# PWR-158 — Surgical and procedural dexterity: learner worksheet Release: Revision 7T · Full Tutorial Edition Estimated time: Estimated 14 min reading; practical time is provider-set Difficulty: Intermediate Equipment: Specialist equipment — an accredited simulation task selected by the relevant training programme.; Accredited simulator, approved instruments, inert consumables, camera/monitor and faculty-validated scoring rubric.; Pre-brief checklist, no-touch zone map, force/damage markers and event log. Space: Desk / seated Automated structural checklist: 10 of 10 structural checks present Evidence quality/context: G4; Deep research depth Automated method-quality band: Comprehensive Method-rating basis: Structure coverage, instruction/check specificity, alternative distinctness, source troubleshooting, comparison depth and whether purpose/check fields are authored rather than derived. Editorial review: Pending manual editorial sign off ## Before you begin - [ ] I read the tutorial authority and stop conditions. - [ ] I have the required equipment/space or a declared accessible alternative. ## Canonical source context This lesson teaches a complete simulation method for basic procedural dexterity: verify the simulator and role, map instruments and no-touch zones, establish a stable view, move deliberately, manage force, stop on error, inspect damage and debrief. It never authorises touching a patient, animal, biological tissue or live clinical equipment. Target outcome: In an accredited, faculty-supervised dry-lab task, the learner transfers six foam objects between marked zones within the validated error and damage limits and executes the emergency stop correctly. ### Authority and setup conditions - Prepare an accredited programme-selected dry-lab box trainer with inert foam objects and programme-approved instruments - Before the first surgical and procedural dexterity attempt, write the exact result you will score: Validated error, force, damage and quality across simulator and supervised target task. - Faculty verifies enrolment, role, equipment, decontamination, simulator integrity, emergency stop, access and scope of the dry-lab task. - The learner states aloud that the exercise supplies no patient, animal, live-tissue or clinical authority. ### Required or supplied materials - an accredited simulation task selected by the relevant training programme. - Accredited simulator, approved instruments, inert consumables, camera/monitor and faculty-validated scoring rubric. - Pre-brief checklist, no-touch zone map, force/damage markers and event log. ## 1. Verify simulator and stop control With faculty, confirm the dry-lab mode, inert contents, instrument identity, camera orientation and the exact command or action that stops the task. Why: Procedural practice is safe only when the operational boundary and stop are unambiguous. Success check: The learner identifies every inert component and demonstrates the stop before movement. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “The learner identifies every inert component and demonstrates the stop before movement.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 2. Map active tips and no-touch zones On the monitor, point to each instrument tip, target zone and prohibited boundary. Practise moving each tip in free space without contact. Why: Indirect view can hide where the active end is relative to tissue-equivalent boundaries. Success check: Both tips remain visible and out of no-touch zones during free-space rehearsal. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “Both tips remain visible and out of no-touch zones during free-space rehearsal.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 3. Establish a stable view Centre the field, adjust approved ergonomics and pause until the target, both tips and receiving zone are visible at once. Why: Movement without a complete view creates unmeasured collision risk. Success check: The full work area remains visible without leaning, strain or camera drift. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “The full work area remains visible without leaning, strain or camera drift.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 4. Approach before grasping Move one tip toward the centre of the foam object at low speed, stop beside it, then close the grasper only to the marked force cue. Why: Separating approach from closure prevents blind grabbing and excess force. Success check: The tip stops at the object before closure and leaves no crush mark. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “The tip stops at the object before closure and leaves no crush mark.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 5. Transfer through the safe corridor Lift only to the marked height, travel along the programme path and keep the second instrument parked unless assigned a support role. Why: A declared corridor limits collisions and unnecessary two-tool motion. Success check: The object and both tips remain inside their allowed zones. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “The object and both tips remain inside their allowed zones.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 6. Place before releasing Lower into the centre of the receiving mark, stop movement, then open the grasper. Do not throw, flick or release while moving. Why: Controlled placement reveals endpoint accuracy and prevents bounce or loss. Success check: The object stays within the receiving boundary after release. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “The object stays within the receiving boundary after release.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 7. Stop and declare any error At a drop, collision, lost view, force marker or equipment change, freeze, say the error and await faculty reset. Do not self-rescue unless the rubric instructs it. Why: Transparent error response protects the simulation record and prevents escalation. Success check: Every error is declared immediately and handled by the approved reset rule. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “Every error is declared immediately and handled by the approved reset rule.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 8. Inspect and debrief transfer Count completed transfers, drops, collisions, force/damage marks and time; compare with the validated rubric and review one video segment with faculty. Why: Simulator speed alone does not establish technique or clinical transfer. Success check: The record contains error, force, damage, support and faculty decision—not only completion time. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “The record contains error, force, damage, support and faculty decision—not only completion time.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## Reflection What changed? ________________________________________________________________________________ What remains difficult? ________________________________________________________________________________ What will I repeat, adapt, ask for help with, or stop? ________________________________________________________________________________ --- Completion of this worksheet demonstrates tutorial participation only. It does not establish capability, qualification, safety clearance, diagnosis, treatment or independent validation.