Identifying the Performance Criteria for Appraisal of Colposcopists: Benchmarking Delphi

Abstract

Colposcopy is an essential part of screening for cervical cancer. This study was undertaken in order to identify performance criteria that must be satisfied by colposcopists at the time they are evaluated. A two-generational Delphi survey was carried out at the annual British Society for Colposcopy and Cervical Pathology (BSCCP) conference, held in Edinburgh in 2005. A total of 499 delegates attended the conference. Participants were asked to rate the relevance of quality items that might be considered necessary to properly appraise colposcopists' performance. The results were presented, and respondents were given an opportunity to alter their choices. More than half of the delegates (61%) returned a completed questionnaire, and 60% of these returned the second-round questionnaire. Seven items in all were regarded as essential or important for annual appraisal by more than 75% of the respondents. Three of them are specified by the BSCCP as involving aspects of training and continuing professional development (CPD): • Certification by the BSCCP and the Royal College of Obstetricians and Gynaecologists. • More than 50 new abnormal smear cases per year. • CPD compliance, including attendance at a BSCCP-recognized meeting within the past 3 years. In addition, 4 new diagnostic items were chosen: • The quality of recorded findings. • The rate of biopsy when an atypical transformation zone is identified. • The proportion of biopsies, directed and excisional, which are suitable for histological assessment. • The proportion of normal smears at first follow-up after treatment, a measure of therapeutic efficacy. The BSCCP-certified professionals were in agreement with the group consensus, while noncertified delegates were in slight disagreement with consensus views. The latter group, however, in contrast to certified delegates, regarded patient satisfaction as a criterion for appraisal.