Directly Observed Procedural Skills (DOPS)

Update 2020: DOPS have now been replaced by CEPS (Clinical Examination and Procedural Skills).

DOPS is designed to provide feedback on procedural skills essential to the provision of good clinical care.  The mandatory procedures chosen have been selected as sufficiently important and/or technically demanding to warrant specific assessment.  Trainees will be asked to undertake observed encounters during the three years with a different observer for each encounter. Each DOPS should represent a different procedure. The registrar chooses the timing, procedure and observer.

There are 8 mandatory procedures to be covered. When the procedure is observed, a number of competencies are scored as

  • insufficient evidence
  • needs further development
  • competent
  •  excellent

These competencies are scored according what you would expect a competent or excellent fully trained GP to do (not a trainee at their current level of training). Thus many GPRs will “need further development”. After the procedure, the DOPS document is completed online (the GP Registrar will show you how to do this). The observer gives the GP registrar some feedback and documents observed strengths and weaknesses.

Behaviours observed in a DOPS

  1. Demonstrates understanding of indications, relevant anatomy, technique of procedure
  2. Obtains informed consent
  3. Demonstrates appropriate preparation pre-procedure
  4. Appropriate analgesia or safe sedation
  5. Technical ability
  6. Aseptic technique (if appropriate)
  7. Seeks help where appropriate
  8. Post procedure management
  9. Communication skills
  10. Consideration of patient/professionalism
  11. Overall ability to perform procedure

How the DOPS might be organised in practice

DOPS Procedure
Breast examination Observation generally by a nurse practitioner or perhaps female doctor. Ideally GPR will bring patient back to a planned joint consultation (though it is recognised that this will not always be possible).
Female genital examination This DOPS will normally be completed in O&G post.

Observation generally by a nurse practitioner or doctor. GPR will bring patient back to a planned joint consultation.

Male genital examination Observation generally by a doctor. GPR will bring patient back to a planned joint consultation.
Rectal examination Observation generally by a doctor. GPR will bring patient back to a planned joint consultation.
Prostate examination Observation generally by a doctor. GPR will bring patient back to a planned joint consultation.
Cervical cytology Theory session run by VTS. After this, practical experience in the practice smear clinic, which will include DOPS.
Testing for blood glucose Observation generally by a nurse practitioner or doctor. This DOPS will be performed in the diabetic clinic.
Application of simple dressings Observation generally by a nurse, nurse practitioner or doctor. This DOPS could be performed in the minor surgery clinic.

 

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