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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.

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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.

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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.