Challenges in implementing direct observation of procedural skills as assessment tool in postgraduate training of general surgery


  • Zainab Shafiq Assistant Director, DME, Shaheed Zulfiqar Ali Bhutto University, Islamabad
  • Hidayat Ullah Associate Professor, Radiology, Frontier Medical College, Abbottabad
  • Fouzia Sultana Assistant Director, DME, Shaheed Zulfiqar Ali Bhutto University, Islamabad



Direct observation of procedural skills, Workplace based assessment, Challenges, Postgraduate training


Objective: To explore challenges in implementing Direct Observation of Procedural Skills as a workplace based assessment tool in postgraduate training of general surgery.

Methodology: This was a qualitative exploratory study done in Pakistan Institute of Medical Sciences, Islamabad. Nine participants were interviewed in person.  The participants have been involved in DOPS program as resident, assessors or as a member of hospital administration. The interviews were recorded and transcribed. Thematic analysis of the qualitative data was carried out using manual and Computer Assisted Qualitative Data Analysis Software NVivo 10. Tree nodes (codes) were developed and arranged in different categories giving rise to discrete themes.

Results: A total of 57 codes were initially developed which gave rise to two distinct themes. Lack of awareness about the utility of DOPS among faculty and residents, lack of training of assessors and residents and time constraints due to heavy workload in hospitals were the chief challenges in implementing DOPS as an assessment tool. Arranging awareness / training workshops, developing realistic DOPS protocols by monitoring body were considered to be important steps for effective implementation of DOPS. Faculty development programs by training institutes were also suggested.

Conclusion: Lack of awareness, lack of training and time constraints are major the challenges in implementing DOPS program while faculty development by training workshops and making DOPS protocols are the suggestions for an effective implementation.





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