Global Operative Assessment of Laparoscopic Skills (GOALS)

GOALS is a validated assessment tool for grading overall technical proficiency for laparoscopic surgery.  Below are the performance anchors and rating scale for the GOALS tool. Each scale is scored 1 - 5, which means the total score could range from 4 - 20.


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 between hands

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

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



1 - Uncertain, 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 until it is better performed by way of an alternative approach


Tissue Handling 

1 -  Rough movements, tears tissue, injures adjacent structures, poor grasper control, grasper frequently slips

3 - Handles tissue reasonably well, minor trauma to adjacent tissue (i.e., occasional unnecessary bleeding or slipping of the grasper)

5 - Handles tissues well, applies appropriate traction, negligible injury to adjacent structures



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