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.  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



Send us an email at