Health & Personal Services · course plan
⚠ Pending professional review
This course plan, its lessons and its assessments has not yet been verified by a licensed clinician in the field or by a certification or approval body. It is a study draft and may contain errors. Do not use it to make decisions about any patient or medication. Always follow your instructor, your supervising professional, and current official references and regulations.
VoTechWorks program approval and accreditation are still in progress. Credentials are issued only by the certifying bodies named in each program, after their own exams.
Surgical Technology
9 courses · 2,700 clock hours · 12–18 mo full-time. Grading is competency-based: each course requires the written exam, a competent skills demonstration with zero safety faults, a signed log, and a passed safety audit; percentage weights only rank performance above the competency floor.
9courses
79lessons
2,700hours
31assessments
Development progressPlanCourses, lessons and assessments written for this tradeLessons79 of 79 lesson pages writtenPractice631 practice questionsResources120 reference entries (study list)Review0 lesson pages reviewed by a licensed professional
Study now: 79 lesson pages are open (lesson titles below are links).
HLT-SURG65-01 Universal core
Universal Core: Safety, Math, Communication & Career for Surgical Technology
148 hr · $1,185 COMPLIMENTARY
This foundational course prepares students entering the surgical technology program with the safety knowledge, mathematical skills, communication strategies, and professional behaviors required in the perioperative environment. Students complete OSHA 10-Hour General Industry training and hands-on CPR/first aid certification while building the trade-specific numeracy, technical reading, and digital literacy skills that underpin every subsequent course. The course also establishes career readiness habits—professional conduct, scope-of-practice awareness, and credentialing literacy—aligned with the expectations of the NBSTSA Certified Surgical Technologist (CST) credential.
Outcomes- Complete OSHA 10-Hour General Industry training and demonstrate correct responses to common perioperative hazards including bloodborne pathogen exposure, chemical spills, and sharps injuries.
- Perform adult, child, and infant CPR plus first aid for shock and wound care to the standard required for healthcare provider certification.
- Apply trade-specific mathematics—unit conversion, medication-label reading, surgical sponge and instrument counts, and metric/imperial measurement—accurately in simulated OR scenarios.
- Read and correctly interpret surgical consent forms, procedure orders, instrument set cards, material safety data sheets, and other perioperative technical documents.
- Use healthcare digital tools—electronic health record navigation, OR scheduling software concepts, and professional communication platforms—appropriately and in compliance with patient privacy requirements.
- Describe the role, scope of practice, and ethical responsibilities of the surgical technologist, the structure of the NBSTSA CST credential, and a personal plan for sitting the exam after program completion.
Course text
This foundational course prepares students entering the surgical technology program with the safety knowledge, mathematical skills, communication strategies, and professional behaviors required in the perioperative environment. Students complete OSHA 10-Hour General Industry training and hands-on CPR/first aid certification while building the trade-specific numeracy, technical reading, and digital literacy skills that underpin every subsequent course. The course also establishes career readiness habits—professional conduct, scope-of-practice awareness, and credentialing literacy—aligned with the expectations of the NBSTSA Certified Surgical Technologist (CST) credential.
How the course runs. 7 blocks: Perioperative Safety & OSHA 10-Hour General Industry; First Aid, CPR & Emergency Response in the OR Setting; Trade Math: Measurement, Conversion & Surgical Counts; Technical Reading: Perioperative Documents & Medical Terminology; Digital Literacy & Healthcare Information Systems; Professional Role, Scope of Practice & Ethics in Surgical Technology; Career Readiness & NBSTSA CST Credentialing Pathway.
What competent looks like. Complete OSHA 10-Hour General Industry training and demonstrate correct responses to common perioperative hazards including bloodborne pathogen exposure, chemical spills, and sharps injuries. Perform adult, child, and infant CPR plus first aid for shock and wound care to the standard required for healthcare provider certification. Apply trade-specific mathematics—unit conversion, medication-label reading, surgical sponge and instrument counts, and metric/imperial measurement—accurately in simulated OR scenarios. Read and correctly interpret surgical consent forms, procedure orders, instrument set cards, material safety data sheets, and other perioperative technical documents. Use healthcare digital tools—electronic health record navigation, OR scheduling software concepts, and professional communication platforms—appropriately and in compliance with patient privacy requirements. Describe the role, scope of practice, and ethical responsibilities of the surgical technologist, the structure of the NBSTSA CST credential, and a personal plan for sitting the exam after program completion.
| # | Lesson | Hr | Type | Objective | Activities | Materials | Check |
|---|---|---|---|---|---|---|---|
| 1 | Perioperative Safety & OSHA 10-Hour General Industry | 28 | theory | Students complete all ten modules of OSHA 10-Hour General Industry training and correctly identify hazard types, personal protective equipment requirements, and incident reporting procedures specific to the surgical suite. |
| OSHA 10-Hour General Industry authorized course materials; OSHA Bloodborne Pathogens Standard (29 CFR 1910.1030) plain-language summary handout; facility SDS binder samples; nitrile gloves, face shield, gown for PPE demonstration; whiteboard and markers. | Students must pass all required OSHA 10-Hour module assessments at the threshold required for card issuance and score 80% or higher on a 25-question instructor-written post-test covering perioperative hazard identification and PPE selection. |
| 2 | First Aid, CPR & Emergency Response in the OR Setting | 16 | lab | Students demonstrate adult, child, and infant CPR and AED use, and perform first aid for shock, hemorrhage control, and wound care on manikins and simulated patients to the standard required for healthcare provider certification. |
| Adult, child, and infant CPR manikins with feedback devices; AED trainer units; hemorrhage-control bandaging supplies; PPE (gloves, face shields); American Heart Association or American Red Cross Healthcare Provider CPR course materials; SBAR reference card. | Each student must pass the skills station checkoff for CPR/AED to the standard required by the certifying organization (American Heart Association or equivalent) and score 80% or above on the written first aid knowledge check; students who do not pass the skills station on the first attempt receive remediation and one additional attempt within the same course week. |
| 3 | Trade Math: Measurement, Conversion & Surgical Counts | 24 | practice | Students accurately perform metric and imperial unit conversions, calculate volumes and weights relevant to irrigation and medication labels, and complete simulated instrument and sponge count reconciliation using the arithmetic methods required in the scrub and circulator roles. |
| Metric/imperial conversion reference card; calculator; printed medication label samples (generic teaching labels, no real drugs); simulated count sheets; lap sponges, towels, and instrument trays for count practice; Association of Surgical Technologists (AST) Core Curriculum for Surgical Technology. | Students must score 80% or higher on a 30-problem timed math quiz covering conversion, label reading, and count reconciliation; errors on the count-discrepancy scenario that would result in a retained surgical item if real are flagged for mandatory remediation before the student advances. |
| 4 | Technical Reading: Perioperative Documents & Medical Terminology | 20 | theory | Students correctly decode medical terminology using prefix-root-suffix analysis and accurately extract required information from surgical consent forms, procedure preference cards, instrument set cards, MSDS/SDS sheets, and operative reports. |
| Medical terminology textbook (Chabner or equivalent); sample surgical consent forms (de-identified teaching copies); sample instrument set cards and preference cards; sample operative reports (de-identified); SDS binder with representative OR chemicals; AST Core Curriculum. | Students must score 80% or higher on a 40-item reading comprehension and terminology quiz that includes term deconstruction, document interpretation, and SDS question items. |
| 5 | Digital Literacy & Healthcare Information Systems | 20 | demo | Students navigate a simulated electronic health record environment, demonstrate correct patient privacy practices consistent with federal health information privacy requirements, and use professional digital communication tools appropriately in a healthcare workplace context. |
| Computer workstations or tablets with internet access; educational EHR training software or sandbox access; sample EHR navigation handout; federal health information privacy summary handout; professional email rubric; AST Code of Ethics. | Students correctly complete the three-patient EHR checklist with no patient-identification errors (100% accuracy on patient matching is required) and score 80% or higher on a 20-item scenario quiz covering privacy compliance and professional digital communication. |
| 6 | Professional Role, Scope of Practice & Ethics in Surgical Technology | 24 | theory | Students articulate the surgical technologist's defined scope of practice in the scrub, circulator-support, and second-assistant roles, apply the AST Code of Ethics to workplace dilemmas, and describe the hierarchical accountability structure of the perioperative team. |
| AST Scope of Practice for the Surgical Technologist; AST Code of Ethics; perioperative team hierarchy diagram; ethical dilemma scenario handouts; role-play observation rubric; TeamSTEPPS or equivalent structured communication reference. | Students must score 80% or higher on a 25-item scenario-based quiz covering scope of practice boundaries and ethical decision-making, and must receive a passing score on the role-play observation rubric (all required communication behaviors demonstrated). |
| 7 | Career Readiness & NBSTSA CST Credentialing Pathway | 16 | field | Students construct a professional portfolio foundation—resume, cover letter, and a credentialing action plan—and accurately describe the eligibility requirements, application process, and content areas of the NBSTSA CST examination. |
| Computer workstations with internet access; NBSTSA website (nbstsa.org); current NBSTSA CST Examination Candidate Handbook; resume and cover letter templates; credentialing action plan worksheet; professional panel guest or video recording; reflection writing guide. | Resume and cover letter meet all rubric criteria (professional format, trade-specific language, no factual errors) at a score of 80% or higher; credentialing action plan is complete and contains only accurate information verified against the official NBSTSA handbook—any invented or inaccurate credentialing facts require correction before the lesson is considered passed. |
| Assessment | Type | Weight | Pass standard | Method & rubric |
|---|---|---|---|---|
| Safety & Regulatory Knowledge Exam | Written exam | 25% | 80% or higher (20 of 25 items correct) | A 25-item multiple-choice and short-answer exam covering OSHA 10-Hour content, bloodborne pathogen and chemical hazard standards, PPE selection for surgical settings, and first aid/emergency response principles. Items are written at the application level, requiring students to choose correct actions in realistic perioperative hazard scenarios rather than recall definitions alone. Accuracy · Safety · Communication · Professionalism |
| Trade Math & Technical Reading Exam | Written exam | 25% | 80% or higher (32 of 40 items correct); any surgical-count item that would represent a retained surgical item if applied clinically must be answered correctly or the exam is failed regardless of overall score | A 40-item exam combining unit conversion problems, medication label interpretation calculations, instrument and sponge count reconciliation, medical terminology deconstruction, and perioperative document comprehension questions drawn from realistic consent forms, SDS sheets, and preference cards. The exam is timed to simulate the pace required in professional practice. Accuracy · Safety · Communication · Professionalism |
| Professional Portfolio Project | Project | 25% | Rubric composite score of 80% or higher across all four components; credentialing action plan must contain zero inaccurate NBSTSA facts | Students submit a four-part professional portfolio consisting of a polished surgical-technology resume, a position-specific cover letter, a completed NBSTSA CST credentialing action plan verified against official sources, and a one-page written reflection from the career panel activity. Each component is evaluated on accuracy, professionalism, and trade-specific relevance using a detailed rubric shared with students at the start of the lesson. Accuracy · Safety · Communication · Professionalism |
| Scope of Practice & Ethics Oral Defense | Oral / panel | 25% | Score of 3 or higher on all four rubric domains (each scored 1–4); a score of 1 on the patient-safety domain requires immediate remediation and a second attempt before course completion | In a 10-minute structured oral session with the instructor and one additional faculty member, each student is presented with two unrehearsed perioperative scenarios and must verbally identify the scope-of-practice boundary or ethical principle at issue, describe the correct action including who to notify, and explain the patient-safety rationale. The rubric evaluates accuracy of scope knowledge, ethical reasoning, communication clarity, and patient-safety priority. Accuracy · Safety · Communication · Professionalism |
HLT-SURG65-02 Trade course
Aseptic Technique in Surgical Technology
322 hr · $5,565 COMPLIMENTARY
This course develops the knowledge and hands-on skill required to establish and maintain a sterile field throughout the perioperative environment. Students master microbiology principles, sterile barrier systems, gowning and gloving, draping, and contamination recognition and response. Content maps directly to the NBSTSA CST examination domains covering basic science and aseptic technique.
Outcomes- Explain the microbiology principles underlying surgical site infection risk and apply them to aseptic practice decisions in the OR.
- Demonstrate correct surgical hand antisepsis, sterile gowning, and closed-glove technique meeting facility-standard criteria without prompting.
- Establish, maintain, and protect a sterile field according to the Association of Surgical Technologists (AST) Standards of Practice.
- Identify breaks in sterile technique, state the correct corrective action, and document the event accurately.
- Select and apply sterile draping configurations for common surgical positions and procedural sites.
- Explain the principles of disinfection levels (low, intermediate, high) and their appropriate application to non-critical, semi-critical, and critical items.
Course text
This course develops the knowledge and hands-on skill required to establish and maintain a sterile field throughout the perioperative environment. Students master microbiology principles, sterile barrier systems, gowning and gloving, draping, and contamination recognition and response. Content maps directly to the NBSTSA CST examination domains covering basic science and aseptic technique.
How the course runs. 12 blocks: Microbiology Foundations for Aseptic Practice; Principles of Asepsis: Definitions, Standards, and Regulatory Framework; Surgical Hand Antisepsis: Scrub, Rub, and Waterless Techniques; Sterile Gowning: Donning and Assisting; Sterile Gloving: Closed, Open, and Assisted Techniques; Setting Up and Managing the Sterile Back Table and Mayo Stand; Sterile Draping: Principles and Common Configurations; Recognizing and Responding to Breaks in Sterile Technique; Levels of Disinfection and the Spaulding Classification; Surgical Site Preparation and Skin Antisepsis; Personal Protective Equipment and Standard Precautions in the OR; Integrated Aseptic Technique Simulation: Full Perioperative Sequence.
What competent looks like. Explain the microbiology principles underlying surgical site infection risk and apply them to aseptic practice decisions in the OR. Demonstrate correct surgical hand antisepsis, sterile gowning, and closed-glove technique meeting facility-standard criteria without prompting. Establish, maintain, and protect a sterile field according to the Association of Surgical Technologists (AST) Standards of Practice. Identify breaks in sterile technique, state the correct corrective action, and document the event accurately. Select and apply sterile draping configurations for common surgical positions and procedural sites. Explain the principles of disinfection levels (low, intermediate, high) and their appropriate application to non-critical, semi-critical, and critical items.
| # | Lesson | Hr | Type | Objective | Activities | Materials | Check |
|---|---|---|---|---|---|---|---|
| 1 | Microbiology Foundations for Aseptic Practice | 22.5 | theory | The student will classify microorganisms by type and transmission route and link each to the risk of surgical site infection. |
| AST Core Curriculum for Surgical Technology (7th ed.), microbiology reference charts, chain-of-infection diagram handouts, whiteboard | 10-question multiple-choice quiz on organism classification and SSI risk; pass mark 75%. |
| 2 | Principles of Asepsis: Definitions, Standards, and Regulatory Framework | 19 | theory | The student will state each of the seven AST principles of aseptic technique and explain the regulatory and accreditation context that governs them. |
| AST Standards of Practice (current edition), AORN Guidelines for Perioperative Practice (current edition), scenario worksheet handouts | Written scenario worksheet graded by instructor; students must correctly identify violation and corrective action in at least 16 of 20 scenarios (80%). |
| 3 | Surgical Hand Antisepsis: Scrub, Rub, and Waterless Techniques | 26.5 | demo | The student will perform a timed surgical hand scrub and an alcohol-based hand rub using the counted-stroke and timed methods to manufacturer and facility-protocol specifications. |
| Surgical scrub brushes and sponges, chlorhexidine gluconate scrub solution, alcohol-based hand rub product, nail picks, UV fluorescent lotion kit, UV lamp, AST scrub checklist | Instructor observation using AST scrub checklist; all critical steps (nail pick use, anatomic sequence, no recontamination) must be marked satisfactory; 100% of critical steps required to pass. |
| 4 | Sterile Gowning: Donning and Assisting | 26.5 | demo | The student will independently don a sterile surgical gown using closed technique and assist a second person in gowning without contaminating either gown. |
| Sterile surgical gowns (various sizes), gown tables, mannequin arms for initial practice, AST gowning checklist | Instructor observation checklist; student must complete solo donning with zero critical errors (defined as any break in sterile technique); one repeat attempt allowed before remediation. |
| 5 | Sterile Gloving: Closed, Open, and Assisted Techniques | 26.5 | demo | The student will perform closed-glove, open-glove, and assisted-glove techniques correctly and state the clinical indication for each method. |
| Sterile gloves (multiple sizes, latex and latex-free), sterile gown packs, water container for integrity check, AST gloving checklist, comparison chart handout | Instructor observation using AST gloving checklist; closed-glove technique must be performed with zero critical errors on the final attempt; open and assisted techniques scored pass/fail. |
| 6 | Setting Up and Managing the Sterile Back Table and Mayo Stand | 28 | lab | The student will open sterile supplies without contamination, organize a back table and Mayo stand to a defined layout, and maintain the sterile field throughout a simulated 30-minute procedure. |
| Instrument sets, basin sets, laparotomy drape packs, sterile towels, back table, Mayo stand, sterile table covers, layout diagram handouts, contamination tracking sheets | Instructor contamination tracking sheet; no more than two non-critical errors permitted and zero critical contamination events; pass mark 80% of steps performed correctly. |
| 7 | Sterile Draping: Principles and Common Configurations | 28 | lab | The student will apply sterile drapes for at least three surgical site configurations — including extremity, abdominal, and head/neck setups — without contaminating the field or the patient prep site. |
| Sterile drape packs (laparotomy, extremity, split/bar, fenestrated), impervious stockinettes, towel clips, low-fidelity patient mannequin, AST draping checklist | Instructor-scored AST draping checklist; all three configurations must be completed with zero critical contamination events; overall score of 80% or higher required to pass. |
| 8 | Recognizing and Responding to Breaks in Sterile Technique | 22.5 | practice | The student will correctly identify at least nine of ten simulated sterile-technique violations and demonstrate or verbalize the appropriate corrective action for each. |
| Scenario video library, violation log worksheets, active sterile field setup, instrument sets, AST Core Curriculum (Ch. on aseptic technique), debriefing rubric | Violation log scored by instructor; student must correctly identify and state corrective action for at least 9 of 10 violations (90%) to pass. |
| 9 | Levels of Disinfection and the Spaulding Classification | 20.5 | theory | The student will classify surgical items as critical, semi-critical, or non-critical using the Spaulding classification and select the appropriate disinfection or sterilization level for each. |
| Spaulding classification handout, sample disinfectant product inserts, case-study worksheets, AST Core Curriculum (sterilization and disinfection chapter) | Classification matrix and case-study worksheet graded by instructor; must achieve 80% or higher across both documents to pass. |
| 10 | Surgical Site Preparation and Skin Antisepsis | 20.5 | demo | The student will describe the principles of surgical site skin antisepsis and demonstrate the correct prep sequence, pattern, and applicator technique for an abdominal and an extremity site on a mannequin. |
| Low-fidelity mannequin torso and limb, chlorhexidine-alcohol prep applicators (demonstration units or simulators), iodine-based prep applicators, prep checklist, anatomy diagram handouts | Prep observation checklist scored by instructor; both prep demonstrations must be completed with correct sequence and zero contamination of prep site; pass mark 80% of steps correct. |
| 11 | Personal Protective Equipment and Standard Precautions in the OR | 26.5 | practice | The student will select and correctly don and doff required PPE for OR use and explain each element of Standard Precautions as it applies to surgical technology practice. |
| Surgical gowns, gloves, masks, eye protection, shoe covers, UV fluorescent lotion kit, UV lamp, OSHA bloodborne pathogens reference handout, PPE scenario cards, AST Core Curriculum | Doffing observed by instructor with UV lamp review; zero self-contamination events required; PPE selection exercise scored at 80% or higher to pass. |
| 12 | Integrated Aseptic Technique Simulation: Full Perioperative Sequence | 55 | lab | The student will independently execute the complete aseptic technique sequence — from surgical hand antisepsis through sterile setup, draping, and maintenance — across two simulated procedures of different specialty types, with no critical errors. |
| Full OR simulation suite with back table, Mayo stand, instrument sets, basin sets, gown and glove supplies, drape packs, mannequin, contamination tracking rubric, video recording capability (if available), CST exam content outline (NBSTSA, current) | Comprehensive evaluation rubric scored by instructor; student must achieve zero critical errors across both runs and an overall rubric score of 85% or higher; any critical error triggers mandatory remediation before course completion. |
| Assessment | Type | Weight | Pass standard | Method & rubric |
|---|---|---|---|---|
| Aseptic Technique Knowledge Examination | Written exam | 25% | 75% correct (30 of 40 items) | A 40-item multiple-choice examination covering microbiology principles, the seven AST principles of aseptic technique, Spaulding classification, disinfection levels, and contamination recognition scenarios. Items are written to the cognitive level of the NBSTSA CST exam content outline, providing early practice with the credential examination format. Standard met · Safety · Time · Quality/finish · Documentation |
| Sterile Technique Skills Demonstration | Skills demonstration | 45% | Zero critical errors; 85% of total checklist steps rated satisfactory | The student performs a complete observed sequence — surgical hand antisepsis, closed-glove gowning, sterile back table and Mayo stand setup, and patient draping for an assigned surgical site — scored on the program's standardized competency checklist by a credentialed surgical technology instructor. Any critical error (contamination of the sterile field or patient prep site) requires immediate remediation and a repeat demonstration. Standard met · Safety · Time · Quality/finish · Documentation |
| Aseptic Technique Lab Log | Log | 15% | All 12 entries present and complete; instructor-verified accuracy on at least 10 of 12 entries | Students maintain a structured lab log throughout the course, recording the date, skill practiced, self-assessment of performance, identified errors, corrective actions taken, and the AST principle or Spaulding classification that applied. The log is submitted at course end and reviewed by the instructor to confirm reflective accuracy and documentation habits essential for perioperative practice. Standard met · Safety · Time · Quality/finish · Documentation |
| Sterile Field Safety Check | Safety audit | 15% | 100% of critical safety behaviors observed; no unsatisfactory items permitted | A focused pass/fail safety evaluation conducted during the integrated simulation in Lesson 12; the instructor uses a short critical-behavior checklist to verify that the student consistently protects patient safety — including correct PPE use, neutral-zone sharps passing, immediate verbal response to any field contamination, and proper instrument handling — behaviors that are non-negotiable in the OR and directly reflected in NBSTSA CST patient safety competencies. Standard met · Safety · Time · Quality/finish · Documentation |
HLT-SURG65-03 Trade course
Surgical Instrumentation: Identification, Handling, and Set Management
322 hr · $5,565 COMPLIMENTARY
Students develop comprehensive knowledge of surgical instruments across all major specialties, including correct nomenclature, functional classification, handling technique, and set assembly. Emphasis is placed on instrument inspection, passing protocol, and the surgical technologist's role in maintaining an organized, safe sterile field. Lesson content maps directly to NBSTSA CST exam domains covering instrumentation, surgical technology science, and perioperative care.
Outcomes- Identify and name at least 200 surgical instruments by correct nomenclature and classify each by function (cutting, clamping, retracting, suturing, viewing, or accessory).
- Demonstrate safe, ergonomically correct one-handed instrument-passing technique for sharps and non-sharps without contaminating the sterile field.
- Assemble, count, and verify a complete instrument set for at least three different surgical specialties using a standardized count sheet.
- Inspect instruments for defects including misalignment, corrosion, insulation failure, and lumen patency, and correctly remove defective items from service.
- Apply basic trade math to instrument sizing, tray weight calculations, and set completion documentation with 100% accuracy on count records.
- Explain scope-of-practice boundaries for the surgical technologist during instrumentation tasks and identify when to communicate instrument or set problems to the supervising RN or surgeon.
Course text
Students develop comprehensive knowledge of surgical instruments across all major specialties, including correct nomenclature, functional classification, handling technique, and set assembly. Emphasis is placed on instrument inspection, passing protocol, and the surgical technologist's role in maintaining an organized, safe sterile field. Lesson content maps directly to NBSTSA CST exam domains covering instrumentation, surgical technology science, and perioperative care.
How the course runs. 12 blocks: Introduction to Surgical Instrument Classification and Nomenclature; Instrument Anatomy: Parts, Materials, and Construction; Cutting and Dissecting Instruments: Scalpels, Scissors, and Curettes; Clamping and Occluding Instruments: Hemostats, Clamps, and Forceps; Grasping, Holding, and Tissue Forceps; Retracting and Exposing Instruments; Specialty Instrument Sets: Orthopedic, Cardiovascular, and Laparoscopic; Instrument Inspection: Defect Recognition and Quality Control; Instrument Counting: Principles, Protocols, and Documentation; Set Assembly and Tray Management by Specialty; Instrument Passing and Mayo Stand Organization During a Simulated Case; Integration Practicum: Full Instrument Management for a Complex Simulated Case.
What competent looks like. Identify and name at least 200 surgical instruments by correct nomenclature and classify each by function (cutting, clamping, retracting, suturing, viewing, or accessory). Demonstrate safe, ergonomically correct one-handed instrument-passing technique for sharps and non-sharps without contaminating the sterile field. Assemble, count, and verify a complete instrument set for at least three different surgical specialties using a standardized count sheet. Inspect instruments for defects including misalignment, corrosion, insulation failure, and lumen patency, and correctly remove defective items from service. Apply basic trade math to instrument sizing, tray weight calculations, and set completion documentation with 100% accuracy on count records. Explain scope-of-practice boundaries for the surgical technologist during instrumentation tasks and identify when to communicate instrument or set problems to the supervising RN or surgeon.
| # | Lesson | Hr | Type | Objective | Activities | Materials | Check |
|---|---|---|---|---|---|---|---|
| 1 | Introduction to Surgical Instrument Classification and Nomenclature | 20.5 | theory | Students will classify at least 150 common surgical instruments into the six functional categories and state the correct name and primary use of each. |
| Assorted practice instrument sets, instrument identification flashcard decks, AORN Perioperative Standards and Recommended Practices (current edition), Tighe Instrumentation for the Operating Room (current edition), labeled sorting bins, whiteboard | Written instrument ID quiz: students identify 40 instrument images by name and functional category. Pass mark: 78% (31/40) correct on both name and category for each item. |
| 2 | Instrument Anatomy: Parts, Materials, and Construction | 19 | theory | Students will label all standard anatomical parts of ring-handled, box-lock, and hinged instruments and explain how stainless steel grade and surface finish affect instrument performance and care. |
| Assorted instruments including Halsted mosquito hemostat, Mayo-Hegar needle holder, Weitlaner retractor, instrument anatomy diagrams (blank and keyed), Tighe textbook, magnifying loupes for detail inspection | Labeled diagram completion graded by instructor: students must correctly label 90% of anatomical parts across three instrument types to demonstrate readiness to advance to handling lessons. |
| 3 | Cutting and Dissecting Instruments: Scalpels, Scissors, and Curettes | 26.5 | demo | Students will correctly identify and safely handle scalpel handles and blades (sizes 10, 11, 15, 20, 22), standard scissors types (Mayo, Metzenbaum, iris, bandage), and common curettes, stating the surgical application of each. |
| Scalpel handles (sizes 3, 4, 7), assorted blades, Mayo scissors (straight and curved), Metzenbaum scissors, iris scissors, bandage scissors, bone curettes, sharps containers, kidney basin, small draped practice surface, AORN sharps safety guidelines handout | Skills observation checklist: instructor verifies correct blade mounting/removal with no unsafe hand contact (pass/fail) and correct identification of 10 cutting instruments by name and use. Both components must be passed at 80% or better. |
| 4 | Clamping and Occluding Instruments: Hemostats, Clamps, and Forceps | 26.5 | demo | Students will identify at least 30 clamping and occluding instruments by name and demonstrate correct palm-grip and finger-ring handling technique for ring-handled clamps without cross-contaminating the sterile field. |
| Halsted mosquito hemostats, Kelly hemostats, Crile hemostats, Kocher clamps, Allis clamps, Babcock clamps, Rochester-Pean clamps, right-angle clamps, sponge-holding forceps, instrument identification reference cards, Tighe textbook, small draped mayo stand | Practical station check: student identifies 15 clamping instruments by name, demonstrates palm-grip passing technique for three different clamp types. Pass mark: 100% on sharps-safe passing form; 80% on instrument names (12/15 correct). |
| 5 | Grasping, Holding, and Tissue Forceps | 20.5 | demo | Students will differentiate thumb forceps types (tissue, dressing, bayonet, Adson) and ring-handled graspers (Babcock, Allis, sponge forceps) by jaw design, stating the appropriate tissue type and risk of injury for each. |
| Adson tissue forceps (with and without teeth), plain dressing forceps, DeBakey vascular forceps, Russian forceps, Bonney forceps, Babcock clamps, foam practice blocks, latex tubing, lab notebooks, Tighe textbook | Instructor-led oral quiz at the end of the session: student correctly identifies six forceps types and states appropriate tissue application and contraindication for three of them. Pass mark: 80% accuracy across all responses. |
| 6 | Retracting and Exposing Instruments | 20.5 | demo | Students will identify handheld and self-retaining retractors by name and describe the correct placement, angle, and pressure guidelines that prevent tissue and nerve injury during retraction. |
| Richardson retractors (small, medium, large), Army-Navy retractors, Deaver retractors, Balfour self-retaining retractor with blades, Weitlaner retractor, Gelpi retractor, brain retractors, pelvic/abdominal task model, reference sorting cards | Performance checklist: student correctly names 12 of 16 retractors and demonstrates safe passing of three retractors to a partner without field contamination. Both criteria must be met; retractor naming pass mark: 75% (12/16). |
| 7 | Specialty Instrument Sets: Orthopedic, Cardiovascular, and Laparoscopic | 30 | theory | Students will identify the distinguishing instruments, powered equipment components, and accessory items unique to orthopedic, cardiovascular, and laparoscopic instrument sets and explain the safety rules specific to each specialty. |
| Orthopedic basic set (chisels, osteotomes, bone hooks, reamers), cardiovascular basic set (DeBakey clamps, bulldog clamps, vascular forceps, vessel loops), laparoscopic basic set (trocars, Veress needle, 0° and 30° telescopes, laparoscopic scissors and graspers), insulation testing device, lab notebooks, specialty reference cards | Written specialty quiz: 30 questions covering instrument names, purposes, and safety rules across all three specialties. Pass mark: 78% (24/30). Students who do not pass receive targeted review and one retake opportunity. |
| 8 | Instrument Inspection: Defect Recognition and Quality Control | 24.5 | lab | Students will inspect a set of instruments using a standardized checklist and correctly identify and remove from service all items displaying misalignment, box-lock wear, corrosion, cracked insulation, tip damage, or lumen obstruction. |
| Mixed instrument sets with seeded defects, instrument inspection checklist (AORN-aligned), insulation integrity tester, magnifying loupes, pipe cleaners, rejection tags, light source (fiber-optic headlight acceptable), lab notebooks | Lab inspection log graded by instructor: student must correctly identify all five seeded defects (100% detection required for patient safety) and produce zero false positives that would remove serviceable instruments unnecessarily. Full credit requires 100% defect detection. |
| 9 | Instrument Counting: Principles, Protocols, and Documentation | 24.5 | practice | Students will perform a complete three-phase surgical count (initial, closing, final) for a simulated general surgery case using a standardized count sheet, achieving zero count errors across all categories. |
| Laparotomy instrument set (ring forceps, hemostats, retractors, needle holders, suture needles, sponges, blades), standardized surgical count sheets, pens, AORN Recommended Practices for Sponge, Sharp, and Instrument Counts (current edition), whiteboard for count demonstration | Supervised simulated count: student performs a complete three-phase count with a partner acting as circulator; instructor observes. Pass standard: zero count discrepancies undiscovered, all categories documented, and correct verbal discrepancy protocol followed if an error is seeded. Any missed undiscovered discrepancy = repeat required. |
| 10 | Set Assembly and Tray Management by Specialty | 30 | lab | Students will assemble, arrange, wrap-ready, and verify three specialty instrument sets (general surgery, orthopedic, gynecology) against a master set list within the allotted time and without instrument substitution errors. |
| General surgery basic set, gynecology basic set, orthopedic basic set, master set lists for each specialty, instrument count sheets, tip protectors, instrument stringers, closed-weave instrument trays, lab log forms, stopwatch | Instructor verification of completed tray against master set list: pass requires 100% correct instrument selection (no substitutions), all box locks open, sharp tips protected, and tray assembled within the established time limit. Any incorrect instrument or missing item is a deficiency requiring repeat. |
| 11 | Instrument Passing and Mayo Stand Organization During a Simulated Case | 49 | practice | Students will organize a mayo stand and back table for a simulated appendectomy and demonstrate safe, anticipatory instrument-passing technique throughout a scripted surgical sequence with no sterile field breaks or passing errors. |
| Appendectomy instrument set, drape packs, suture packets (non-sterile practice), mayo stand, back table, sterile gown and gloves (or simulated sterile gown), scripted case protocol, video recording device (optional), reflection log forms, AORN field management guidelines | Performance observation checklist: instructor scores each instrument pass on correct name/anticipation, correct passing angle, no field break, and correct sharps handling. Pass mark: 90% of passes scored correct on all four criteria across a full simulated case (approximately 20 instrument passes). |
| 12 | Integration Practicum: Full Instrument Management for a Complex Simulated Case | 30.5 | lab | Students will independently manage all instrumentation responsibilities—set assembly, inspection, mayo stand organization, instrument passing, counting, and documentation—for a simulated laparoscopic cholecystectomy from setup through case completion without instructor prompting. |
| Laparoscopic cholecystectomy instrument set (trocars, Veress needle, telescope, laparoscopic clip applier, laparoscopic scissors, graspers, irrigation/suction), case card, surgeon preference card template, sterile field setup supplies, count sheets, self-assessment rubric, lab log | Summative performance rubric scored by instructor across six domains: set assembly accuracy, defect identification, sterile field organization, passing technique, count accuracy, and documentation. Each domain scored on a 4-point scale; pass requires an average of 3.0 or higher with no domain scoring below 2, and a perfect count record (zero unresolved discrepancies). |
| Assessment | Type | Weight | Pass standard | Method & rubric |
|---|---|---|---|---|
| Surgical Instrument Identification and Classification Written Exam | Written exam | 25% | 78% or higher (minimum 78 of 100 points) | A 100-question written examination covering instrument nomenclature, functional classification, anatomical parts, specialty sets, inspection criteria, and counting principles aligned to NBSTSA CST exam domains for instrumentation and perioperative care. Questions include image-based identification, multiple choice, and short-answer matching; students who score below 78% receive one retake opportunity after targeted remediation. Standard met · Safety · Time · Quality/finish · Documentation |
| Instrument Passing and Mayo Stand Skills Demonstration | Skills demonstration | 45% | Pass on all critical safety items (zero tolerance for sterile field breaks or unsafe sharps handling); 85% overall on performance checklist | A live observed performance in which the student sets up a mayo stand and passes instruments through a scripted 15-minute simulated surgical sequence; the instructor scores each pass on anticipation, correct naming, passing technique, and sharps safety using a standardized checklist mapped to NBSTSA CST competencies for scrub role performance. Standard met · Safety · Time · Quality/finish · Documentation |
| Instrumentation Lab Log | Log | 15% | All 10 required entries submitted; average score of 80% or higher across all entries | A cumulative lab log maintained throughout the course in which students document findings from each hands-on lab session, including instrument inspection results, tray assembly discrepancies, count practice outcomes, and self-reflections; each entry is reviewed by the instructor for completeness, accuracy of terminology, and evidence of corrective action when errors occurred. Standard met · Safety · Time · Quality/finish · Documentation |
| Instrument Count and Field Safety Check | Safety audit | 15% | 100% on all critical safety items; zero unresolved count discrepancies | A focused safety verification in which the student independently conducts a complete three-phase instrument count for a seeded instrument tray under instructor observation, documents all count categories correctly on a count sheet, and correctly executes the discrepancy resolution protocol when the instructor introduces one intentional missing-item scenario; any undetected discrepancy or unsafe sharps event constitutes an automatic failure requiring full remediation and retest. Standard met · Safety · Time · Quality/finish · Documentation |
HLT-SURG65-04 Trade course
Surgical Procedures by Specialty
321 hr · $5,545 COMPLIMENTARY
Students learn the anatomy, pathology, surgical workflow, instrumentation, and scrub-role responsibilities for major surgical specialties encountered in the operating room. Emphasis is placed on anticipating the surgeon's needs, maintaining the sterile field, and protecting patient safety throughout each procedure. Lessons are mapped to NBSTSA CST exam content domains covering surgical procedures, anatomy and physiology, and equipment/technology.
Outcomes- Identify the anatomical structures involved and the surgical objectives for procedures in at least eight surgical specialties.
- Select and arrange correct instrumentation, supplies, and implants for assigned specialty procedures without prompting.
- Demonstrate the scrub role—including gowning, gloving, draping, passing instruments, and maintaining the sterile field—for simulated specialty cases.
- Anticipate procedural steps and surgeon needs by following the surgical sequence for representative procedures in each specialty.
- Apply correct counts (sponge, sharps, instrument) and document discrepancies using established safety protocols for each specialty case.
- Explain how patient positioning, prep solutions, and special equipment requirements differ across surgical specialties and justify choices in terms of patient safety.
Course text
Students learn the anatomy, pathology, surgical workflow, instrumentation, and scrub-role responsibilities for major surgical specialties encountered in the operating room. Emphasis is placed on anticipating the surgeon's needs, maintaining the sterile field, and protecting patient safety throughout each procedure. Lessons are mapped to NBSTSA CST exam content domains covering surgical procedures, anatomy and physiology, and equipment/technology.
How the course runs. 12 blocks: Foundations of Specialty Surgery: Anatomy Review, Surgical Pathology, and Case Planning; General Surgery: Laparoscopic and Open Abdominal Procedures; Orthopedic Surgery: Fracture Fixation, Joint Replacement, and Arthroscopy; Neurosurgery: Cranial and Spinal Procedures; Cardiothoracic Surgery: Open-Heart, Coronary Artery Bypass, and Thoracic Procedures; Obstetric and Gynecologic Surgery: Cesarean Section, Hysterectomy, and Laparoscopic GYN; Genitourinary Surgery: Cystoscopy, TURP, Nephrectomy, and Robotic-Assisted Procedures; Ophthalmic Surgery: Cataract Extraction, Vitrectomy, and Corneal Procedures; Ear, Nose, and Throat (ENT) Surgery: Tympanoplasty, Sinus Endoscopy, and Tonsillectomy; Plastic and Reconstructive Surgery: Skin Grafts, Flaps, and Wound Closure Techniques; Vascular Surgery: Carotid Endarterectomy, Peripheral Bypass, and AV Fistula; Integrated Specialty Case Simulation: Full Scrub Role Across Multiple Specialties.
What competent looks like. Identify the anatomical structures involved and the surgical objectives for procedures in at least eight surgical specialties. Select and arrange correct instrumentation, supplies, and implants for assigned specialty procedures without prompting. Demonstrate the scrub role—including gowning, gloving, draping, passing instruments, and maintaining the sterile field—for simulated specialty cases. Anticipate procedural steps and surgeon needs by following the surgical sequence for representative procedures in each specialty. Apply correct counts (sponge, sharps, instrument) and document discrepancies using established safety protocols for each specialty case. Explain how patient positioning, prep solutions, and special equipment requirements differ across surgical specialties and justify choices in terms of patient safety.
| # | Lesson | Hr | Type | Objective | Activities | Materials | Check |
|---|---|---|---|---|---|---|---|
| 1 | Foundations of Specialty Surgery: Anatomy Review, Surgical Pathology, and Case Planning | 24 | theory | Students will correlate relevant anatomy and common surgical pathology to the scrub role's planning responsibilities for each major specialty covered in the course. |
| Fuller's Surgical Technology: Principles and Practice (current edition); anatomical models; printed case-planning templates; NBSTSA CST exam content outline; whiteboard | Students complete a 20-question matching quiz linking pathology to specialty, anatomical structure, and scrub-role planning element; pass mark 75%. |
| 2 | General Surgery: Laparoscopic and Open Abdominal Procedures | 30 | demo | Students will describe the procedural sequence and demonstrate correct instrument passing and laparoscopic equipment handling for common open and laparoscopic general surgery cases. |
| Laparoscopic trainer box with camera and monitor; laparoscopic instrument set (trocars, clip applier, graspers, scissors); standard laparotomy instrument set; suture samples; draped manikin torso; procedure checklist handouts | Instructor observes each student passing five designated instruments in correct orientation and sequence without breaking sterile technique; all five must be passed correctly (100%) to pass the station. |
| 3 | Orthopedic Surgery: Fracture Fixation, Joint Replacement, and Arthroscopy | 30 | lab | Students will set up an orthopedic back table and mayo stand, handle power equipment safely, and sequence the scrub role for a total knee arthroplasty and an arthroscopic knee procedure. |
| Orthopedic instrument tray; simulated knee arthroplasty implant system or training kit; bone model; sagittal saw trainer (non-powered or deactivated demo unit); drill with bits; count sheets; manufacturer surgical technique guide | Completed and instructor-signed orthopedic lab log entry documenting back-table setup, power-tool transfer steps performed, and three accurate count entries; all three counts must be correctly recorded to pass. |
| 4 | Neurosurgery: Cranial and Spinal Procedures | 24 | theory | Students will explain the specialized equipment, positioning devices, and sterile-field requirements unique to cranial and spinal surgical procedures and identify scrub-role responsibilities at each phase. |
| Surgical technology textbook neurosurgery chapter; guided notes handout; surgical procedure video (licensed educational source); Mayfield head holder (or photo/model); equipment-request card template; whiteboard | Students submit a completed equipment-request card with written rationale for each item; instructor grades against an answer key requiring correct identification of at least eight of ten items with accurate rationale; pass mark 80%. |
| 5 | Cardiothoracic Surgery: Open-Heart, Coronary Artery Bypass, and Thoracic Procedures | 27 | demo | Students will identify cardiopulmonary bypass components, describe the scrub role during coronary artery bypass grafting, and demonstrate correct handling of cardiothoracic instruments and chest retractors. |
| Cardiothoracic instrument tray; Finochietto sternal retractor; CPB circuit diagram and tubing samples; vascular clamp set; fine vascular suture samples (e.g., polypropylene); limb model; suture needle counter | Instructor observes each student correctly assembling the sternal retractor and passing it in proper orientation, then passing three vascular sutures with correct needle accounting; errors in needle accounting result in automatic repeat before credit is given. |
| 6 | Obstetric and Gynecologic Surgery: Cesarean Section, Hysterectomy, and Laparoscopic GYN | 24 | lab | Students will set up the sterile field for a cesarean section and a total abdominal hysterectomy, correctly sequencing instrumentation and anticipating rapid-delivery steps specific to OB/GYN surgery. |
| OB/GYN instrument tray (cesarean set and hysterectomy set); pelvic anatomical model; mayo stand; back table; procedure-specific instrument list; timed setup checklist; procedural flowchart handout | Timed setup is scored on a 20-point checklist (instrument presence, placement, and organization); student must score 16 of 20 and complete setup within 12 minutes to pass. |
| 7 | Genitourinary Surgery: Cystoscopy, TURP, Nephrectomy, and Robotic-Assisted Procedures | 24 | demo | Students will describe the scrub role for endoscopic and open genitourinary procedures and demonstrate correct setup and handling of cystoscopy equipment and robotic-assisted surgery draping. |
| Cystoscopy trainer and tower (or simulation unit); cystoscope with light source cable; robotic draping kit (or simulation equivalent); TURP resectoscope set; irrigation tubing; step-by-step lab card; genitourinary chapter in textbook | Instructor evaluates completed cystoscopy setup lab card against a 10-step checklist; student must complete all 10 steps correctly and in order to pass. |
| 8 | Ophthalmic Surgery: Cataract Extraction, Vitrectomy, and Corneal Procedures | 21 | lab | Students will set up a microsurgical sterile field for ophthalmic surgery, handle delicate ophthalmic instruments without damage, and describe the sequence of phacoemulsification cataract extraction. |
| Ophthalmic microsurgical instrument tray; magnifying loupes; phacoemulsification trainer or simulation unit; irrigation/aspiration tubing; IOL inserter (simulation); ophthalmic drape; cataract extraction flowchart template | Instructor inspects arranged instrument tray against a labeled reference photo; all instruments must be present, correctly identified, and undamaged; tubing connection must be leak-free on instructor check; pass requires both stations complete. |
| 9 | Ear, Nose, and Throat (ENT) Surgery: Tympanoplasty, Sinus Endoscopy, and Tonsillectomy | 21 | demo | Students will identify ENT instrument sets and microscope-assisted equipment and demonstrate scrub-role responsibilities for functional endoscopic sinus surgery and tympanoplasty. |
| Surgical microscope (or trainer unit) with draping kit; ENT endoscopy instrument tray; manufacturer instrument reference cards; head/neck model; tray-ID worksheet; tonsillectomy instrument set | Tray-ID worksheet is graded against an answer key; students must correctly identify and state the use of at least 18 of 22 instruments to pass. |
| 10 | Plastic and Reconstructive Surgery: Skin Grafts, Flaps, and Wound Closure Techniques | 21 | practice | Students will prepare a sterile field for skin-graft and local-flap procedures and demonstrate precise suture and closure-material handling appropriate to plastic surgery. |
| Dermatome trainer or simulation unit; skin-graft model or suture practice pad; fine suture (absorbable and non-absorbable, 4-0 through 6-0); tissue adhesive (simulation); steri-strips; wound VAC demonstration kit; plastic surgery instrument set | Instructor evaluates dermatome loading and suture handling on a 15-point skills checklist; student must score 12 of 15 and demonstrate no unsafe needle-handling behaviors to pass. |
| 11 | Vascular Surgery: Carotid Endarterectomy, Peripheral Bypass, and AV Fistula | 21 | lab | Students will set up a vascular surgery sterile field including graft materials and shunting supplies, and demonstrate safe handling and passing of vascular clamps and fine vascular suture. |
| Vascular instrument tray (including DeBakey clamps, bulldog clamps, tunnelers); Javid shunt (or simulation equivalent); vascular graft material (dacron or PTFE sample); polypropylene suture (double-armed); vascular bench model; count sheets; procedure card | Instructor checks labeled diagram for 100% accuracy on clamp identification and verifies that needle count was performed and documented correctly at each of three suture passes during simulation; any unresolved count error requires repeat. |
| 12 | Integrated Specialty Case Simulation: Full Scrub Role Across Multiple Specialties | 54 | practice | Students will independently perform the complete scrub role—setup, gowning, gloving, draping, instrument management, counts, and breakdown—for two assigned specialty cases selected from different specialties covered in the course. |
| Two complete specialty instrument trays (assigned per student); full OR simulation suite setup (back table, mayo stand, draped manikin or OR table, anesthesia screen); gown and glove supplies; draping sets; preference card template; count sheets; skills rubric | Instructor scores each student's scrub performance on a 50-point rubric (setup 15 pts, sterile technique 15 pts, instrument management and anticipation 10 pts, counts 10 pts); student must score at least 40 of 50 on each case to pass the lesson; a failed case may be repeated once. |
| Assessment | Type | Weight | Pass standard | Method & rubric |
|---|---|---|---|---|
| Specialty Procedures Written Examination | Written exam | 25% | 75% correct (75 of 100 questions) | A 100-question multiple-choice examination covering anatomy, pathology, procedural sequence, instrumentation, patient positioning, and scrub-role responsibilities across all eight specialties taught in the course, mapped to NBSTSA CST exam content domains for surgical procedures and anatomy and physiology. Questions are written at application and analysis level to reflect the style of the credentialing examination. Standard met · Safety · Time · Quality/finish · Documentation |
| Specialty Scrub Role Skills Demonstration | Skills demonstration | 45% | 40 of 50 points on the skills rubric with no critical safety failures | Each student performs the complete scrub role for one instructor-assigned specialty case in the simulated OR, evaluated on sterile field setup, gowning and gloving, draping, instrument passing accuracy and anticipation, and correct counts using the standardized 50-point rubric. Any break in sterile technique or unresolved count discrepancy constitutes a critical safety failure requiring the demonstration to be repeated before a passing score can be awarded. Standard met · Safety · Time · Quality/finish · Documentation |
| Specialty Procedures Lab Log | Log | 15% | All 12 lesson lab entries submitted and at least 10 entries scored satisfactory by the instructor | Students maintain a cumulative lab log with one entry per lesson documenting the procedure(s) practiced, instrument and equipment names encountered, scrub-role steps performed, count outcomes, and one patient-safety reflection per entry. Entries are reviewed and initialed by the instructor at the end of each lesson; incomplete, inaccurate, or missing entries must be corrected before the log is accepted. Standard met · Safety · Time · Quality/finish · Documentation |
| Count Protocol and Sterile Field Safety Check | Safety audit | 15% | 100% on all mandatory safety behaviors; any critical item failure requires immediate repeat | Using a standardized safety checklist, the instructor evaluates each student's ability to perform and verbally confirm a correct initial count, closing count, and final count during a simulated case, and to respond correctly to a simulated count discrepancy by halting closure and notifying the surgeon. The checklist also verifies that the student never reaches across an unsterile area, maintains sterile field boundaries throughout, and disposes of sharps safely; all items are mandatory pass criteria with no partial credit. Standard met · Safety · Time · Quality/finish · Documentation |
HLT-SURG65-05 Trade course
Sterilization: Principles and Practice in the Surgical Environment
321 hr · $5,545 COMPLIMENTARY
This course covers the science and practice of sterilization and disinfection as applied to surgical instrumentation, equipment, and the perioperative environment. Students learn to select, operate, and monitor all major sterilization modalities used in central sterile processing and the OR, applying manufacturer instructions for use, quality assurance protocols, and regulatory standards. Emphasis is placed on patient safety, scope of practice, and the relationship between proper sterilization technique and infection prevention.
Outcomes- Classify microorganisms by type and resistance level and explain how each sterilization or disinfection method achieves the required level of microbial kill.
- Correctly decontaminate, inspect, package, and load surgical instruments for steam, ethylene oxide, hydrogen peroxide plasma, and dry-heat sterilization following established protocols and manufacturer instructions for use.
- Interpret biological, chemical, and mechanical indicators and take appropriate corrective action when a sterilization cycle fails quality assurance parameters.
- Apply OSHA bloodborne pathogen and hazardous-chemical standards to protect self and others throughout the decontamination and sterilization workflow.
- Maintain accurate sterilization records and complete recall documentation in compliance with facility policy and accreditation requirements.
- Demonstrate proper sterile storage, sterile transfer, and event-related sterility principles to preserve package integrity from sterilizer to surgical field.
Course text
This course covers the science and practice of sterilization and disinfection as applied to surgical instrumentation, equipment, and the perioperative environment. Students learn to select, operate, and monitor all major sterilization modalities used in central sterile processing and the OR, applying manufacturer instructions for use, quality assurance protocols, and regulatory standards. Emphasis is placed on patient safety, scope of practice, and the relationship between proper sterilization technique and infection prevention.
How the course runs. 12 blocks: Microbiology Foundations for Sterilization; OSHA Standards and Personal Protective Equipment in Decontamination; Decontamination: Point-of-Use Treatment Through Manual and Ultrasonic Cleaning; Inspection, Assembly, and Lubrication of Surgical Instruments; Packaging Systems: Wraps, Pouches, Rigid Containers, and Shelf Life; Steam Sterilization: Principles, Cycles, and Loading; Monitoring Sterilization Efficacy: Mechanical, Chemical, and Biological Indicators; Alternative Sterilization Methods: EO, Hydrogen Peroxide Plasma, and Dry Heat; Disinfection Levels: High, Intermediate, and Low; Common Disinfecting Agents; Sterile Storage, Event-Related Sterility, and Sterile Transfer; Documentation, Traceability, and Recall Procedures; Quality Assurance, Accreditation Standards, and Career Integration.
What competent looks like. Classify microorganisms by type and resistance level and explain how each sterilization or disinfection method achieves the required level of microbial kill. Correctly decontaminate, inspect, package, and load surgical instruments for steam, ethylene oxide, hydrogen peroxide plasma, and dry-heat sterilization following established protocols and manufacturer instructions for use. Interpret biological, chemical, and mechanical indicators and take appropriate corrective action when a sterilization cycle fails quality assurance parameters. Apply OSHA bloodborne pathogen and hazardous-chemical standards to protect self and others throughout the decontamination and sterilization workflow. Maintain accurate sterilization records and complete recall documentation in compliance with facility policy and accreditation requirements. Demonstrate proper sterile storage, sterile transfer, and event-related sterility principles to preserve package integrity from sterilizer to surgical field.
| # | Lesson | Hr | Type | Objective | Activities | Materials | Check |
|---|---|---|---|---|---|---|---|
| 1 | Microbiology Foundations for Sterilization | 24.5 | theory | Students will classify bacteria, viruses, fungi, spores, and prions by their resistance to sterilization and disinfection and explain why spores and prions require the most aggressive treatment. |
| Whiteboard, pathogen card set, Association for the Advancement of Medical Instrumentation (AAMI) ST79 standard (current edition), course textbook (e.g., Rutala & Weber CDC Guideline for Disinfection and Sterilization), projection display | 10-question multiple-choice quiz covering Spaulding classification and pathogen resistance hierarchy; pass mark 80%. |
| 2 | OSHA Standards and Personal Protective Equipment in Decontamination | 20.5 | theory | Students will identify OSHA bloodborne pathogen and hazard communication requirements that apply to the decontamination area and correctly don, doff, and dispose of required PPE. |
| OSHA Bloodborne Pathogen Standard (29 CFR 1910.1030), OSHA Hazard Communication Standard materials, sample SDS sheets, full decontamination PPE sets (gown, gloves, face shield, shoe covers), disposal containers | Skills checklist: student dons and doffs decontamination PPE in correct sequence without contaminating self; each of eight checklist steps must be performed correctly for a pass (100% on safety-critical steps, 90% overall). |
| 3 | Decontamination: Point-of-Use Treatment Through Manual and Ultrasonic Cleaning | 30.5 | lab | Students will perform point-of-use treatment, manual scrubbing with enzymatic detergent, and ultrasonic cleaning of soiled surgical instruments following AAMI ST79 guidelines. |
| Simulated soiled instruments, enzymatic detergent (per IFU), instrument brushes, decontamination sinks, ultrasonic cleaner, personal protective equipment, aluminum foil for cavitation test, decontamination log forms, AAMI ST79 | Instructor observes manual cleaning technique using a 12-step performance checklist; all safety-critical steps (PPE, covered transport, correct dilution) must be correct; overall pass mark 85%. |
| 4 | Inspection, Assembly, and Lubrication of Surgical Instruments | 24.5 | demo | Students will inspect cleaned instruments for cleanliness, corrosion, and function, reassemble multi-part instruments correctly, and apply water-soluble lubricant per manufacturer instructions for use. |
| Cleaned surgical instruments (various types including box-lock, laparoscopic components), lighted magnifying glass, instrument inspection log forms, water-soluble instrument lubricant (instrument milk), manufacturer IFU binders | Student completes inspection of a 20-instrument tray and correctly classifies each instrument; accuracy of pass/fail/repair decisions compared to instructor key must be 90% or higher. |
| 5 | Packaging Systems: Wraps, Pouches, Rigid Containers, and Shelf Life | 26.5 | demo | Students will select the appropriate packaging material for each instrument set, wrap trays using sequential (double) wrap technique, seal pouches correctly, and apply all required labeling elements. |
| SMS (spunbond-meltblown-spunbond) sterilization wrap, peel pouches (paper-plastic and Tyvek), rigid sterilization containers with filters, instrument trays, sterilization tape, pre-printed label templates, AAMI ST79, facility policy samples | Instructor evaluates one completed double-wrapped tray and one sealed peel pouch using a 10-point packaging checklist; no gaps, seal integrity, and complete label are mandatory; pass mark 90%. |
| 6 | Steam Sterilization: Principles, Cycles, and Loading | 30.5 | lab | Students will explain the mechanism of moist-heat sterilization, select the correct cycle (gravity, pre-vacuum, flash/immediate-use) for a given load, and load a tabletop steam sterilizer per AAMI ST79. |
| Tabletop gravity and pre-vacuum steam sterilizer, wrapped instrument sets, peel pouches, AAMI ST79, sterilizer loading reference cards, sterilizer cycle printouts, documentation forms | Student correctly loads a mixed steam sterilizer load (trays plus pouches) and verifies cycle selection; instructor uses a 10-item loading checklist; pass mark 90%, with all weight and position criteria met. |
| 7 | Monitoring Sterilization Efficacy: Mechanical, Chemical, and Biological Indicators | 30.5 | lab | Students will correctly place, read, and interpret mechanical, chemical, and biological indicators for steam sterilization cycles and follow the established protocol when a biological indicator returns a positive or equivocal result. |
| Biological indicator vials and incubator, Class 5 and 6 chemical integrators, mechanical printout samples from sterilizer, process challenge devices (Bowie-Dick test pack), sterilization log forms, recall protocol procedure card, AAMI ST79 | Students complete a written scenario-based exercise with three indicator interpretation cases (one passing, one chemical failure, one BI failure) and document correct actions for each; pass mark 80%. |
| 8 | Alternative Sterilization Methods: EO, Hydrogen Peroxide Plasma, and Dry Heat | 30.5 | theory | Students will compare ethylene oxide (EO), hydrogen peroxide gas plasma, and dry-heat sterilization with respect to mechanism, compatible materials, cycle parameters, and safety requirements. |
| Manufacturer IFU reference cards for EO sterilizer and H₂O₂ plasma sterilizer, OSHA EO standard reference, comparison matrix worksheet, AAMI ST79, course textbook | Completed comparison matrix and materials sorting exercise reviewed by instructor; matrix must be fully accurate; sorting exercise scored against answer key with pass mark 80%. |
| 9 | Disinfection Levels: High, Intermediate, and Low; Common Disinfecting Agents | 24.5 | theory | Students will match each level of disinfection to the Spaulding classification of the item being treated, identify commonly used disinfecting agents (glutaraldehyde, OPA, quaternary ammonium, accelerated hydrogen peroxide), and state required contact times. |
| CDC Guideline for Disinfection and Sterilization in Healthcare Facilities (current edition), sample disinfectant product labels (glutaraldehyde, OPA, QAC), MEC test strip samples, case study handout | 15-question quiz on disinfection levels, agent selection, and contact times; pass mark 80%. |
| 10 | Sterile Storage, Event-Related Sterility, and Sterile Transfer | 26.5 | practice | Students will apply event-related sterility principles to organize a sterile storage area correctly and demonstrate proper sterile transfer from storage to the surgical field without compromising package integrity. |
| Simulated sterile storage shelving, assorted sterile and intentionally compromised packages, sterile transfer demonstration area, wrapped trays and peel pouches, package integrity log form, AAMI ST79 | Student correctly identifies all compromised packages in the 15-item inspection set (100% identification of any item with a torn seal or moisture; overall pass mark 85%) and performs one sterile transfer without break in technique as judged by instructor checklist. |
| 11 | Documentation, Traceability, and Recall Procedures | 24.5 | practice | Students will complete sterilization cycle records with all required data elements, apply lot control numbering to packages, and execute a simulated instrument recall using facility-style traceability records. |
| Sterilization cycle log forms, lot control label stock, pre-seeded error log sheets, recall worksheet template, scenario cards, facility policy sample documents, pen | Recall simulation scored on completeness: all affected packages correctly identified, recall worksheet fully completed, notification memo written; pass mark 85% on combined documentation accuracy rubric. |
| 12 | Quality Assurance, Accreditation Standards, and Career Integration | 27.5 | field | Students will connect sterilization department quality assurance practices to accreditation requirements and NBSTSA CST exam content areas, and reflect on how sterile processing competence supports their role as a surgical technologist. |
| NBSTSA CST Examination Content Outline (current edition), accreditation standard excerpts, guest speaker preparation guide, alignment chart template, index cards for study cards | Completed accreditation alignment chart and NBSTSA content mapping study cards reviewed by instructor for accuracy and completeness; pass mark 80% on accuracy rubric. |
| Assessment | Type | Weight | Pass standard | Method & rubric |
|---|---|---|---|---|
| Sterilization Principles Knowledge Exam | Written exam | 25% | 75% correct (38 of 50 questions) | A 50-question multiple-choice exam covering microbiology foundations, Spaulding classification, sterilization modalities, disinfection levels, indicator types, documentation requirements, and recall procedures, mapped to NBSTSA CST content areas. Questions are written at application and analysis levels, mirroring the style of the credentialing exam. Standard met · Safety · Time · Quality/finish · Documentation |
| Sterilization Cycle Skills Demonstration | Skills demonstration | 45% | All safety-critical steps performed correctly; overall score 90% on the performance checklist (27 of 30 items) | The student independently processes a complete surgical instrument set from point-of-use treatment through manual cleaning, inspection, assembly, packaging with correct labeling, steam sterilizer loading, cycle selection, and indicator placement and interpretation. The instructor scores performance using a 30-item task-specific checklist; any breach of decontamination PPE protocol or sterilizer safety procedure results in an automatic retest. Standard met · Safety · Time · Quality/finish · Documentation |
| Sterilization Laboratory Log | Log | 15% | 85% of entries complete and accurate; zero entries missing indicator results or lot control numbers | Students submit a cumulative lab log containing completed decontamination records, packaging inspection logs, sterilization cycle logs, indicator reading documentation, and the simulated recall worksheet from all lab and practice lessons throughout the course. Entries are evaluated for completeness, accuracy, correct use of required data elements, and professional legibility. Standard met · Safety · Time · Quality/finish · Documentation |
| Decontamination and PPE Safety Check | Safety audit | 15% | 100% on all eight safety-critical items; no safety-critical step may be missed or performed incorrectly | A direct observation safety check in which the student enters the decontamination area, dons full PPE in correct sequence, processes a soiled instrument (point-of-use treatment through manual scrub), safely removes and disposes of PPE, and performs hand hygiene. The eight safety-critical items (impervious gown, face shield, puncture-resistant gloves, covered transport, correct detergent dilution, hands-free instrument passing, doffing order, hand hygiene) must each be performed without error; a single critical error requires immediate remediation and retest. Standard met · Safety · Time · Quality/finish · Documentation |
HLT-SURG65-06 Trade course
OR Clinicals: Scrub Role Practice in the Surgical Suite
321 hr · $5,545 COMPLIMENTARY
Students apply aseptic technique, instrumentation knowledge, and specialty procedure skills in simulated and supervised operating room environments, performing the full scrub role from patient setup through case breakdown. Lessons progress from room preparation and draping through specialty-specific scrub sequences, culminating in timed, assessed case simulations that mirror real OR expectations and NBSTSA CST competency areas.
Outcomes- Set up a sterile back table and Mayo stand correctly for at least three surgical specialties, maintaining aseptic technique throughout.
- Pass instrumentation, retractors, and supplies to the surgeon using correct technique and anticipatory sequencing without prompting.
- Perform accurate soft, sharp, and instrument counts with the circulator at all required count intervals, reconciling any discrepancy before wound closure.
- Don sterile gown and gloves using closed-glove technique and assist team members with gowning and gloving without contaminating the sterile field.
- Identify and respond to sterile field breaks, environmental hazards, and specimen-handling errors within the scope of the scrub surgical technologist role.
- Complete full case documentation including count records, implant logs, and specimen labels to program-standard accuracy.
Course text
Students apply aseptic technique, instrumentation knowledge, and specialty procedure skills in simulated and supervised operating room environments, performing the full scrub role from patient setup through case breakdown. Lessons progress from room preparation and draping through specialty-specific scrub sequences, culminating in timed, assessed case simulations that mirror real OR expectations and NBSTSA CST competency areas.
How the course runs. 12 blocks: OR Suite Orientation and Traffic Patterns; Surgical Attire, Hand Antisepsis, and Gowning/Gloving; Back Table and Mayo Stand Setup; Surgical Counts: Soft Goods, Sharps, and Instruments; Passing Technique and Surgeon Anticipation; Draping Techniques for Common Surgical Positions; Electrosurgery, Hemostasis Devices, and Energy Sources; Specimen Handling, Labeling, and Chain of Custody; General Surgery Scrub Role Simulation; OB/GYN and Urology Scrub Sequences; Orthopedic and Neurosurgery Scrub Sequences; Full Case Simulations and Clinical Readiness Assessment.
What competent looks like. Set up a sterile back table and Mayo stand correctly for at least three surgical specialties, maintaining aseptic technique throughout. Pass instrumentation, retractors, and supplies to the surgeon using correct technique and anticipatory sequencing without prompting. Perform accurate soft, sharp, and instrument counts with the circulator at all required count intervals, reconciling any discrepancy before wound closure. Don sterile gown and gloves using closed-glove technique and assist team members with gowning and gloving without contaminating the sterile field. Identify and respond to sterile field breaks, environmental hazards, and specimen-handling errors within the scope of the scrub surgical technologist role. Complete full case documentation including count records, implant logs, and specimen labels to program-standard accuracy.
| # | Lesson | Hr | Type | Objective | Activities | Materials | Check |
|---|---|---|---|---|---|---|---|
| 1 | OR Suite Orientation and Traffic Patterns | 20 | theory | Students describe the three zones of the OR suite, explain restricted-area protocols, and state the rationale for each traffic and attire rule. |
| OR suite floor-plan handouts, AORN Guidelines for Perioperative Practice (current edition), scrub attire and cover gown samples, program simulated OR suite | Students correctly label all three zones and list at least four attire or traffic rules with rationale on a 20-item diagram quiz; pass mark 80%. |
| 2 | Surgical Attire, Hand Antisepsis, and Gowning/Gloving | 28 | demo | Students perform a surgical hand scrub or waterless handrub and don a sterile gown and gloves using closed-glove technique without contaminating the sterile field. |
| Sterile gown packs, sterile glove sets in multiple sizes, surgical scrub brushes, CHG-based scrub solution, alcohol-based hand antiseptic, scrub sink, peer-assessment checklist, video camera or tablet for playback | Instructor evaluates each student's closed-glove technique on a pass/fail skills checklist; zero critical errors (touching outer glove surface or unsterile area) required to pass; students with errors repeat until no critical errors in two consecutive attempts. |
| 3 | Back Table and Mayo Stand Setup | 30 | lab | Students open sterile supplies using aseptic technique, arrange a back table and Mayo stand for a general surgical case within a set time limit, and maintain sterile field integrity throughout. |
| General surgery instrument set, sterile back table drapes, Mayo stand covers, basin set, sterile saline, electrosurgical pencil, suture assortment, case-card deck, photographic layout reference, stopwatch | Instructor scores setup on a 30-point standardized checklist (correct item placement, no sterile field breaks, completion within time limit); pass mark 24/30 with zero critical sterile field violations. |
| 4 | Surgical Counts: Soft Goods, Sharps, and Instruments | 24 | lab | Students perform initial, closing, and final surgical counts in the scrub role, reconcile a deliberate discrepancy, and document count results on a count record accurately. |
| Laparotomy sponges (x-ray detectable), 4x4 gauze, sharps containers, suture needles, instrument set, program count record forms, AORN count guideline reference sheet, mock surgical field (table with drape) | Students correctly identify the seeded discrepancy in 100% of attempts and complete the count record with no omissions; pass requires correct discrepancy identification and a fully completed, accurate count record in two consecutive simulated cases. |
| 5 | Passing Technique and Surgeon Anticipation | 28 | demo | Students pass instruments, suture, and supplies to a simulated surgeon using correct hand position, grip, and sequencing without prompting during a simulated case sequence. |
| General surgery instrument set, loaded needle holders with suture, irrigation syringes, passing rubric, laminated case-step cards (appendectomy and hernia repair), Mayo stand, safety scalpel handles and blades | Instructor evaluates a timed 10-step passing sequence using a rubric; students must score 8/10 correct passes with zero unsafe sharp-passing events; unsafe events require immediate remediation and retest. |
| 6 | Draping Techniques for Common Surgical Positions | 24 | lab | Students apply sterile drapes to a mannequin patient in supine, lithotomy, and lateral positions, maintaining sterile field integrity and correct drape orientation throughout. |
| Adult mannequin on an OR table, laparotomy drape set, lithotomy drape set, split-sheet drapes, towel clamps, contamination-detection checklist, draping log template | Instructor evaluates one full draping sequence per position on a pass/fail checklist; zero contamination events and correct orientation required for each; students failing any position repeat that position before progressing. |
| 7 | Electrosurgery, Hemostasis Devices, and Energy Sources | 20 | theory | Students explain how monopolar and bipolar electrosurgery work, identify the safety responsibilities of the scrub role, and state correct handling procedures for common energy-based devices encountered in the OR. |
| Electrosurgical unit (unpowered for handling), monopolar pencil, bipolar forceps, ultrasonic shears (unpowered), AORN Guideline for Electrosurgery, case-study handouts, device-labeling diagram worksheet | Students answer a 15-question quiz covering mechanism, fire risk, and scrub responsibilities; pass mark 80%; questions requiring identification of unsafe actions must all be answered correctly. |
| 8 | Specimen Handling, Labeling, and Chain of Custody | 18 | lab | Students receive a surgical specimen from a simulated surgeon, verify verbal orders, label the specimen container correctly, and complete a specimen requisition without errors. |
| Simulated specimen containers (labeled with contents for training), formalin-safe practice containers, specimen requisition forms, case-card deck, specimen-labeling policy reference, peer-review checklist | Each student's six requisition forms are scored by the instructor; pass requires 100% accuracy on site, laterality, and fixative fields across all six specimens; any error on laterality is an automatic retest. |
| 9 | General Surgery Scrub Role Simulation | 35 | practice | Students perform the complete scrub role from room setup through case breakdown for a simulated appendectomy and a simulated open inguinal hernia repair, meeting time and quality benchmarks. |
| General surgery instrument sets (appendectomy and hernia), OR table, full drape set, suture assortment, electrosurgical pencil, irrigation supplies, specimen containers, count record forms, case-performance rubric, stopwatch | Instructor scores each case on a 50-point case-performance rubric covering setup, sterile technique, passing, counts, and breakdown; pass mark 40/50 with zero critical sterile field violations and zero unsafe sharp events. |
| 10 | OB/GYN and Urology Scrub Sequences | 30 | practice | Students correctly set up and scrub for a simulated cesarean section and a simulated cystoscopy, adapting instrument and supply selection to each specialty's specific requirements. |
| OB instrument set including bulb syringe and neonatal items, cystoscopy tower (cart only, no power for practice), flexible scope trainer model, lithotomy drape set, cesarean drape set, specialty procedure reference binder, setup checklist template, reflective log form | Instructor verifies each setup checklist against the reference standard before the case begins; students must achieve 90% item accuracy on each checklist and demonstrate correct draping for the assigned position with no contamination events. |
| 11 | Orthopedic and Neurosurgery Scrub Sequences | 32 | practice | Students set up and scrub for a simulated open knee procedure and a simulated craniotomy, correctly handling power equipment, implants, and specialty positioning adjuncts within the scrub role. |
| Orthopedic instrument set with simulated implant trays, craniotomy instrument set including self-retaining retractor system, orthopedic power tool replicas (non-powered training models), implant log forms, count record forms, positioning device reference guide | Instructor evaluates implant log and count record accuracy (100% required on all lot-number and laterality fields) and scores setup completeness on a specialty checklist; pass mark 85% on the checklist with no critical sterile field violations. |
| 12 | Full Case Simulations and Clinical Readiness Assessment | 32 | practice | Students independently perform two full simulated cases assigned at random from the specialties covered in the course, meeting all time, quality, and documentation benchmarks without coaching. |
| Random case-card deck covering all six specialties studied, full instrument sets for each specialty, OR table, drape sets, suture and supply assortment, count record and specimen requisition forms, implant log forms, clinical-readiness observation form, student self-assessment form | Instructor scores both cases on the 50-point case-performance rubric; student must average 40/50 across both cases with no critical sterile field violations and no unsafe sharp events on either case; students not meeting the standard receive targeted remediation and one retest opportunity. |
| Assessment | Type | Weight | Pass standard | Method & rubric |
|---|---|---|---|---|
| OR Clinicals Written Examination | Written exam | 25% | 80% or higher on a 60-question exam | A proctored written examination covering OR suite zones and traffic protocols, electrosurgery safety, specimen handling and chain of custody, count policy and discrepancy response, and the scrub-role responsibilities for each specialty covered in the course. Questions are multiple-choice and short-answer, mapped to NBSTSA CST exam content areas including basic science, instrumentation, and the intraoperative phase. Standard met · Safety · Time · Quality/finish · Documentation |
| Scrub Role Skills Demonstration | Skills demonstration | 45% | 40/50 on the case-performance rubric with zero critical sterile field violations and zero unsafe sharp-passing events | The instructor assigns one case from a pool covering the six specialties studied; the student performs the complete scrub role from surgical scrub through case breakdown without coaching, evaluated on a 50-point rubric covering aseptic technique, setup accuracy, passing technique, counts, specimen handling, and documentation. This demonstration directly maps to the NBSTSA CST competency domain for intraoperative care and scrub-role performance. Standard met · Safety · Time · Quality/finish · Documentation |
| Clinical Lab Log | Log | 15% | Complete and accurate entries for all 12 lessons with no missing required fields; instructor-rated satisfactory on narrative reflection entries | Students maintain a cumulative lab log throughout the course documenting each simulation or practice session, including the case performed, instruments used, count outcomes, specimen handling actions, any sterile field events and corrective actions taken, and a brief reflection on performance. The log is reviewed by the instructor at three checkpoints and submitted in full at course end; it serves as a professional practice record and preparation for the externship practicum. Standard met · Safety · Time · Quality/finish · Documentation |
| Sterile Field and Sharps Safety Check | Safety audit | 15% | Zero critical violations across a live 30-minute observed scrub sequence; any critical violation results in an automatic fail and mandatory remediation before progression | An instructor conducts a targeted safety observation during one of the full case simulations in Lesson 12, using a standardized safety checklist that focuses specifically on sterile field maintenance, correct sharp-passing and sharps-disposal protocol, specimen-labeling accuracy, and response to a deliberately introduced sterile field break. This check maps to the NBSTSA CST safety and aseptic technique domains and serves as a gate to progression into the Clinical Practicum. Standard met · Safety · Time · Quality/finish · Documentation |
HLT-SURG65-07 Capstone
Surgical Technology Capstone Project
324 hr · $3,240 COMPLIMENTARY
Students integrate all prior coursework by designing, executing, and defending a comprehensive surgical case study that demonstrates mastery of aseptic technique, instrumentation, surgical procedures, sterilization, and perioperative patient safety. Each student produces a full surgical case packet—including instrument count sheets, sterile field setup plans, and a written surgical procedure analysis—then presents and defends their work before a faculty panel. Successful completion verifies readiness for the clinical practicum and the NBSTSA CST credentialing examination.
Outcomes- Construct a complete surgical case packet for an assigned specialty procedure, including correct instrument selection, count documentation, and sterile field setup plan, with no critical safety errors.
- Apply aseptic technique principles and sterilization standards to a simulated OR scenario, identifying and correcting at least three intentional breaks in sterile technique introduced by the evaluator.
- Analyze a perioperative patient safety event using a root-cause framework and propose evidence-based corrective actions in a written report of at least 1,500 words.
- Demonstrate proper intraoperative scrub role performance—gowning, gloving, instrument passing, and count reconciliation—during a full-length simulated surgical procedure in the skills lab.
- Produce a professional capstone portfolio that organizes case documentation, competency records, and a reflective self-assessment aligned to NBSTSA CST exam domain areas.
- Defend all capstone deliverables orally before a faculty panel, accurately answering questions drawn from the four NBSTSA CST exam content areas within the allotted time.
Course text
Students integrate all prior coursework by designing, executing, and defending a comprehensive surgical case study that demonstrates mastery of aseptic technique, instrumentation, surgical procedures, sterilization, and perioperative patient safety. Each student produces a full surgical case packet—including instrument count sheets, sterile field setup plans, and a written surgical procedure analysis—then presents and defends their work before a faculty panel. Successful completion verifies readiness for the clinical practicum and the NBSTSA CST credentialing examination.
How the course runs. 4 blocks: Case Selection, Research, and Surgical Case Packet Development; Simulated OR Setup and Sterile Field Competency Lab; Patient Safety Event Analysis and Capstone Portfolio Assembly; Capstone Defense: Oral Presentation and Panel Examination.
What competent looks like. Construct a complete surgical case packet for an assigned specialty procedure, including correct instrument selection, count documentation, and sterile field setup plan, with no critical safety errors. Apply aseptic technique principles and sterilization standards to a simulated OR scenario, identifying and correcting at least three intentional breaks in sterile technique introduced by the evaluator. Analyze a perioperative patient safety event using a root-cause framework and propose evidence-based corrective actions in a written report of at least 1,500 words. Demonstrate proper intraoperative scrub role performance—gowning, gloving, instrument passing, and count reconciliation—during a full-length simulated surgical procedure in the skills lab. Produce a professional capstone portfolio that organizes case documentation, competency records, and a reflective self-assessment aligned to NBSTSA CST exam domain areas. Defend all capstone deliverables orally before a faculty panel, accurately answering questions drawn from the four NBSTSA CST exam content areas within the allotted time.
| # | Lesson | Hr | Type | Objective | Activities | Materials | Check |
|---|---|---|---|---|---|---|---|
| 1 | Case Selection, Research, and Surgical Case Packet Development | 80 | theory | The student selects an assigned surgical specialty procedure and produces a fully documented surgical case packet—including procedure overview, patient positioning, equipment and supply list, instrument count sheet, and step-by-step scrub role responsibilities—with all entries accurate and free of critical omissions. |
| AST Core Curriculum for Surgical Technology (current edition), facility-style count sheets and preference card templates, anatomical atlases, word processing software, faculty-supplied case packet rubric, printer for hard-copy submission | Faculty scores the completed surgical case packet using the rubric; all critical safety items (count sheet accuracy, aseptic setup steps, correct instrument identification) must be marked correct; a score of 80% or higher overall is required to advance, with any critical safety error requiring revision before progression. |
| 2 | Simulated OR Setup and Sterile Field Competency Lab | 90 | lab | The student sets up a complete sterile field for their assigned procedure in the skills lab OR suite—including draping, instrument arrangement, gowning and gloving, and initial count—and correctly identifies and reports a minimum of three evaluator-introduced breaks in sterile technique during a timed observation period. |
| Skills lab OR suite with OR table, Mayo stand, back table, overhead lights; sterile gown and glove sets; drape sets; standard instrument sets appropriate to assigned specialty (e.g., basic laparotomy set, orthopedic set); task trainers or anatomical models; faculty sterile-technique observation checklist; standardized count sheets; stopwatch | Faculty uses the standardized observation checklist; student must complete the sterile setup with zero unresolved critical aseptic breaks (any break the student fails to self-identify or correct is counted against them), identify at least three of five planted breaks, and achieve a score of 80% or higher on the checklist; a failed critical item (e.g., unresolved contamination of sterile field) requires a repeat station before portfolio submission. |
| 3 | Patient Safety Event Analysis and Capstone Portfolio Assembly | 84 | practice | The student analyzes a provided perioperative patient safety scenario using a structured root-cause approach, submits a written report of at least 1,500 words with evidence-based recommendations, and assembles a complete capstone portfolio that organizes all course deliverables against NBSTSA CST exam content domains. |
| Faculty-supplied patient safety scenario packet, fishbone diagram template, word processing and presentation software, AST Standards of Practice (current edition), AORN Guidelines for Perioperative Practice (current edition or library access), The Joint Commission online sentinel event resources (publicly available), portfolio binder or approved digital platform, program portfolio organization guide, NBSTSA CST Candidate Handbook (publicly available from NBSTSA) | Faculty scores the written safety report on a rubric requiring: minimum 1,500 words, correct root-cause framework application, at least three credible references, and actionable recommendations—a score of 80% or higher is required; the portfolio is checked against a completeness checklist and must contain all required sections with correct domain labeling before the student is cleared for the oral defense. |
| 4 | Capstone Defense: Oral Presentation and Panel Examination | 70 | field | The student presents their surgical case packet and patient safety report to a faculty panel in a structured oral defense, accurately answering panel questions drawn from all four NBSTSA CST exam content domains within the allotted time and at a level that demonstrates readiness for the CST credentialing examination. |
| Capstone portfolio (student's completed binder or digital file), faculty defense rubric aligned to NBSTSA CST exam content domains, standardized question bank drawn from all four CST domains (faculty-developed), NBSTSA CST Candidate Handbook, timer, conference room or simulated professional setting, student self-evaluation form | Faculty panel scores the presentation and Q&A using the defense rubric; the student must score 80% or higher overall, with no domain scoring below 70%, to pass the capstone; a failing domain score requires a targeted remediation session and a second oral examination limited to the deficient domain within two weeks; full pass is required before advancing to the Clinical Practicum. |
| Assessment | Type | Weight | Pass standard | Method & rubric |
|---|---|---|---|---|
| Surgical Case Packet and Simulated OR Performance Project | Project | 60% | 80% or higher on the combined case packet rubric and OR lab observation checklist, with zero unresolved critical aseptic or count-accuracy errors | Students submit a complete surgical case packet for their assigned procedure and complete the full simulated OR setup and procedure run-through; faculty evaluate instrument accuracy, count documentation, aseptic technique, and break-in-sterility identification using standardized rubrics tied to NBSTSA CST perioperative care and specialty surgery domains. Meets specification · Within estimate · Workmanship · Safety · Documentation |
| Capstone Portfolio | Portfolio | 20% | All required sections present and correctly labeled (completeness checklist 100% complete); written patient safety report scores 80% or higher on the content rubric | The portfolio collects all major capstone deliverables—case packet, count sheets, setup documentation, patient safety root-cause report, competency checklists, and a reflective self-assessment—organized by NBSTSA CST exam content domain; it serves as the primary evidence record of integrated program competency and is reviewed by faculty prior to the oral defense. Completeness · Organization · Evidence quality |
| Capstone Oral Defense | Oral / panel | 20% | 80% or higher overall on the defense rubric, with no individual NBSTSA CST exam content domain scoring below 70%; any domain below 70% requires targeted remediation and a second oral examination in that domain | The student presents their case and safety analysis to a faculty panel and answers questions drawn from all four NBSTSA CST exam content domains in a 30-minute structured defense; scores reflect accuracy, integration of program content, professional communication, and demonstrated readiness for both the clinical practicum and the CST credentialing examination. Explains decisions · Answers technical questions · Professional communication |
HLT-SURG65-08 Externship / clinical
Clinical Practicum: Supervised Surgical Technology Externship
486 hr · $1,945 COMPLIMENTARY
Students complete 486 supervised hours in a credentialed operating room setting, functioning as a scrub surgical technologist under the direct supervision of a qualified preceptor. Learners apply aseptic technique, instrumentation, surgical specialty knowledge, and sterilization practice in live perioperative cases across multiple surgical specialties. Performance is formally evaluated by the clinical site preceptor and correlates directly to the competency domains assessed on the NBSTSA CST examination.
Outcomes- Perform the complete scrub role—including sterile field setup, gowning and gloving, instrument passing, and field maintenance—without break in aseptic technique across a minimum of 120 documented surgical cases.
- Demonstrate correct anticipation and handling of instruments, supplies, and equipment for at least four surgical specialties encountered during the externship, consistent with NBSTSA CST competency domains.
- Execute accurate sponge, sharp, and instrument counts in compliance with facility policy and AORN recommended practices on every assigned case.
- Communicate effectively with the surgical team—surgeon, circulator, and anesthesia provider—using correct anatomical and procedural terminology appropriate to each case.
- Identify and respond to intraoperative emergencies (specimen handling errors, break in sterile field, retained item risk) by applying established protocols within the student scope of practice.
- Receive a satisfactory or above rating on the preceptor clinical evaluation instrument for all required competency categories by the end of the 486-hour externship.
Course text
Students complete 486 supervised hours in a credentialed operating room setting, functioning as a scrub surgical technologist under the direct supervision of a qualified preceptor. Learners apply aseptic technique, instrumentation, surgical specialty knowledge, and sterilization practice in live perioperative cases across multiple surgical specialties. Performance is formally evaluated by the clinical site preceptor and correlates directly to the competency domains assessed on the NBSTSA CST examination.
How the course runs. 4 blocks: Orientation, Site Integration, and Perioperative Role Expectations; Scrub Role in General and Abdominal Surgery Cases; Scrub Role Across Surgical Specialties; Preceptor Final Evaluation, Clinical Log Completion, and Exit Conference.
What competent looks like. Perform the complete scrub role—including sterile field setup, gowning and gloving, instrument passing, and field maintenance—without break in aseptic technique across a minimum of 120 documented surgical cases. Demonstrate correct anticipation and handling of instruments, supplies, and equipment for at least four surgical specialties encountered during the externship, consistent with NBSTSA CST competency domains. Execute accurate sponge, sharp, and instrument counts in compliance with facility policy and AORN recommended practices on every assigned case. Communicate effectively with the surgical team—surgeon, circulator, and anesthesia provider—using correct anatomical and procedural terminology appropriate to each case. Identify and respond to intraoperative emergencies (specimen handling errors, break in sterile field, retained item risk) by applying established protocols within the student scope of practice. Receive a satisfactory or above rating on the preceptor clinical evaluation instrument for all required competency categories by the end of the 486-hour externship.
| # | Lesson | Hr | Type | Objective | Activities | Materials | Check |
|---|---|---|---|---|---|---|---|
| 1 | Orientation, Site Integration, and Perioperative Role Expectations | 40 | field | The student will complete clinical site orientation and demonstrate compliance with facility policies, dress code, infection control standards, and the supervised scrub role before participating in any surgical case. |
| Facility orientation packet, program clinical handbook, personal protective equipment per site policy, sterile gown and glove supplies, clinical log forms, AORN Perioperative Standards and Recommended Practices (current edition) | Preceptor signs off on the orientation checklist confirming 100% completion of all required facility modules; sterile gown-and-glove demonstration is rated satisfactory (no break in technique) before the student proceeds to case participation. |
| 2 | Scrub Role in General and Abdominal Surgery Cases | 130 | field | The student will independently perform the full scrub role—including back table setup, sterile field maintenance, instrument anticipation and passing, and closing counts—in general and abdominal surgery cases under preceptor supervision. |
| OR-issued sterile supplies and instrument sets, facility preference cards, Mayo stand and back table drapes, laparoscopic equipment stack (camera, insufflator, light source), specimen containers and labels, program clinical case log, case evaluation rubric | Preceptor rates the student at satisfactory or above on each case evaluation rubric dimension (aseptic technique, instrument management, count accuracy, team communication); a minimum of 30 general/abdominal cases must be logged with no unsatisfactory ratings by the end of this lesson block. |
| 3 | Scrub Role Across Surgical Specialties | 270 | field | The student will demonstrate competent scrub performance across a minimum of four additional surgical specialties—including orthopedic, obstetric/gynecologic, genitourinary, and one elective specialty available at the site—achieving satisfactory preceptor ratings on specialty-specific instrumentation and technique requirements. |
| Specialty instrument sets and implant systems available at the site, power equipment, robotic or laparoscopic towers as applicable, program instrumentation reference guide, NBSTSA CST Candidate Handbook (current edition), clinical case log, specialty case evaluation rubrics | Student accumulates a minimum of 90 specialty cases (combined across all specialties) with satisfactory or above ratings on all case evaluation rubric dimensions; the preceptor verifies breadth by signing the specialty coverage section of the clinical log confirming cases in at least four distinct specialty services. |
| 4 | Preceptor Final Evaluation, Clinical Log Completion, and Exit Conference | 46 | field | The student will compile a complete, accurate clinical case log documenting all 486 externship hours, participate in the preceptor's formal summative evaluation, and engage in an exit conference that identifies professional strengths and development priorities relative to NBSTSA CST exam readiness. |
| Completed clinical case log (all pages), Clinical Performance Evaluation instrument, program clinical handbook grading rubric, NBSTSA CST Candidate Handbook (current edition), any remediation documentation as needed | Clinical case log is verified complete with 486 hours and a minimum of 120 documented cases with preceptor initials; Clinical Performance Evaluation instrument shows satisfactory or above on every competency domain, or a written remediation plan is in place for any domain rated below satisfactory before the course grade is awarded. |
| Assessment | Type | Weight | Pass standard | Method & rubric |
|---|---|---|---|---|
| Preceptor Clinical Performance Evaluation | Clinical evaluation | 70% | Satisfactory or above rating on all competency domains of the Clinical Performance Evaluation instrument, with no domain left as unsatisfactory without an approved remediation plan at exit conference. | The site preceptor completes the program's standardized Clinical Performance Evaluation instrument at the conclusion of the 486-hour externship, scoring the student across six competency domains: aseptic technique and sterile field maintenance, instrumentation and equipment management, count accuracy and retained item prevention, surgical team communication, professionalism and conduct, and response to intraoperative events. Scores are drawn from documented observations across the full case series and reviewed in a three-way exit conference with the student and the program clinical coordinator; this evaluation constitutes the primary summative measure of clinical competence for the course and maps to all major NBSTSA CST examination content areas. Competency · Safety · Attendance · Conduct · Initiative |
| Clinical Case Log | Log | 30% | 486 verified externship hours documented, minimum 120 completed surgical cases across at least four surgical specialties, all entries initialed by preceptor, and clinical coordinator sign-off confirming accuracy. | The student maintains a contemporaneous clinical case log throughout all 486 externship hours, recording for each case the date, facility, procedure name, surgical specialty, primary role performed (scrub), count outcome, any intraoperative events, and the preceptor's initials as verification. The log is audited by the program clinical coordinator at the end of the externship for completeness, accuracy, and required case volume and specialty breadth; a log that meets all requirements serves as the official record of externship completion and supports the student's eligibility to apply for the NBSTSA CST examination. Complete · Verified |
HLT-SURG65-09 Exam prep
Certification Exam Preparation: NBSTSA CST
135 hr · $1,350 COMPLIMENTARY
This course systematically reviews every content domain tested on the NBSTSA Certified Surgical Technologist (CST) examination, using spaced repetition, case-based questions, and timed full-length mock exams to build both knowledge accuracy and test-taking stamina. Students identify personal weak areas through diagnostic practice, receive targeted instruction on high-yield topics such as aseptic technique, instrumentation, anatomy, and surgical procedures by specialty, and finish the course having completed multiple simulated exam experiences under realistic conditions.
Outcomes- Correctly answer practice questions across all NBSTSA CST content domains at a rate consistent with passing-level performance on the credentialing examination.
- Analyze personal diagnostic data to identify weak content areas and apply a structured self-study plan to close knowledge gaps before the credentialing exam.
- Apply disciplined test-taking strategies—including question parsing, elimination of distractors, and time management—across a 200-question timed simulation without exceeding per-question time limits.
- Explain the role, portability, and maintenance requirements of the CST credential, including the continuing education obligations required for recertification.
- Accurately recall and apply the principles of aseptic technique, sterilization, surgical pharmacology, and patient safety that are most heavily weighted on the CST exam.
- Demonstrate professional readiness by completing at least two full-length mock exams under proctored, timed conditions and meeting the program's minimum passing benchmark on the final mock.
Course text
This course systematically reviews every content domain tested on the NBSTSA Certified Surgical Technologist (CST) examination, using spaced repetition, case-based questions, and timed full-length mock exams to build both knowledge accuracy and test-taking stamina. Students identify personal weak areas through diagnostic practice, receive targeted instruction on high-yield topics such as aseptic technique, instrumentation, anatomy, and surgical procedures by specialty, and finish the course having completed multiple simulated exam experiences under realistic conditions.
How the course runs. 4 blocks: CST Exam Blueprint, Credential Pathway, and Diagnostic Baseline; Targeted Domain Review — Perioperative Care, Aseptic Technique, Sterilization, and Patient Safety; Targeted Domain Review — Surgical Procedures by Specialty, Instrumentation, Pharmacology, and Anesthesia; Full-Length Proctored Mock Examinations and Final Readiness Conference.
What competent looks like. Correctly answer practice questions across all NBSTSA CST content domains at a rate consistent with passing-level performance on the credentialing examination. Analyze personal diagnostic data to identify weak content areas and apply a structured self-study plan to close knowledge gaps before the credentialing exam. Apply disciplined test-taking strategies—including question parsing, elimination of distractors, and time management—across a 200-question timed simulation without exceeding per-question time limits. Explain the role, portability, and maintenance requirements of the CST credential, including the continuing education obligations required for recertification. Accurately recall and apply the principles of aseptic technique, sterilization, surgical pharmacology, and patient safety that are most heavily weighted on the CST exam. Demonstrate professional readiness by completing at least two full-length mock exams under proctored, timed conditions and meeting the program's minimum passing benchmark on the final mock.
| # | Lesson | Hr | Type | Objective | Activities | Materials | Check |
|---|---|---|---|---|---|---|---|
| 1 | CST Exam Blueprint, Credential Pathway, and Diagnostic Baseline | 15 | theory | Students will describe the structure, content domains, and administrative requirements of the NBSTSA CST examination and establish a personal performance baseline by completing a full-length diagnostic practice exam. |
| NBSTSA CST Examination Content Outline (current edition, downloaded from nbstsa.org); Association of Surgical Technologists Core Curriculum for Surgical Technology (current edition); approved online CST practice-exam platform with domain scoring; gap-analysis worksheet (program-provided); printed exam-application checklist from NBSTSA | Student completes the diagnostic exam and produces a completed gap-analysis worksheet with at least three specific domains ranked by priority for remediation; instructor reviews worksheets for accuracy of self-assessment — pass requires submission of a complete, plausible gap plan |
| 2 | Targeted Domain Review — Perioperative Care, Aseptic Technique, Sterilization, and Patient Safety | 45 | practice | Students will answer practice questions and explain rationales across the highest-weight CST exam domains covering basic science foundations, aseptic technique principles, sterilization and disinfection, and patient care and safety. |
| AST Core Curriculum for Surgical Technology (current edition); program-approved CST question bank (minimum 1,500 questions); AST Standards of Practice (current edition); sterilization reference charts from courses 2 and 5; instructor-prepared OR scenario cards; flashcard platform or physical index cards | Student achieves 75% or higher on each domain-focused quiz before the domain is considered complete; students scoring below 75% on a given domain complete an additional instructor-assigned 20-question remediation set and must score 75% or higher on that set — instructor reviews all written rationales weekly |
| 3 | Targeted Domain Review — Surgical Procedures by Specialty, Instrumentation, Pharmacology, and Anesthesia | 45 | practice | Students will correctly identify surgical instruments, describe the scrub role during procedures across all major surgical specialties, and answer practice questions on surgical pharmacology and anesthesia concepts as tested on the CST exam. |
| Program instrument sets and sterile-field drug reference cards; AST Core Curriculum for Surgical Technology (current edition); approved CST question bank; specialty-procedure reference sheets from course 4; instructor-prepared pharmacology scope-of-practice summary; stopwatch or timer | Students must correctly identify 90% of instruments in two consecutive timed drills and score 75% or higher on each specialty case-question set; any set below 75% requires one remediation set before moving to the next specialty — updated gap-analysis worksheet reviewed by instructor at end of lesson |
| 4 | Full-Length Proctored Mock Examinations and Final Readiness Conference | 30 | lab | Students will complete two full-length, timed, proctored mock CST examinations under conditions that replicate the credentialing exam environment and participate in a structured readiness conference to finalize their exam-day plan. |
| Program-approved full-length CST mock exam sets (200 questions each, domain-balanced to NBSTSA blueprint); proctored testing room free of distractions; domain score report printouts; written reflection template (program-provided); NBSTSA candidate handbook (current edition) for exam-day logistics reference | Students must score 75% or higher on Mock Exam 2 to meet the program's exam-readiness benchmark; students scoring below 75% on Mock Exam 2 complete an additional instructor-directed remediation plan and a third mock exam before program completion — both mock exam scores and the readiness conference are documented in the student file |
| Assessment | Type | Weight | Pass standard | Method & rubric |
|---|---|---|---|---|
| Final Proctored CST Mock Certification Examination | Mock certification exam | 100% | 75% overall score (150 of 200 questions correct) on the second full-length proctored mock exam, with no single NBSTSA content domain scoring below 60%; students not meeting this standard complete a documented remediation plan and sit a third mock exam before program completion | A 200-question multiple-choice examination administered under proctored, timed conditions that replicate the NBSTSA CST credentialing exam in format, domain weighting, and time constraints, serving as the program's summative measure of student readiness to sit the national credential examination. Results are reviewed in a one-on-one instructor readiness conference, and the score, conference notes, and any remediation plan are retained in the student's permanent program file. Score · Time management |
Program completion
External credential: NBSTSA CST
Students prepare to sit the Certified Surgical Technologist (CST) examination administered by the National Board of Surgical Technology and Surgical Assisting (NBSTSA). Passing this national exam awards the CST credential, which is recognized by employers across the United States. Pass standard: Credential issued by the body.
Back to Surgical Technology · How the school gets authority to award these credentials
