The quality of smear taking training for hospital medical trainees

Training for cervical smear takers in primary care is well established. We aimed to assess the adequacy of training in cervical smear taking among hospital medical trainees.

An anonymous questionnaire survey was conducted among hospital medical trainees within the North West region of England. The questionnaire assessed the trainees' level of confidence in their knowledge and skills in the theoretical and practical aspects of cervical smear taking, and the training they had received. The standards used were as stated in the National Health Service Cervical Screening Programme Resource Pack for Training Smear Takers (July 1998). These included practical smear taking, pre- and post-test counselling, the background to cervical screening, the National Health Service Cervical Screening Programme, the role of the Health Authority and the laboratory, provision for women with special needs, acceptability, accountability and quality assurance.

Seventy-eight per cent of trainees returned the questionnaires. Although all the trainees were confident about taking smears, a significant percentage was concerned about the theoretical and specific issues associated with smear taking such as the care of women with special needs. Only 60.7% had received formal training in practical smear taking. Furthermore, only 48.3% had been formally trained in the clinical management of smears.

There appears to be an urgent need for formal training in the theory and practice of smear taking and for the standardization of the course content. The introduction of training in liquid-based cytology provides us with a golden opportunity to address this deficit.