repeated measure ANOVA. Both theassessor and intern satisfaction increased significantly from thefirst to the third DOPS, but not statistically significant between thefirst and the second and between the second and the third DOPS.
Conclusions: We found significant improvement in interns’clinical skills through repeated DOPS and the method waswell accepted by both the students and the faculty. Internshipperiod can be well utilized for improving clinical skills andnovel performance assessment methods like DOPS might proveto be highly beneficial in ensuring adequacy of learning duringinternship and also to assess their readiness for acceptingprofessional responsibilities in future.

Keywords

  1. Delamothe T. Modernising medical careers: final report. BMJ. 2008; 336(7635):54-5.
  2. Day SC, Grosso LJ, Norcini JJ Jr, Blank LL, Swanson DB, Horne MH. Residents' perception of evaluation procedures used by their training program. J Gen Intern Med. 1990;5(5):421-6.
  3. Beard J, Strachan A, Davies H, Patterson F, Stark P, Ball S, Taylor P, Thomas S. Developing an education and assessment framework for the Foundation Programme. Med Educ. 2005;39(8):841-51.
  4. Naeem N. Validity, reliability, feasibility, acceptability and educational impact of direct observation of procedural skills (DOPS). J Coll Physicians Surg Pak. 2013 ;23(1):77-82.
  5. Zieky MJ. So much has changed: how the setting of cut scores has evolved since the 1980s. In: Cizek GJ, editor. Setting performance standards. Mahwah, NJ: Lawrence Erlbaum Associates; 2001. p. 19-52.
  6. Eyes & vision curriculum for undergraduate and foundation doctors [INTERNET]. Royal college of ophthalmologists [cited 2018 March 19]. Available from:https://www.rcophth.ac.uk/wp-content/uploads/2014/07/Undergraduate-and-Foundation-doctors-curriculum.pdf.
  7. Profanter C, Perathoner A. DOPS (Direct Observation of Procedural Skills) in undergraduate skills-lab: Does it work? Analysis of skills-performance and curricular side effects. GMS Z Med Ausbild. 2015;32(4):45.
  8. McLeod R, Mires G, Ker J. Direct observed procedural skills assessment in the undergraduate setting. Clin Teach. 2012;9(4):228-32.
  9. Shumway JM, Harden RM; Association for medical education in Europe. AMEE guide No. 25: The assessment of learning outcomes for the competent and reflective physician. Med Teach 2003;25(6):569-584.
  10. Kundra S, Singh T. Feasibility and acceptability of direct observation of procedural skills to improve procedural skills. Indian Pediatr. 2014;51(1):59-60.
  11. Amini A, Shirzad F, Mohseni M et al.Designing Direct observation of procedural skills (dops) test for selective skills of orthopedic residents and evaluating its effects from their points of view. Res Dev Med Edu. 2015;4(2):147-152.
  12. Bazrafkan L, Shokrpour N, Torabi K. comparison of the assessment of dental students’ laboratory performance through MCQ and DOPS methods. J Med Educ. 2009;13(1,2):16-23.
  13. Bagher M, Sadeghnezhad M, Sayyadee T, Hajiabadi F. The Effect of direct observation of procedural skills (DOPS) evaluation method on learning clinical skills among emergency medicine students. Iranian J Med Educ. 2014;13(12):1073-1081.
  14. Akbari M, Mahavelati Shamsabadi R. Direct observation of procedural skills (DOPS) in restorative dentistry: advantages and disadvantages in student’s point of view. Iranian J Med Educ. 2013;13(3):212-220.
  15. Khoshrang H. Assistants specialized perspectives on evaluation method of practical skills observations (DOPS) in Guilan university of medical sciences. J Res Med Educ. 2011;2(2):40-44.
  16. Farajpour A, Amini M, Pishbin E, Mostafavian Z, Akbari Farmad S. Using Modified Direct Observation of Procedural Skills (DOPS) to assess undergraduate medical students. J Adv Med Educ Prof. 2018 Jul;6(3):130-136.