用于评估医疗服务提供者宫颈视诊技能的基于网络的工具。

Web-based instrument to assess skills in visual inspection of the cervix among healthcare providers.

作者信息

Negulescu Raluca-Anca, Catarino Rosa, De Vuyst Hugo, Undurraga-Malinverno Manuela, Meyer-Hamme Ulrike, Alec Milena, Campana Aldo, Vassilakos Pierre, Petignat Patrick

机构信息

Division of Gynecology, Department of Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland.

出版信息

Int J Gynaecol Obstet. 2016 Jul;134(1):107-13. doi: 10.1016/j.ijgo.2015.11.024. Epub 2016 Apr 8.

DOI:10.1016/j.ijgo.2015.11.024

PMID:27126908

Abstract

OBJECTIVE

To validate a web-based instrument for assessing healthcare providers' skills in visual inspection with acetic acid or Lugol iodine (VIA/VILI) for the diagnosis and management of cervical intraepithelial neoplasia.

METHODS

An observational cross-sectional study enrolled healthcare providers in a web-based assessment of VIA/VILI skills between August and November 2014. Participants participated in a four-module training course, followed by a multiple-choice test with 70 questions based on cervical photographs of HPV-positive women participating in cervical screening. Logistic regression was used to identify relationships between independent variables and success on the test.

RESULTS

Overall, 255 participants completed the test and 99 (38.8%) passed. No correlation was found between age or sex and test performance. Compared with other healthcare workers, physicians (odds ratio [OR] 1.91, 95% confidence interval [CI] 1.01-3.63; P=0.048), and participants with more colposcopy experience (OR 3.62, 95% CI 1.91-6.85; P<0.001) and postgraduate VIA/VILI training (OR 1.95, 95% CI 1.16-3.29; P=0.012) were more likely to pass the test. Participants who repeated the test (31/255 [12.2%]) were five times more likely to succeed on their second repeat (OR 5.89, 95% CI 1.46-23.73; P=0.013).

CONCLUSION

Web-based training for VIA/VILI is feasible and can identify healthcare workers who are proficient in this technique.

摘要

目的

验证一种基于网络的工具，用于评估医疗保健提供者使用醋酸或卢戈氏碘进行目视检查（VIA/VILI）以诊断和管理宫颈上皮内瘤变的技能。

方法

一项观察性横断面研究于2014年8月至11月招募医疗保健提供者进行基于网络的VIA/VILI技能评估。参与者参加了一个四模块培训课程，随后进行了一项包含70道选择题的测试，这些题目基于参与宫颈筛查的HPV阳性女性的宫颈照片。采用逻辑回归来确定自变量与测试成功之间的关系。

结果

总体而言，255名参与者完成了测试，99名（38.8%）通过。未发现年龄或性别与测试成绩之间存在相关性。与其他医护人员相比，医生（优势比[OR]1.91，95%置信区间[CI]1.01 - 3.63；P = 0.048）、具有更多阴道镜检查经验的参与者（OR 3.62，95% CI 1.91 - 6.85；P < 0.001）以及接受过研究生VIA/VILI培训的参与者（OR 1.95，95% CI 1.16 - 3.29；P = 0.012）更有可能通过测试。重复测试的参与者（255名中的31名[12.2%]）在第二次重复测试时成功的可能性高出五倍（OR 5.89，95% CI 1.46 - 23.73；P = 0.013）。