Surgical Procedures Clinical III

Course Description

Surgical Procedures Clinical III is advanced participation 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 course, and the 0000-level number marks it as PSAV clock-hour instruction. Daytona State publishes it at 156 clock hours, offered summer. ⚠ It carries no college credit.

This is the terminal rotation, and the word is advanced. The expectation is that you now function as a surgical technologist who happens to be supervised rather than a student who is being shown things — scrubbing a full list, managing your own setup, and being genuinely useful to the team. It is also where the programme converges on three things at once: completing the case log, passing the final competencies, and getting hired. Many graduates are offered positions by facilities where they rotated, which makes this rotation an extended job interview whether or not anyone says so.

Learning Outcomes

Required Outcomes

• Function as the scrub with minimal supervision across routine procedures.
• Apply sterile technique reliably and correct others' breaks appropriately.
• Set up independently and efficiently for assigned procedures.
• Anticipate consistently, including through unexpected changes of plan.
• Manage complex or lengthy cases while maintaining organisation.
• Scrub cases in the specialties required for programme completion.
• Handle specialty instrumentation, implants, and equipment competently.
• Set up and troubleshoot endoscopic, powered, and imaging equipment.
• Participate in counts assertively and resolve discrepancies correctly.
• Manage medications and solutions on the field without prompting.
• Respond appropriately to intraoperative complications and emergencies.
• Apply all safety practice consistently: sharps, radiation, laser, and fire.
• Contribute to efficient room turnover and list flow.
• Communicate effectively with all members of the surgical team.
• Advocate for the patient, including raising safety concerns to senior staff.
• Maintain professional conduct, reliability, and appearance throughout.
• Complete the required surgical case log across all specialty categories.
• Meet all programme clinical competency requirements.
• Evaluate your own practice accurately and identify remaining gaps.
• Describe the transition from student to employed surgical technologist.
• Prepare for the CST certification examination.
• Prepare application materials and secure professional references.
• Describe employment expectations, orientation, and probationary practice.
• Describe continuing education and certification maintenance requirements.

Optional Outcomes

• Scrub in a specialty service of particular interest in depth.
• Participate in call or after-hours emergency coverage.
• Participate in robotic or hybrid theatre procedures.
• Mentor students in earlier rotations.
• Participate in departmental quality or safety activities.
• Complete employment interviews and secure a position.

Major Topics

Required Topics

• Independent scrub practice
• Reliable sterile technique and correction of others
• Independent setup
• Consistent anticipation
• Managing complex and lengthy cases
• Specialty case coverage
• Specialty instrumentation and implants
• Endoscopic, powered, and imaging equipment
• Assertive count participation and discrepancy resolution
• Independent medication management
• Complication and emergency response
• Comprehensive safety practice
• Room turnover and list flow
• Team communication
• Patient advocacy and speaking up
• Professional conduct
• Completing the case log
• Meeting competency requirements
• Accurate self-evaluation
• Transition to employment
• CST examination preparation
• Applications and references
• Employment expectations and orientation
• Continuing education and recertification

Optional Topics

• Specialty depth rotation
• Call and emergency coverage
• Robotic and hybrid theatre
• Mentoring earlier students
• Quality and safety activities
• Interviews and job placement

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 final rotation is an extended job interview — treat it as one

• A large share of graduates are hired by a facility where they rotated. Everyone in that room is forming a view about whether they would want you on their team, whether or not it is ever stated.
• Reliability outweighs technical brilliance. The student who is early, prepared, and pleasant at hour ten gets offered a post ahead of the faster scrub who is difficult to work with.
• Ask for feedback explicitly and act on it visibly. Demonstrating that you change in response to correction is exactly what employers are assessing.
• Say what you are interested in. Preceptors who know you want cardiovascular or orthopaedics will steer those cases toward you, and may mention you when a post opens.
• Secure references before you leave, while people remember you clearly — ask directly and get contact details.
• Be equally professional with everyone. How you treat sterile processing staff, orderlies, and environmental services is noticed and is reported on.
• Do not badmouth another facility, a preceptor, or your programme. This is a small professional community in any Florida region, and it travels.
• Leave well. Thank people individually; it costs nothing and it is remembered.

⚠ Finishing: the case log, the competencies, and the examination

• The case log is a graduation and CST eligibility requirement, and it must cover the required specialty categories and roles — not merely a total number.
• Audit your log now against the requirement, not in the final fortnight. Missing categories can usually be arranged if raised early and cannot if raised late.
• Verify signatures and documentation are complete as you go; an unsigned case may not count.
• Book the CST examination close to completion, while the content is current. Pass rates fall the longer graduates wait.
• Use your own case cards to revise — the material you wrote across the specialties sequence is better revision than any commercial summary.
• Take practice examinations under timed conditions, and treat wrong answers as a study plan rather than a score.
• Confirm your programme's accreditation status covers your graduation date if there is any doubt at all.
• Plan certification maintenance from the start — continuing education requirements begin immediately and lapsed certification is a real employment problem.

⚠⚠ 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.

STS0257L is 156 clock hours, offered summer, alongside STS0122. ⚠ Clock hours carry no college credit.

It completes the 723-hour clinical sequence and the PSAV certificate. See the certification note above for CST eligibility, accreditation, and case log requirements — and verify them directly with NBSTSA rather than relying on this guide.