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Ce Evaluation review GYNECOLOGICAL SURGICAL PROCTORING EVALUATION FORM - CONFIDENTIAL Date of this review: Individual proctored: Diagnosis: Medical record number: Proctor: Procedure: Evaluate in terms of completeness and accuracy Acceptable Intraoperative phase Punctuality of surgeon/anesthetist Technical skill Knowledge of procedure Blood loss Surgical judgment: Completeness and degree/extent of resection; degree to which operation conforms to acceptable practices Conduct in operating roo.

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