Global Operative Assessment of Laparoscopic Skills (GOALS)

GOALS is a validated assessment tool for grading overall technical proficiency for laparoscopic surgery. While it measures domains, such as fluidity of motion, it does not define surgical or clinical judgement, e.g., autonomy. Each of the five domains shown below are scored on a Likert Scale between 1 – 5, a scoring anchor, with a total score range from 5 – 25. The Autonomy domain is not scored by C-SATS due to video analysis limitations which do not allow for evaluation of verbal guidance, which means the total score achieved through the C-SATS platform 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

Efficiency 

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

Questions?

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