Surgical Procedures Clinical I

Course Description

Surgical Procedures Clinical I is an introduction as a surgical technologist by practicing learned skills and acquiring additional skills in clinical affiliate facility's operating rooms in various surgical specialties and procedures.

Within the SCNS taxonomy, STS is the Surgical Technology prefix, the L suffix marks this as a clinical or laboratory course, and the 0000-level number marks it as PSAV clock-hour instruction. Daytona State publishes it at 192 clock hours, offered fall, with STS0003, STS0120 and STS0155 as corequisites. ⚠ It carries no college credit.

This is the first of three clinical rotations totalling 723 hours — nearly three fifths of the STS-prefix programme. It is the first time you scrub on a living person, and the transition from the mock operating room is substantial: the room is faster, louder, and less forgiving than the laboratory, and everything takes longer than you expect. The purpose of this first rotation is orientation and the beginning of your case log, not mastery.

Learning Outcomes

Required Outcomes

• Function safely and professionally within an operating room team.
• Apply sterile technique reliably in a live clinical environment.
• Perform the surgical scrub, gowning, and gloving in clinical conditions.
• Set up a back table and Mayo stand for real procedures.
• Assist with patient positioning, preparation, and draping.
• Function in the scrub role under direct supervision.
• Pass instruments accurately during live procedures.
• Anticipate the surgeon's needs with increasing reliability.
• Participate accurately in surgical counts.
• Handle sharps safely using the neutral zone technique.
• Handle and label specimens correctly.
• Participate in the surgical safety checklist and time-out.
• Communicate clearly and appropriately with the surgical team.
• Apply HIPAA and patient confidentiality requirements without exception.
• Break down cases and manage contaminated instruments and waste.
• Assist with room turnover efficiently.
• Identify instruments and supplies used in the specialties observed.
• Recognise and report breaks in sterile technique, including your own.
• Apply standard precautions and personal protective equipment consistently.
• Respond appropriately to intraoperative events within your role.
• Accept direction and correction professionally under pressure.
• Maintain an accurate and current surgical case log.
• Reflect on performance and identify specific improvements.
• Demonstrate reliability, punctuality, and professional appearance.

Optional Outcomes

• Observe specialties beyond those scrubbed.
• Participate in endoscopic and minimally invasive cases.
• Observe sterile processing operations.
• Participate in preoperative and postoperative areas.
• Observe robotic procedures.
• Begin building professional references for employment.

Major Topics

Required Topics

• Functioning in the operating room team
• Sterile technique in clinical conditions
• Clinical scrub, gown, and glove
• Back table and Mayo setup
• Positioning, preparation, and draping
• The scrub role under supervision
• Instrument passing in live cases
• Anticipating the surgeon
• Participating in counts
• Safe sharps handling
• Specimen handling
• Surgical safety checklist and time-out
• Team communication
• HIPAA and confidentiality
• Case break-down
• Room turnover
• Instrument and supply identification
• Recognising contamination
• Standard precautions
• Responding to intraoperative events
• Receiving direction under pressure
• Case log maintenance
• Reflective practice
• Professional conduct

Optional Topics

• Observation of additional specialties
• Endoscopic and minimally invasive cases
• Sterile processing
• Preoperative and postoperative areas
• Robotic procedures
• Building professional references

Resources & Tools

• Surgical Technology for the Surgical Technologist: A Positive Care Approach (AST) — the core text, and the one the CST examination is built around.
• Alexander's Care of the Patient in Surgery — the comprehensive perioperative reference.
• Berry & Kohn's Operating Room Technique — the standard on technique and sterile practice.
• Surgical Instrumentation (Rutherford) — instrument identification, which is largely a memorisation task and needs a good picture reference.
• AST — Association of Surgical Technologists (ast.org) — the professional body; student membership is inexpensive and includes practice materials.
• NBSTSA (nbstsa.org) — free CST examination content outline and eligibility rules; read the eligibility page before you enrol anywhere.
• ARC/STSA (arcstsa.org) and CAAHEP (caahep.org) — free accreditation lookup; verify your programme.
• AORN (aorn.org) — perioperative nursing body whose Guidelines for Perioperative Practice are the standard the whole room works to.
• Flashcards for instruments, and a study partner — unglamorous and the single most effective study method in this programme.
• Anatomy atlas or app — surgical anatomy is approached by region and approach, not by system, and a visual reference helps.
• Your programme's mock operating room and open lab time — gowning, gloving, and draping are motor skills built only by repetition.

Career Pathways

• Surgical technologist — SOC 29-2055.
• Hospital operating rooms — the largest employer, and where most graduates begin.
• Ambulatory surgery centres — a large and growing Florida sector, frequently with better hours than hospital work.
• Specialty services — cardiovascular, neurosurgery, orthopaedics, and transplant; specialisation raises pay significantly.
• Labour and delivery — caesarean section teams.
• Physician offices and specialty clinics performing procedures.
• Central sterile processing — a related pathway with its own certification.
• Travel surgical technologist — substantially higher pay for mobility, once experienced.
• Surgical first assistant — an advanced role requiring further education and separate credentialing (CSFA); the usual route to higher earnings in this field.
• Medical device and instrument sales or clinical support — companies recruit experienced surgical technologists specifically for operating room credibility.
• Programme instruction — teaching in a surgical technology programme after several years in practice.
• ⚠ Progression to nursing, physician assistant, or other licensed roles requires separate degree programmes, and PSAV clock hours generally do not transfer into them — plan the pathway deliberately if that is the goal.

Special Information

⚠ The first rotation: expect to be slow, and do not mistake that for failure

• Everyone is overwhelmed at first. The room is faster than the lab, the language is compressed, and the case does not pause for you. This is expected and it is not evidence you chose wrongly.
• Your first goal is to be safe and useful, not fast. Speed arrives with repetition; contamination and dropped sharps do not become acceptable with practice.
• Prepare the night before. Look up tomorrow's cases, review the anatomy and the steps, and you will follow the procedure instead of merely watching it. This is the single highest-return habit in the whole rotation.
• Arrive early, every day. Being present and ready before you are needed is most of a student's reputation.
• Ask questions at the right time — not during a critical step; afterwards, or during closure. Knowing when to ask is itself professional judgement.
• Say "I don't know" rather than guessing, and never pretend to a competency you do not have. Bluffing in an operating room is dangerous and it is noticed immediately.
• Take correction without visible defensiveness. Sharp instruction during a case is about the patient, not about you — process it afterwards.
• Introduce yourself to the team each day and learn names. Being known is how you get taught.
• Log every case the same day. The log is a graduation requirement and a CST eligibility requirement, and reconstructing it later is genuinely difficult.

⚠⚠ This is a PSAV clock-hour course — it carries no college credit

• The leading zero in the course number is the signal. Under the Florida Statewide Course Numbering System, a 0000-level number denotes postsecondary adult vocational (PSAV) instruction, which is measured in clock hours rather than semester credit hours. These courses carry zero college credit.
• ⚠ A catalog may display the clock-hour figure under a heading that reads "credit hours." It is not credits. When you see a number like 192 or 375 attached to a 0000-level course, that is hours of instruction — no course is worth 375 semester credits.
• PSAV hours do not transfer as college credit to an associate or bachelor's degree, and they do not satisfy general education requirements.
• What they do produce is a workforce credential — a career certificate that qualifies you to sit a national certification examination and to be hired. For many students that is exactly the right outcome, and it is reached faster and more cheaply than a degree.
• Some institutions offer articulation from a PSAV certificate into a related associate degree, sometimes through an articulated credit agreement or a "gold standard" statewide articulation. ⚠ These are institution-specific and change. If your intention is to continue to a degree later, get the articulation in writing from the receiving institution before you enrol, not after you finish.
• Financial aid rules differ for clock-hour programmes. Eligibility, disbursement, and satisfactory-progress rules are not the same as for credit programmes — ask the financial aid office specifically about clock-hour programmes.
• Attendance is the currency. Clock-hour programmes track attendance directly, and hours missed generally must be made up; this is stricter than a typical credit course.

⚠ Clinical placement requirements — sort these out early

• Health clearance and immunisations are required before you may enter a clinical facility — typically hepatitis B, MMR, varicella, tetanus, an annual influenza vaccination, and tuberculosis screening.
• Level 2 background screening and drug testing are standard for Florida health care placements, and a facility may refuse a student it declines to screen.
• Current BLS certification is normally required, from a provider the programme accepts.
• You travel to the affiliate, and placements are assigned rather than chosen. Transport is your responsibility, and a Florida clinical affiliate can be a substantial drive.
• Clinical hours are unpaid and follow the operating room's schedule, not a class timetable — expect early starts, full days, and occasional late finishes when a case runs long.
• Plan employment and childcare around the rotation, not the other way round. This is the single most common reason students struggle in the clinical terms.
• Professional behaviour is assessed continuously, and a facility may remove a student for conduct without a right of appeal to the college.
• You are a guest and a learner, not staff. Work within your role, ask when unsure, and never exceed what you have been checked off to do.
• HIPAA applies fully. No phones in the operating room, no photographs, and no discussion of cases outside the clinical team — a social media post about a case ends placements and careers.

⚠⚠ Surgical conscience: if you break sterility and nobody saw, you say so

• This is the defining professional value of surgical technology, and it is taught from the first day because everything else rests on it.
• Sterility is absolute, not probabilistic. An item is sterile or it is not; there is no "probably fine." When in doubt, it is contaminated.
• You will contaminate something, and the only question is what you do next. Announcing your own break in technique — when no one else noticed and no one would ever know — is the whole of surgical conscience, and it is the single trait that defines a trustworthy surgical technologist.
• The consequence of staying silent is a surgical site infection in a real person. That is not an abstraction; it is prolonged illness, reoperation, and sometimes death.
• Know the boundaries of the sterile field — table height, gown front from chest to sterile-field level and sleeves from cuff up, and never turn your back on the field.
• Monitor everyone. Watching for other people's breaks in technique is part of the role, and saying so out loud is expected of you, not presumptuous.
• Movement discipline matters — sterile to sterile, non-sterile to non-sterile, face the field, and keep hands above waist and below shoulders.
• Verify every package. Integrity, indicators, expiry, and moisture — a wet package is a contaminated package.
• Speaking up is a clinical skill, and programmes assess it. A student who will not say "that's contaminated" to a surgeon is not yet safe to practise.

⚠⚠ Counts — a retained surgical item is a never event

• A sponge, needle, or instrument left inside a patient is classed as a "never event" — an error considered wholly preventable. The count is how it is prevented, and the scrub role owns it jointly with the circulator.
• Counts happen at defined points: before the procedure, before closure of a cavity, at the start of wound closure, and at skin closure, plus whenever staff change.
• Count audibly and together, with both people seeing each item as it is counted. A count performed silently or alone is not a count.
• Never remove counted items from the room during a procedure.
• A discrepancy stops the process. Recount, search the field and the floor, notify the surgeon, and an X-ray is taken if the item is not found. This is not negotiable and not a judgement call.
• Do not let pressure shorten the count. The end of a long case, an impatient team, and an urgent turnover are exactly the conditions under which retained items happen.
• Account for every needle and every blade fragment. Broken instrument tips count too.
• Document counts accurately — the record is the evidence that it was done.
• Emergencies do not remove the obligation; they change how it is managed, and the policy covers that.

⚠⚠ Sharps and bloodborne pathogens — your own safety

• The scrub role handles more sharps than anyone else in the room, and passing them is the highest-risk moment of a procedure.
• Use the hands-free or neutral zone technique. Sharps are placed in a designated basin or magnetic pad rather than passed hand to hand, and both people announce the transfer. This measurably reduces injuries and is the standard of practice.
• Never recap a needle by hand, and never reach into a basin blindly.
• Announce every sharp — "sharp back," "needle," "blade" — every time.
• One sharp on the field at a time where practical, and keep them contained rather than loose.
• Load and unload blades with an instrument, never with fingers.
• Standard precautions apply to every patient, because you do not know who is infectious and neither does the chart.
• Wear the protection: eye protection every case, plus double gloving, which is standard practice in many services and substantially reduces exposure.
• Report every exposure immediately. Post-exposure prophylaxis is time-critical, and students under-report injuries out of embarrassment — do not be one of them.
• Know the surgical smoke and radiation hazards too — evacuate plume, and wear lead when imaging is in use.

⚠⚠ Certification and accreditation — verify before you enrol

• The recognised credential is the CST — Certified Surgical Technologist, awarded by the National Board of Surgical Technology and Surgical Assisting (NBSTSA).
• ⚠⚠ Eligibility to sit the CST examination generally requires graduation from a programme accredited by CAAHEP (through the ARC/STSA) or ABHES. Confirm a programme's accreditation before enrolling — this is the same trap as CAPTE for physical therapist assistants, and it is unrecoverable after the fact.
• Accredited programmes require a documented minimum number of surgical cases before graduation, commonly cited as 120, distributed across specialties and roles. Keep your case log meticulously and from the first day — reconstructing it later is difficult and sometimes impossible.
• Most employers require certification even where the law does not, and many require it within a set period after hire.
• Certification is maintained by continuing education or re-examination on a defined cycle.
• ⚠ State regulation of surgical technologists varies and has changed in several states. Florida has not historically licensed surgical technologists as a separate licensed profession in the way it licenses nurses or physical therapist assistants, but requirements set by statute, by facility, and by accreditor do change.
• ⚠ Rule 11 applies. Verify current certification, accreditation, and any state requirements directly with NBSTSA, the accreditor, and the Florida Department of Health rather than relying on any course guide, including this one.
• Background screening and drug testing are required for clinical placement, and a criminal record can end a career pathway before it starts — raise any concern with the programme early and privately.

⚠ The physical and psychological demands are real

• You stand still for hours. Long cases mean sustained standing in one position, frequently with arms elevated, and it is more fatiguing than moving work. Supportive footwear and compression stockings are a genuine professional investment.
• You lift. Instrument trays are heavy, and patient positioning and transfers are part of the job — use the equipment and the team.
• Operating rooms are cold, and you will be gowned and gloved for hours without the ability to adjust anything.
• Bathroom and meal breaks are constrained by the case, which surprises students more than anything else. Hydrate and eat before a long list, sensibly.
• Radiation exposure occurs when imaging is used intraoperatively — wear lead, use distance, and monitor with a dosimeter where provided.
• Latex and chemical sensitivities matter here; disclose them to the programme early.
• You will see trauma, and some cases end badly. Paediatric cases and unexpected deaths affect experienced staff, and it is normal to be affected. Know what support the programme and the facility provide, and use it.
• The culture can be blunt under pressure. Sharp instruction during a critical moment is about the case, not about you — but genuine abuse is not acceptable, and there is a route to report it.

STS0255L is 192 clock hours, offered fall, with STS0003, STS0120 and STS0155 as corequisites. ⚠ Clock hours carry no college credit.

It is the first of three rotations — STS0255L (192) → STS0256L (375) → STS0257L (156), 723 hours in total. Start the case log on day one.