DOAP Vs DOPS

What Are DOAP and DOPS?

DOAP: Demonstrate–Observe–Assist–Perform

• A structured method to learn procedural skills step-by-step.
• Flow:

1. Faculty Demonstrates the skill (ideal technique).
2. You Observe actively (with a checklist).
3. You Assist (handle instruments, help with steps).
4. You Perform (first on models/task trainers, then on real patients under supervision).

Think of DOAP as your “learning pathway” from not knowing to doing.

DOPS: Direct Observation of Procedural Skills

• A workplace-based assessment where an assessor observes you performing a real procedure on a real patient (or sometimes in a high-fidelity sim) and gives structured feedback.
• Short (10–20 minutes), focused, with ratings and immediate feedback.

Think of DOPS as a “snapshot assessment plus coaching” of how you actually perform.

Why They Matter in CBME

• CBME focuses on outcomes: not just “knowing” but “doing.”
• DOAP builds your skill in a safe, staged way.
• DOPS verifies and improves your performance in real clinical settings.
• Both align with Miller’s Pyramid:
  • Knows → Knows How → Shows How (DOAP in skills lab) → Does (DOPS in real practice)

Where You’ll Use DOAP and DOPS in General Surgery

Common MBBS-level general surgery skills suited to DOAP and DOPS include:

• Surgical hand scrub, gowning, and gloving
• Asepsis and sterile field setup
• Instrument handling and knot tying
• Local anesthesia infiltration
• Simple interrupted suturing of superficial wounds
• Incision and drainage (I&D) of a superficial abscess
• Wound dressing, suture removal, and drain removal
• Nasogastric (Ryle’s) tube insertion
• Basic pre-op counseling/consent for minor procedures
• Documentation and safe surgery checklist use (adapted for minor procedures)

Your institution’s exact list may vary—follow local curriculum and supervision policies.

The DOAP Method: Step-by-Step (with Real Examples)

1) Demonstrate

• Faculty performs the procedure at full speed once, then repeats slowly explaining each step, highlighting:
  • Indications/contraindications
  • Consent and communication
  • Equipment and setup
  • Asepsis and analgesia/anesthesia
  • Stepwise technique
  • Troubleshooting and complications
  • Aftercare and documentation

Example (General Surgery): Simple interrupted suturing of a 3-cm clean forearm laceration in the casualty.

• Faculty demonstrates:
  • Hand hygiene, sterile glove
  • Wound assessment, irrigation with saline
  • Local infiltration of lignocaine (check for allergy)
  • Proper instrument handling (needle holder, toothed forceps)
  • Needle entry at 90°, eversion of wound edges, spacing/placement, knot security
  • Dressing and advice (analgesia, warning signs, review for suture removal)
  • Documentation in case sheet

2) Observe

• You watch actively using a checklist. Tip: Stand where you can see hand–instrument coordination.
• Ask clarifying questions after the demo: “Why choose 3-0 nylon here?” “How do you achieve eversion?”

3) Assist

• You hold instruments, retract, cut sutures, open sterile packs correctly.
• You practice parts of the task: placing one suture on a model; infiltrating local on a sim pad.
• Faculty corrects your grip, angles, and force.

4) Perform

• You perform the entire procedure, first on a task trainer/manikin, then on a patient with close supervision.
• Faculty observes and gives targeted feedback.

Real-life scenario (I&D of a small abscess):

• Demonstrate: Site marking, LA infiltration in a diamond pattern, incision over maximal fluctuation, breaking loculations, irrigation, packing, dressing, advice.
• Observe: Note ergonomics, incision length, safe instrument use.
• Assist: Pass instruments, help with irrigation and packing.
• Perform: You do the procedure on a model or with supervision in minor OT.

A Helpful Universal Mnemonic: I C S A F E

Use this for any procedure to structure your thinking:

• I – Indications and contraindications
• C – Consent and patient communication
• S – Setup and equipment check
• A – Asepsis and anesthesia/analgesia
• F – Focused technical steps (the procedure)
• E – End steps: aftercare, documentation, disposal, patient advice

Write ICSAFE on your pocket card. It keeps you safe and systematic.

DOPS: How It Works (And How to Ace It)

What Is Assessed

A typical DOPS form covers:

• Pre-procedure: indications, consent, patient ID, positioning
• Technical skills: instrument handling, tissue respect, flow, economy of movement
• Asepsis and safety: sterile technique, sharps handling
• Communication: explains to patient, reassures, responds to discomfort
• Professionalism and teamwork
• Post-procedure: hemostasis, dressing, waste disposal, documentation, advice
• Overall performance and readiness for independent practice (at the undergraduate level: “with supervision”)

The DOPS Encounter (10–20 minutes)

1. Choose a suitable case (appropriate complexity for your level).
2. Confirm consent (patient and assessor).
3. Perform the procedure while the assessor observes silently.
4. Receive immediate feedback (3–5 minutes): what you did well, what to improve, agreed action points.
5. Get the form signed and file it in your logbook/e-portfolio.

Feedback Styles You’ll Encounter

• Pendleton’s model (start with what went well → what could be improved → action plan)
• SBI/A (Situation–Behavior–Impact/Alternative)
• Ask–Tell–Ask (your self-assessment → faculty tips → your plan)

Tip: Come with a self-assessment ready; it makes feedback sharper and more constructive.

DOAP vs DOPS at a Glance

They complement each other: DOAP builds the skill; DOPS refines and validates it.

Putting It Together: A Simple Learning Pathway in General Surgery

Week 1 (Skill Lab Focus)

• DOAP: Hand scrub, gown, glove; basic instrument handling; knot tying; local anesthesia on sim pad; simple interrupted sutures on foam/pig’s foot/synthetic pad.
• Micro-DOPS (formative on simulators) to practice feedback style.

Week 2 (Minor OT/OPD)

• DOAP: Wound assessment and irrigation; dressing technique; suture removal; drain removal.
• Assisted cases in minor OT under supervision.

Week 3 (Ward/Emergency)

• DOAP: NG tube insertion; IV cannulation (if part of local curriculum); documentation and consent.
• Begin DOPS on simple suturing, suture removal, dressing.

Week 4 (Consolidation)

• DOPS: At least 2–3 observed encounters across different procedures (e.g., suturing a superficial laceration, suture removal and dressing, NG tube insertion).
• Reflection: Write what improved, what to practice next.

Note: Numbers and schedule vary by institution; follow local policies.

Tips to Excel (Student Playbook)

• Before the case:
  • Revise steps using ICSAFE; visualize the procedure.
  • Check equipment yourself—don’t assume it’s all there.
  • Introduce yourself to the patient; gain trust early.
• During the case:
  • Narrate key steps briefly to your assessor (“Now I’ll irrigate with copious saline…”).
  • Mind ergonomics: patient height, your posture, instrument handling.
  • Be gentle, respect tissues, and be safe with sharps.
• After the case:
  • Give clear post-procedure advice in simple language.
  • Document concisely but completely.
  • Ask for one actionable improvement if time is short.
• Practice routine:
  • 10–15 minutes daily on knot tying and suturing on a pad improves your DOPS performance dramatically.
  • Video yourself (if allowed) on a task trainer; compare to faculty demo.

• • Bringing It All Together: A Student-Centered View

    • DOAP is your roadmap for learning a procedure safely and correctly.
    • DOPS is your chance to show you can do it with a patient—and to get targeted coaching.
    • In general surgery postings, combine both:
      • Learn in the lab → assist in minor OT → perform under supervision → get observed and coached via DOPS.
    • Keep your learning active: checklists, reflections, and small daily practice add up to big gains.

    Take-Home Messages

    • Use ICSAFE for any procedure: Indications, Consent, Setup, Asepsis/Analgesia, Focused steps, End with aftercare and documentation.
    • Treat DOAP as your practice ladder and DOPS as your performance mirror.
    • Focus on asepsis, tissue respect, communication, and documentation—they’re universally assessed.
    • Build confidence with repetition on task trainers, then transfer to patients under supervision.
    • Ask for feedback; own your action plan; track progress in your logbook.