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Trainees' interactional skills when performing Pap smears. A needs assessment
J Ward1, N Harding, R Sanson-Fisher
1Needs Assessment and Health Outcomes Unit, Central Sydney Area Health Service.
Australian Family Physician
|February 1, 1997
Summary
Trainee doctors demonstrate low use of communication skills during Papanicolaou (Pap) smears, indicating a need for improved training in preventive care. Further assessment of clinical behaviors is crucial before independent practice.
Area of Science:
- Medical Education
- General Practice Training
- Preventive Care Communication
Background:
- Specific interactional behaviors can alleviate patient anxiety during Papanicolaou (Pap) smears.
- Limited research exists on doctors' utilization of these skills and the training needs of junior doctors.
Purpose of the Study:
- To identify the learning needs of trainees regarding interactional skills for Pap smear procedures.
- To assess current practices within the Royal Australian College of General Practitioners (RACCP) Training Program.
Main Methods:
- Analysis of 23 audio-recorded consultations between trainees and patients undergoing Pap smears.
- Utilized a 29-item interactional skills rating scale.
- Checked intra-rater reliability on a sample of recordings.
Main Results:
- Low rates of specific interactional skills were observed.
- Procedure explanations occurred in 30% of consultations; stop signals were not explained.
- Information on results was provided to 43% of patients; smoking status ascertained in only 9%.
Conclusions:
- Undergraduate medical education in Australia inadequately prepares graduates in practical preventive care skills.
- Findings highlight implications for GP supervisors and the RACGP Training Program.
- Trainee performance in Pap smear consultations requires observation, improvement, and assessment during supervised training.