Bedside Assisting Case Evaluation - Attending Surgeon Feedback

1 Start 2 Complete

Your name: *

Your email: *

Your resident's name: *

Your resident's email: *

Your resident has indicated that 10 robot bedside assisting cases have been completed. Please provide feedback by completing the following checklist:

Indicate whether your resident passed for the following tasks: *

	Yes	No
Drive robot to patient and dock robotic arms to each trocar	Drive robot to patient and dock robotic arms to each trocar - Yes	Drive robot to patient and dock robotic arms to each trocar - No
Optimize clearance of arms and joints	Optimize clearance of arms and joints - Yes	Optimize clearance of arms and joints - No
Manipulate robotic arms using the port and instrument clutches	Manipulate robotic arms using the port and instrument clutches - Yes	Manipulate robotic arms using the port and instrument clutches - No
Load and insert robotic instruments and sponge rolls	Load and insert robotic instruments and sponge rolls - Yes	Load and insert robotic instruments and sponge rolls - No
Burp, pull out, or push in trocar to facilitate ease of operation	Burp, pull out, or push in trocar to facilitate ease of operation - Yes	Burp, pull out, or push in trocar to facilitate ease of operation - No
Exchange robotic instruments and camera safely	Exchange robotic instruments and camera safely - Yes	Exchange robotic instruments and camera safely - No
Insert new, or upsize trocar	Insert new, or upsize trocar - Yes	Insert new, or upsize trocar - No
Suction in the surgical field without causing injury, or causing the lung to reinflate	Suction in the surgical field without causing injury, or causing the lung to reinflate - Yes	Suction in the surgical field without causing injury, or causing the lung to reinflate - No
Provide effective retraction	Provide effective retraction - Yes	Provide effective retraction - No
Remove specimens with a grasper (lymph nodes)	Remove specimens with a grasper (lymph nodes) - Yes	Remove specimens with a grasper (lymph nodes) - No
Remove specimens with a bag (lung)	Remove specimens with a bag (lung) - Yes	Remove specimens with a bag (lung) - No

Does your resident need additional 5 bedside assisting cases to gain competency? *

Yes

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Bedside Assisting Case Evaluation - Attending Surgeon Feedback

Your resident has indicated that 10 robot bedside assisting cases have been completed. Please provide feedback by completing the following checklist: