Survey of smear taking practice in the former North Thames region

Abstract

One hundred and seventy-seven doctors and 161 nurses from 230 clinics responded to a questionnaire on smear taking practice. The responses show that 66% of smear takers use the Aylesbury spatula and 30% use the Ayre spatula. A total of 53% use a cytobrush for selected cases. Training of smear takers and preparation of smears was satisfactory. Most (but not all) smear takers routinely record clinical information on the request form. Only 20 cytology laboratories in the North Thames region (70%) provide additional feedback to the smear takers about the quality of their smears apart from the information on the request form. Our study shows that feedback is an area where interaction between the laboratory and smear taker could be encouraged.

Transformation zone sampling rate is a useful performance indicator for practitioners collecting cervical samples using SurePathTM liquid‐based cytology system

“…However, as yet there is little agreement on an accepted performance indicator for smear takers. Whilst there is general agreement on the need to audit performance and provide feedback, 2,5,[9][10][11] the actual format recommended ranges from Ôpick upÕ rates 12 to TZ sampling rates 13 and unsatisfactory smear rates 10,14 for individual practitioners. It is generally agreed that the two yearly audit of unsatisfactory smear rates (for conventional smears) as is recommended by the General Medical Services (GMS) 14 offers limited useful information on clinical ability.…”

“…He proposed that the comparison of TZ sampling rates achieved by smear takers sending samples to the same laboratory was a useful performance indicator – a view which echoed those of Curtis et al. , 4 who cited the presence of TZ cells as one of the main criteria that reflects clinical proficiency, and Awadhi and Coleman who suggested that periodic feedback to clinicians and smear takers has an important role in improving performance in health care 5 …”

“…He proposed that the comparison of TZ sampling rates achieved by smear takers sending samples to the same laboratory was a useful performance indicator -a view which echoed those of Curtis et al, 4 who cited the presence of TZ cells as one of the main criteria that reflects clinical proficiency, and Awadhi and Coleman who suggested that periodic feedback to clinicians and smear takers has an important role in improving performance in health care. 5 With the advent of liquid-based cytology (LBC), monitoring the quality of specimens remains an important requirement as indicated by Tibbs et al 6 who found a significant reduction of LBC smears lacking TZ component (18% down to 5.3%) after feedback and corrective action.…”

The quality of smear taking training for hospital medical trainees

“…13,14 Most trainees were either fairly or very confident about the practical aspects but not about the theoretical aspects of cervical smear taking. 13,14 Most trainees were either fairly or very confident about the practical aspects but not about the theoretical aspects of cervical smear taking.…”

“…The number of trainees with assigned smear takers numbers was small (12%) thus reducing the ability to audit individual practice both in terms of training accreditation and ongoing practice, and to facilitate feedback and identification of those requiring updating. 13,14 Most trainees were either fairly or very confident about the practical aspects but not about the theoretical aspects of cervical smear taking. This is in accordance with the fact there was a lack of formal training.…”