Effectiveness of DOPS “direct observation of procedural skills” as a method of formative assessment for improving the clinical skills of post-graduate students in the department of obstetrics and gynecology

Sanjivani Wanjari, Alka Rawekar


Introduction: Traditional procedural training with heavier focus on factu­al knowledge and lower attentions to skill train­ing can lead to graduates with poor procedural competence. DOPS –Direct observation of procedural skills is one of the means of assessing clinical performance by direct observation by the assessor. Performance using DOPS is structured and continuous.

Materials and Methods: Study design – Prospective interventional study was conducted in the department of obstetrics and gynaecology at JNMC Wardha. Sample size- 12 first year postgraduate students, were assessed with the help of 3 DOPS encounters and 2 procedures were observed for each student. The assessment of the post-graduate students was taken during the normal course of the student’s work.

Results: The scores of 1st, 2nd and 3rd DOPS was compared to see if there is an improvement of the students. Two DOPS assessments were taken. First was on suturing techniques (skill 1) and second on urinary catheterization (skill 2). The mean DOPS scores in ‘skill 1’ group were 3.91 in first encounter A1, 6.50 in second encounter A2, and 7.25 in third encounter A3. In the ‘skill 2’ group the mean DOPS scores were 4.50 in first encounter B1, 6.75 in second encounter B2 and 7.33 in third encounter B3. There was a gross improvement in scores in the third encounter as compared to the first encounter.

Conclusion: Observing, assessing and providing feedback to students enhanced the quality of the skills. The DOPS assessments done repeatedly helped to improve the clinical skills of post graduate students.

Keywords: Medical education, Direct observation, Postgraduate, Training, Evaluation.

Full Text:



Miller G E. (1990). Instrument (IPPI). Medical Education. 40(11):1105-1114. 3. The assessment of clinical skills/ competence/performance. Acad Med 65(Supplement 9):S63-S7.

Norcini JJ, McKinley DW. Assessment methods in medical education. Teach Teach Educ 2007;23:239–50.

Faghani F. Teaching and educational meth¬ods: Health educational programs management Improvement health development center of treat¬ment vice-presidency in Iran health and treatment ministry.

Sidhu R, Grober E D, Musselman L J, Reznick R K. Assessing competency in surgery: where to begin? Surg 2004;135(1):6-20.

Darzi A, Smith S, Taffinder N. Assessing operative skill. Needs to become more objective. BMJ 1999;318:887-8.

Shumway J M, Harden R M, Association for Medical Education in Europe. AMEE Guide No. 25: The assessment of learning outcomes for the competent and reflective physician. Med Teacher 2003;25(6):569-84.

Crossley J, Humphris G, Jolly B. Assessing health professionals. Med Educ 2002;36(9):800-4.

Ericsson K A. Deliberate practice and the acquisition and maintenance of expert performance in medicine and related domains. Acad Med 2004;79(10):S70-S81.

Shahgheibi Sh, Pooladi A, Bahram Rezaie, Farhadifar F, Khatibi R. Evaluation of the Effects of Direct Observation of Procedural Skills (DOPS) on Clinical Externship Students’ Learning Level in Obstetrics Ward of Kurdistan University of Medical Sciences. J Med Educ Winter Spring 2009;13(1, 2):29-33.

Shaveta Kundra and Tejinder Singh. Feasibility and Acceptability of Direct Observation of Procedural Skills to Improve Procedural Skills. Indian Pediatr 2014;51:59-60. Department of Pediatrics, Christian Medical College and Hospital, Ludhiana, Punjab, India.

Gina Singh, Ravleen Kaur, Anushi Mahajan, Abi M Thomas, and Tejinder Singh. Piloting Direct Observation of Procedural Skills in Dental Education in India. Int J Appl Basic Med Res 2017;7(4):239–42.

Masoumeh Erfani Khanghahi, Farbod Ebadi Fard Azar, Direct observation of procedural skills (DOPS) evaluation method: Systematic review of evidence. Med J Islam Repub Iran 2018(3 June);32.45. https://doi.org/10.14196/mjiri.32.45

Nazari Roghieh, Hajihosseini Fateme, Sharifnia Hamid, Hojjati Hamid. The effect of formative evaluation using “direct observation of procedural skills” (DOPS) method on the extent of learning practical skills among nursing students in the ICU. Iran J Nurs Midwifery Res 2013;18(4):290–3.

Roderick A McLeod, Gary J Mires, Jean S Ker. The use of the Direct Observation of Procedural Skills (DOPS) assessment tool in the clinical setting - the perceptions of students. Int J Clin Skills IJOCS 2011;5(2):77-82.

Memon MA, Brigden D, Subramanya MS, Memon B, Assessing the surgeon's technical skills: analysis of the available tools. Acad Med 2010;85(5):869-80. doi: 10.1097/ACM.0b013e3181d74bad.


  • There are currently no refbacks.