Congress Abstracts 2006

171

TEACHING COLPOSCOPY: PROCESS AND OUTCOMES. Carol Dallred, RNC, MSN, WHCNP, Joyce Dains, DrPH, JD, RN, FNP, BC, NAP, and Faye Gregory, RN, MSN, FNP, BC, University of Texas M.D. Anderson Cancer Center, Houston, TX.

Cervical cancer is the second most common cancer in women in the world and, in the U. S., rural underserved women are at highest risk. Even though cervical cancer has decreased in the U.S. by 70% over the last four decades, 1.7 billion dollars is spent in the U. S. annually on cervical cancer treatment. The best and least expensive way to reduce the burden of cervical cancer is to detect the disease in its precancerous state. The pap test serves to screen for this disease, but colposcopy with biopsy is necessary for diagnosis of both precancerous and malignant disease.

In the U.S. many rural and underserved areas do not have a physician to perform colposcopy. Mid-level clinicians, such as Nurse Practitioners and Physicians Assistants, can acquire the skills to perform colposcopy successfully. However, there are limited numbers of programs that teach colposcopy. The largest educational program for this procedure does not provide hands-on training, and other programs last four or more days taking valuable resources out of the field for lengthy periods of time.

Professional Education for Prevention and Early Detection at M.D. Anderson Cancer Center has developed a unique colposcopy program to prepare mid-level clinicians to perform this critical procedure.

The 2-½ day program includes didactic, practice, and application experiences. Participants practice skills in the laboratory and then perform colposcopy of the normal cervix in the clinical setting.

A 20-item multiple-choice pretest and posttest is administered to ensure that the participants have acquired the essential knowledge base. Professional educators observe the participants performing colposcopy to ensure skillful performance.

Over a three-year period, over 50 clinicians from eight different states have received the necessary didactic and hands-on training to perform colposcopy. Pre and Posttest scores are available for 31 of the participants. Posttest scores were significantly higher than pretest scores (p < 0.001) for each year and for all years combined. Posttest scores were about 15-20 points higher than pretest scores, indicating a substantial increase in knowledge. Feedback from participants indicates satisfaction with the program and successful integration of colposcopy into practice.