The impact of using Direct observation of procedural skills (DOPS ) evaluation method on the some clinical skills of midwifery students

Document Type : Original Article


1 Mother and child care research center,Hamadan University of medical Scineces,Hamadan,Iran

2 Khorramabad University of Medical Sciences, Poldokhtar, Iran

3 PhD candidate, Student Research Committee, Department of Midwifery and Reproductive Health, Nursing and midwifery school, Isfahan University of Medical Sciences, Isfahan, Iran


Background: The present study was done in order to evaluate the students’ clinical skill, enhance the quality of cares given, and consider limitations of common evaluation ways, as well as loss of texts about impact of new evaluation in education. The aim of this study was the impact of using direct observation of procedural skill (DOPS) evaluation method on some clinical skills of midwifery students.
Methods: This quasi-experimental study was performed on 70 midwifery students in the delivery ward of Fatemieh Hospital in Hamadan during the first semester of 2017-2018. In this stage, the students in the control group were evaluated according to the current method of the faculty and the experimental group was evaluated by the DOPS method through a checklist. Finally, the evaluation scores of students were compared in both control and experimental groups.
Results: According to T-test results, the average score in vaginal examination, Leopold maneuver and hearing fetal heart rate has been equal before doing the test (P>0.05); however, after intervention the difference between the results obtained from these two groups was significant (p <0.05). Then scores prior and after intervention in each group was compared through T-paired test. According to results of this test, before intervention, the difference within two groups were not significant but after intervention (p>0.05), the scores have significantly increased in test group (p <0.05).
Conclusion: Findings showed that using DOPSevaluation way can be effective in enhancing clinical skills of midwifery students in vaginal examination; however, Leopold maneuver and hearing fetal heart rate are recommended for other procedures.


.1         Grauer GF, Forrester SD, Shuman C, Sanderson MW. Comparison of student performance after lecture-based and case-based/problem-based teaching in a large group. J Vet Med Educ. 2008;35(2):310-7.
.2         Smith-Strøm H, Nortvedt MW. Evaluation of evidence-based methods used to teach nursing students to critically appraise evidence. Journal of Nursing Education. 2008;47(8):372-5.
.3         Adib-Hajbaghery M, MirBagher N, Heidari S. Clinical nursing education based on nursing process and group discussion. Iran J Med Educ. 2012;11:728–34. Persian.
.4         Stenberg M, Carlson E. Swedish student nurses' perception of peer learning as an educational model during clinical practice in a hospital setting-an evaluation study. BMC Nurs. 2015;14:48.
.5         Hassanzahraee R SS, Ehsanpoor S, Atash Sokhan G, Hassanzadeh A. Evaluation of International Standards of Educational Planning and Clinical Evaluation and Expression and Comparison of Teachers and Students' Viewpoints. Iranian Journal of Medical Education. 2005;5(14). Persian.
.6         Terzioğlu F, Yücel Ç, Koç G, Şimşek Ş, Yaşar BN, Şahan FU, et al. A new strategy in nursing education: From hybrid simulation to clinical practice. Nurse Educ Today. 2016;39:104–8.
.7         Tazakori Z mN, Movahedpour A, Mazaheri E, Karim Elahi M, Mohamadi MA. Comparison of nursing students and instructors about OSPE performance and evaluation methods in common practice. Iranian Journal of Medical Education. 2005;5(14). Persian.
.8         Omidvar Sh BF, Salmalian H. Clinical Education Problems: the Viewpoints of Midwifery Students in Babol Medical University. Iranian Journal of Medical Education. 2005;5(2):15-21. Persian.
.9         Kariman NHT. The effect of Portfolio’s evaluation on learning and satisfaction of midwifery students. Arak Medical University Journal (AMUJ). 2010;12(4):81-8. Persian.
.10       Habibi HKM, Mahmoudi H, Ebadi A, Mazhari M. Comparison of the Effects of Modern Assessment Methods (DOPS and Mini-CEX) with traditional method on Nursing Students' Clinical Skills: A Randomized Trial. Iranian Journal of Medical Education. 2013;13(5): 372. Persian.
.11       Sahebalzamani M, Farahani H, Jahantigh M.Validity and reliability of direct observation of procedural skills in evaluating the clinical skills of nursing students of Zahedan Nursing and Midwifery School. Zahedan Journal of Research in Medical Sciences (TABIB-E-SHARGH). 2012;14(2):76-81.
.12       Norcini JJ, McKinley DW. Assessment methods in medical education. Teaching and teacher education. 2007;23(3):239-50.
.13       Dent J, Harden RM. A practical guide for medical teachers: Elsevier Health Sciences; 2013.
.14       Amin Z, Chong YS, Khoo HE. Practical guide to medical student assessment: World Scientific; 2006.
.15       Wilkinson JR, Crossley JG, Wragg A, Mills P, Cowan G, Wade W. Implementing workplace based assessment across the medical specialties in the United Kingdom. Medical education. 2008;42(4):364-73.
.16       Sumita S, Dinesh KB. Clinical procedural skills assessment during internship in ophthalmology. J Adv Med Educ Prof. 2019; 7(2): 56–61.
.17       Downing SM. Validity: on the meaningful interpretation of assessment data. Medical education. 2003;37(9):830-7.
.18       Nooreddini A, Sedaghat S, Sanagu A, Hoshyari H, Cheraghian B. Effect of clinical skills evaluation applied by direct observation csinical Skills (DOPS) on the clinical performance of junior nursing students. Journal of Research Development in Nursing & Midwifery. 2015; 12 (1) :8-16.
.19       Bagheri M, Sadeghnezhad M, Sayyadee T, Hajiabadi F. The Effect of Direct Observation of Procedural Skills (DOPS) Evaluation Method on Learning Clinical Skills among Emergency Medicine Students. Iranian Journal of Medical Education. 2014;13(12):1073-81. Persian.
.20       Akbari M, Mahavelati Shamsabadi R. Direct Observation of Procedural Skills (DOPS) in Restorative Dentistry: Advantages and Disadvantages in Student's Point of View. Iranian Journal of Medical Education. 2013; 13 (3) :212-20. Persian.
.21      Shahgheibi SH, Pooladi A, BahramRezaie M, Farhadifar F, Khatibi R. Evaluation of the Effects of Direct Observation of Procedural Skills (DOPS) on clinical externship students’ learning level in obstetrics ward of Kurdistan University of Medical Sciences. Journal of Medicine Education. 2009;13(1, 2): 29-33.
.22      Hoseini BL, Mazloum SR, Jafarnejad F, Foroughipour M. Comparison of midwifery students’ satisfaction with direct observation of procedural skills and current methods in evaluation of procedural skills in Mashhad Nursing and Midwifery School. Iran J of Nurs Midwifery Res. 2013;18(2): 94-100.
.23     Cobb KA, Brown G, Jaarsma DA, Hammond RA. The educational impact of assessment: a comparison of DOPS and MCQs. Med Teach. 2013;35(11):e1598-607.
.24    Naeem N. Validity, reliability, feasibility, acceptability and educational impact of direct observation of procedural skills (DOPS). J Coll Physicians Surg Pak. 2013;23(1):77–82.
.25       Nicol D, MacFarlane-Dick D. Formative assessment and self-regulated learning: A model and seven principles of good feedback practice. Stud Higher Educ. 2006; 31(2):199–218.
.26       Norcini J, Burch V. Review Workplace-based assessment as an educational tool: AMEE Guide No 31. Med Teach. 2007;29 (9):855–71.
.27        Holmboe E, Hawkins R, Huot S. Effects of training in direct observation of medical residents clinical competence: a randomized trial. Ann Intern Med. 2004;140(11):874–81.
28.      Chen W, Liao S, Tsai C, Huang C, Lin C, Tsai C. Clinical Skills in Final-year Medical Students: The Relationship between Self-reported Confidence and Direct Observation by Faculty or Residents. Ann Acad Med Singapore. 2008;37(1):3–8.
29.        Tsui K, Liu C, Lui J, Lee S, Tan R, Chang P. Direct observation of procedural skills to improve validity of students' measurement of prostate volume in predicting treatment outcomes. Urol Sci. 2013;24(3):84–88.
30. Sohrabi Z, Salehi K, Rezaie H, Haghani F. The Implementation of Direct Observation of Procedural Skills (DOPS) in Iran’s Universities of Medical Sciences: A Systematic Review. Iranian Journal of Medical Education. 2016; 16 :407-417. Persian.
31.        Bindal N, Goodyear H, Bindal T, Wall D. DOPS assessment: a study to evaluate the experience and opinions of trainees and assessors. Med Teach. 2013;35(6):1230–4
32.      De Oliveria Filho G. The construction of learning curves for basic skills in anaesthetic procedures: An application for the cumulative sum method. Anesth Analg. 2002; 95(2):411–6.
33.       Beard JD, Jolly BC, Newble DI, Thomas WEG, Donnelly J, Southgates LJ. Assessing the technical skills of surgical trainees. Br J Surg. 2005;92(6):778–82.
34.       Bould M, Crabtee N, Naik VN. Assessment of procedural skills in anesthesia. Br J Anaesth. 2009;103(4):472–83.
35.      Erfani Khanghahi M, Ebadi Fard A. Direct observation of procedural skills (DOPS) evaluation method: Systematic review of evidence. Med J Islam Repub Iran. 2018(3);32:45.