Skip to main content Skip to navigation

VALS for the Test Center

Proctor Instructions: A quick guide

Peg transfer

  • Peg board is placed centered so all pegs are visible in field
  • Time starts when instrument touch peg sleeve
  • Time ends when final sleeve is dropped over the peg
  • Drop outside field on first pass (non-dominant to dominant) is -50
  • Drop outside field on second pass (dominant to non-dominant) is -25
  • Drop inside field is no error other than the additional time
  • Proctor needs to intervene if incorrect instrument is being used

Pattern cut

  • Single circle gauze from fls-products is attached in jumbo clip with alligator clips attached to top layer only
  • Time starts when instrument touches gauze
  • Time ends when circle is cut loose from gauze
  • Cutting starts from free end
  • No penalty if participant cuts both layers
  • Switching of instrument portals is allowed
  • Top layers are saved for error calculation

Ligature loop

  • Attach lung foam model in jumbo clip
  • Time starts when the first instrument is visible on the screen
  • Time ends when suture material is cut
  • Participant is allowed to breaking off end before introducing in box
  • Proctor needs to intervene if cinching is inadequate

Extracorporeal knot

  • Suture block is mounted transversely in box and Penrose model is mounted perpendicular to the axis of the suture block.
  • Time starts when first instrument is visible on screen
  • Time ends when suture material is cut
  • Participant is required to tie slip knot. Any slip knot is allowed. A single throw or a surgeon’s throw is not allowed, whereas a sliding half hitch (two throws) is.
  • Three single throws are applied with intracorporeal or extracorporeal technique.
  • If slip knot locks prior to being cinched down, the participant can start over with new suture if there is time remaining. Participant needs to request to start over, should not be proctored to start over.
  • If the Penrose model is dislodged from the suture block the score is 0. Please note that this is if the Velcro-velcro comes undone. If the dislodgement is due to failure of the Velcro adhesive, the participant can re-do the task.
  • Knot security is subjectively assessed by inserting the tip of the jaws of a mosquito hemostat into the knot and distract the jaws. If the knot completely slips open it is insecure. If the jaws can be opened a few millimeters but the knot then tightens and becomes secure it is counted as a secure knot. If the knot is deemed insecure a -50 error is marked.
  • The gap error is measured in mm across the insicion at the level of the marks.
  • The distance error is added from bilateral marks. Distance is measured from the periphery of the mark.

Intracorporeal knot

  • Suture block is mounted transversely in box and Penrose model is mounted perpendicular to the axis of the suture block.
  • Time starts when first instrument is visible on screen.
  • Time ends when suture material is cut.
  • Participant is required to tie one double (surgeon’s) throw and two single throws. The surgeon’s throw can be the first, second or third throw placed.
  • If the Penrose model is dislodged from the suture block the score is 0. Please note that this is if the Velcro-velcro comes undone. If the dislodgement is due to failure of the Velcro adhesive, the participant can re-do the task.
  • Error calculation as for extracorporeal knot tying.

 

Proctor Quiz (For proctors affiliated with a VALS Test Center)

VALS proctors affiliated with VALS Test Centers are required to pass a quiz, as part of the proctor training. This quiz outlines details of the proctor’s function at VALS examinations, as outlined above. The quiz can be taken unlimited number of times, until the 100% pass rate has been reached. See link to Quiz below. Please note that passing this quiz is not the only requirement on a VALS proctor; additional training is required. Also note that when the passing rate is reached an automated email will be sent to the Chair of the Veterinary Board for Assessment of Laparoscopic Skills.

Link to Proctor Quiz