Mock gynecologic cytology proficiency testing as a milestone assessment tool for anatomic pathology residents

Abstract

One of the major aims of the Next Accreditation System is to move toward an outcomes-based evaluation system where each accredited medical residency program must demonstrate that its residents are competent in performing the essential tasks necessary for clinical practice. Because all pathologists who sign-out or screen Papanicolaou (Pap) tests are required to pass an annual 10-slide gynecologic cytology proficiency test (PT), we developed mock PT modules as a tool for assessing competency. In 2007, we introduced mock proficiency testing with 3 distinct modules, each consisting of 3 10-slide test sets (10 ThinPrep, 10 SurePath, and 10 conventional Pap slides). Each module was administered at 3 different time points. We evaluated the following parameters: (1) performance differences between Pap preparations; (2) performance over time; (3) performance before and after initiation of one-on-one teaching sessions with cytotechnologists in 2009; and (4) quality of test slides. Residents showed improvement over time, and overall scores did not differ significantly among ThinPrep, SurePath, and conventional slide sets. The average score for the first test set was significantly higher for residents who received formal training by a cytotechnologist than for those who did not. Overall, 16 of 90 slides were misclassified by 40% or more of residents, half of which exhibited glandular abnormalities. The objective assessment provided by mock PT is a useful tool for both faculty and residents.