Global Evaluative Assessment of Robotic Skills (GEARS)

Ref. Goh et al, Journal of Urology, 2012. 

GEARS is a validated assessment tool for grading overall technical proficiency for robotic surgery. GEARS measures manual dexterity and fluidity of motion and does not define surgical or clinical judgement. Below are the performance anchors and rating scale for the GEARS tool. Each scale is scored 1 - 5, which means the total score could range from 5 - 25.


Depth Perception

1 - Constantly overshoots target, wide swings, slow to correct

3 - Some overshooting or missing target, but quick to correct    

5 - Accurately directs instruments in the correct plane to target


Bimanual Dexterity 

1 - Uses only one hand, ignores non dominant hand, poor coordination

3 - Users both hands, but does not optimize interaction between hands

5 - Expertly uses both hands in a complementary way to provide optimal exposure



1 - Inefficient efforts; many tentative movements; constantly changing focus or persisting without progress

3 - Slow, but planned movements are reasonably organized

5 - Confident, efficient and safe conduct, maintains focus on task, fluid progression


Force Sensitivity 

1 - Rough moves, tears tissue, injures nearby structures, poor control, frequent suture breakage

3 - Handles tissue reasonably well, minor trauma to adjacent tissue, rare suture breakage

5 - Applies appropriate tension, negligible injury to adjacent structures, no suture breakage


Robotic Control

1 - Consistently does not optimize view, hand position, or repeated collisions even with guidance

3 - View is sometimes not optimal. Occasionally needs to relocate arms. Occasional collisions and obstruction of assistant.

5 - Controls camera and hand position optimally and independently. Minimal collisions or obstruction of assistant



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