Background and Aims Pain fellow performance evaluations have historically emphasized categories such as medical knowledge, communication skills, and professionalism. Objective evaluation of procedural skills, while extremely important, has historically been neglected due to lack of standardization, subjectivity, and a wide variety of procedures between institutions. Due to this deficiency, an objective ‘Pain Procedure Rating System’ (PaPRS) was adapted from the ‘Operative Performance Rating System’ (OPRS) used in general surgery residencies for evaluating surgeries such as cholecystectomy. Similarly, the PaPRS provides a standardized rubric which converts individual operative performance observations into an objective performance assessment for the most fundamental pain medicine procedures.

The study was considered IRB-exempt Procedure-specific rubrics were developed for nine of the most common fluoroscopically guided procedures (e.g. epidural steroid injection, radiofrequency ablation, spinal cord stimulation, etc). Each pain procedure rating instrument used 5-point Likert scales across procedure-specific technical skill items and general performance competencies with overall performance is then calculated based on the total score of the individual instruments (example survey: http://ucdenver.co1.qualtrics.com/jfe/form/SV_a3pO4Zk3PKnoc7A ). The PaPRS was then implemented at two different major academic medical centers to demonstrate feasibility in objective assessment of trainee procedural performance.

Results The PaPRS assessment tools were successfully utilized at two academic medical centers with 23 trainees (13 pain fellows and 10 residents). Evaluators and trainees confirmed the ease of use, appreciation of objective measures, and longitudinal tracking ability of the scored assessments.

Conclusions The PaPRS is a feasible tool to objectively assess procedural competence. Future studies include a year long longitudinal study for trainees at the academic centers.