ICO-Ophthalmology Surgical Competency Assessment Rubric: Lateral Tarsal Strip (ICO-OSCAR: LTS) Date ______ Novice Beginner Advanced Beginner Competent Not Resident __________ (score = 2) (score = 3) (score = 4) (score = 5) applicable. Evaluator __________ Done by preceptor score= 0 1 Local anesthetic Inappropriate amount. Anaesthetic Excessive amount of Appropriate amount of Infiltration of local anesthetic administration: too deep or too superficial (i.e. anaesthesia, causing chemosis anaesthetic applied in near (with epinephrine) extending location & volume scraping bone or periosteum or and interfering with dissection optimal locations. Does not from the lateral canthal angle blanching). Wrong location leading or insufficient interfere with completion of down to the orbital rim to pain later in the procedure. amount/suboptimal placement. case. periosteum avoiding larger vessels. Sufficient volume to deliver analgesia and assist hemostasis without inducing chemosis. 2 Preparation & Inadequate drape position. Hair Drapes placed adequately, but Drapes placed adequately Good access to the lateral Draping: clear sticking out. Poorly wrapped so exposure is not optimal and but exposure is not optimal. canthus and lateral orbital rim. surgical field unravels during procedure. Drape drapes become loose during Light angled appropriately. Light angled from above patient’s interfering with surgical access. the procedure. Light not angled head, allowing gradual Sudden, direct focusing of optimally. adjustment to brightness. Face overhead lamp on exposed from hairline to below patient’ face nose to allow comparison of right and left canthal positions during surgery. 3 Incision: Location, Poorly constructed incision. Too Incision is too long with poor Incision is small, but Incision extending from the Length, direction, short/long or against relaxed skin respect for relaxed skin tension surgeon realizes and canthal angle approximately Orientation tension line. Inappropriate depth. line. lengthens it. Incision follows laterally along the relaxed Anatomy not appropriately relaxed skin tension line. skin tension line to expose the exposed. orbital rim.
ICO-Ophthalmology Surgical Competency Assessment Rubric: Lateral Tarsal Strip (ICO-OSCAR: LTS) Date ______ Resident __________ Evaluator __________ Novice (score = 2) Beginner (score = 3) Advanced Beginner (score = 4) Competent (score = 5) Not applicable. Done by preceptor score= 0 1 Local anesthetic administration: location & volume Inappropriate amount. Anaesthetic too deep or too superficial (i.e. scraping bone or periosteum or blanching). Wrong location leading to pain later in the procedure. Excessive amount of anaesthesia, causing chemosis and interfering with dissection or insufficient amount/suboptimal placement. Appropriate amount of anaesthetic applied in near optimal locations. Does not interfere with completion of case. Infiltration of local anesthetic (with epinephrine) extending from the lateral canthal angle down to the orbital rim periosteum avoiding larger vessels. Sufficient volume to deliver analgesia and assist hemostasis without inducing chemosis. 2 Preparation & Draping: clear surgical field Inadequate drape position. Hair sticking out. Poorly wrapped so unravels during procedure. Drape interfering with surgical access. Sudden, direct focusing of overhead lamp on patient’ face Drapes placed adequately, but exposure is not optimal and drapes become loose during the procedure. Light not angled optimally. Drapes placed adequately but exposure is not optimal. Light angled appropriately. Good access to the lateral canthus and lateral orbital rim. Light angled from above patient’s head, allowing gradual adjustment to brightness. Face exposed from hairline to below nose to allow comparison of right and left canthal positions during surgery. 3 Incision: Location, Length, direction, Orientation Poorly constructed incision. Too short/long or against relaxed skin tension line. Inappropriate depth. Anatomy not appropriately exposed. Incision is too long with poor respect for relaxed skin tension line. Incision is small, but surgeon realizes and lengthens it. Incision follows relaxed skin tension line. Incision extending from the canthal angle approximately laterally along the relaxed skin tension line to expose the orbital rim.
ICO-OSCAR-LTS.docx