ICO-Ophthalmology Surgical Competency Assessment Rubric-Panretinal Laser Photocoagulation (ICO-OSCAR: PRP)

Date ______
Not applicable.
Resident ___________ Novice Beginner Advanced Beginner Competent Done by
(score = 2) (score = 3) (score = 4) (score = 5) preceptor
Evaluator __________ (score= 0)

Patient selection Lack of understanding of Understands basic indications and Understands indications and Fully understands indications and
indications (neovascularization) absolute contraindications of PRP but contraindications of PRP and rarely contraindications of PRP, always able
and contraindications (macular frequently unable to clearly identify misses cases of neovascularization, to clearly identify cases of
edema, macular tractional cases of neovascularization and would would rarely perform PRP in patients neovascularization, and would only
1 detachment) for PRP occasionally perform PRP in patients with relative contraindications perform PRP in patients without any
with relative contraindications (macular edema, tractional retinal contraindications (macular edema,
(macular edema, tractional retinal detachments) tractional retinal detachments). Can
detachments) triage to appropriate alternatives.

Patient preparation Does not explain risks (pain, Minimal explanation of risks and Appropriate basic explanation of risks, Clearly explains risks, benefits, and
bleeding, vision loss, and insufficient understanding of pre- benefits, and alternatives and generally alternatives to patients and answers
macular edema) as well as procedure medications appropriate use of pre-operative pain patient questions, uses pre-operative
benefits (resolution of medications and topical anesthetics medicines appropriately, and
neovascularization and administers topical anesthetics
prevention of vision loss) and appropriately
2
alternatives (anti-VEGF
treatment or vitrectomy) to
patient and lack of
understanding of pre-procedure
medications

Laser setup Unable to set laser parameters Able to set parameters with Can independently set parameters with Can independently set all parameters
3 assistance minimal guidance appropriately for PRP (power, spot
size, duration, laser attachment)

Retinal visualization Unable to place the lens on the Appropriate lens placement but Consistently good visualization of Able to place the lens and consistently
eye or visualize retina minimal visualization of the retina retina in the absence of media opacity visualize the retina including periphery
4 with lens
but visualizes periphery with effort in uncomplicated and complicated
cases
Laser focus beam blurry and Extensive effort and time needed to Able to focus beam and reasonable Consistently able to focus beam with
Focus and power excessive power needed focus laser beam and/or not able to power used for visualizing burn in an appropriate power in more difficult
adjustment of laser adjust for distance from optic nerve uncomplicated eye and able to adjust eyes adjusting for distance from optic
5 beam
for distance from optic nerve with nerve
extensive effort

Spacing between Laser spots inappropriately Laser spots 0.5 – 1 spot diameter Laser spots 0.5 – 1 spot diameter Laser spots 0.5 – 1 spot diameter
laser spots spaced and frequently hitting spaced in uncomplicated eye but spaced in uncomplicated eye and rarely spaced in complicated eyes without
6
blood vessels frequently hitting blood vessels hitting blood vessels hitting blood vessels

7 Spacing from macula Unable to space laser Able to space laser nasally superiorly Able to space laser appropriately in all Able to space laser appropriately in all
appropriately from macula in and inferiorly in an uncomplicated eye directions in an uncomplicated eye directions in uncomplicated and
all directions but inappropriate spacing temporally complicated eyes with variable
vascular architecture

1
Comments: ___________________________________________________________________________________________________________________________