Bringing Colposcopy into Focus: A Multidisciplinary Curriculum for Residents

Objective: Appropriate training in colposcopy for residents is essential to improve management of abnormal cervical cytology and histology and reduce unnecessary testing and procedures. Materials and Methods: A colposcopy curriculum including multidisciplinary colposcopy conferences, weekly smallgroup didactic sessions and hands-on procedural training was introduced into an obstetrics and gynecology residency curriculum. Third and fourth year residents participated in colposcopy clinics as part of their routine clinical experience. Residents completed the American Society for Colposcopy and Cervical Pathology (ASCCP) Resident Assessment of Competency in Colposcopy exam prior to and after initiation of the curriculum. Resident scores were analyzed based on year of training and attendance patterns. Residents also completed a survey about their subjective experience of the curriculum. Results: Nineteen residents participated in the curriculum over two years and completed ASCCP exam at baseline and two years later. Eight residents attended at 5 or fewer small-group didactic sessions (low-attendance group), and 11 residents attended 6-13 sessions (high-attendance group). Residents in high-attendance group had an improvement in their overall score at the follow up exam (+8.7%, p=0.02) despite the fact that residents in this group started out with a significantly lower baseline score (57.8 vs. 67.6, p=0.04). Scores in the management of colposcopy category improved significantly in this high attendance group (+11.3%, p=0.01). Attendance did not impact scores on the categories of medical knowledge, diagnosis and biopsy placement. Year of training was associated with improved performance for fourth-year (overall score (+10.0%, p=0.002) and diagnosis score (+14.7%, p=0.03) and third-year residents (management scores (+12.0%, p=0.05)). Conclusions: This study suggests that a multidisciplinary colposcopy curriculum is a feasible and effective addition to a residency education program. Participation in this program may improve residents’ competency and confidence in colposcopy especially in conjunction with clinical experience. Journal of Women’s Health and Gynecology J Womens Health Gyn 2014 | Vol 2: 10