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Converting the converted

Converting the converted. An overview of LBC training. Roll out of LBC. 5 year roll out Approximately 3000 laboratory staff Approximately 40,000 primary care sample takers. Provision of LBC training. NHSCSP approved Cytology Training Centre

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Converting the converted

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  1. Converting the converted An overview of LBC training

  2. Roll out of LBC • 5 year roll out • Approximately 3000 laboratory staff • Approximately 40,000 primary care sample takers

  3. Provision of LBC training • NHSCSP approved Cytology Training Centre • Training for particular system dependent on first hand experience • Minimum of 15,000 samples per system • 6 months experience

  4. Situation at NPH • T3000 since October 2003 • Commenced LBC training December 2003 • Completed LBC training June 2004 • Smear taker training commenced March 2004 • Full conversion 1st July 2004

  5. Slide requirements for training For 12 people:- • 3 day course = 720 • In-house training = 420 • Total number of slides = 1140

  6. LBC training courses at NPH • First intake expected by end of the year

  7. Laboratory LBC training

  8. NHSCSP Certificate of Completion in Liquid Based Cervical Cytopathology Training

  9. Format of LBC training • 3 day LBC Induction Course • In-house consolidation stage • In-house NHSCSP LBC Interim test • In-house LBC Performance review • Liquid based cervical cytopathology training log

  10. Who has to undergo training? • Every one involved in screening and reporting cervical smears

  11. Who has to do what

  12. Requirements • Fully trained in conventional smear microscopy and qualified to sign out negative and unsatisfactory smear reports • Time • Access to multiheaded microscope

  13. LBC Induction Course • NHSCSP accredited Cytology Training Centre • 3 days • Minimum of 20 hours • Approximately 12 hours dedicated to individual microscopy • Approximately 6 hours allocated to multiheader discussion of cases

  14. LBC Induction Course Lectures topics • Background to LBC • LBC preparation devices • Use of Training Log • Normal cytological appearances and infections • Squamous and glandular dyskaryosis • Rapid rescreening technique • Troubleshooting

  15. LBC Induction Course Microscopy • 20 slides per set • Test sets 1 & 2 dotted • Test sets 3 – 6 unmarked • Work in pairs • Marked by Training Centre staff • Reviewed at multiheaded microscope

  16. Marking of slides • Slide no examined 0 marks • Assessment matches 5 marks proffered response • One grade out from 4 marks proffered response • 2 or 3 grades out from 3 marks proffered response • Negative smear called 2 marks abnormal • Dyskaryotic smear called 2 marks negative • Glandular neoplasia called 5 marks severe dyskaryosis or vice versa

  17. LBC consolidation stage • In-house • 200 unmarked slides • High proportion of abnormals • Individual response sheets • Marked by Training Centre • Obtain sensitivity of 95% (moderate dyskaryosis and above) • Multiheader review of slides

  18. LBC consolidation stage • Pass Interim test • Fail Additional training / slides

  19. Interim Test • 20 unmarked slides • In-house • Individual response sheets • Marked by Training Centre • Pass mark is 80%

  20. Interim test stage • Pass Performance review Medical staff can stop at this stage • Fail Additional training / slides

  21. LBC Performance Review • In-house • 200 unmarked slides • 95% sensitivity for moderate dyskaryosis and above

  22. LBC Training Log • Completed by all grades of scientific staff • Record of individuals progress • Progress monitored by Training Officer • Scientific lead must indicate date on which training completed • Completed Log Book sent to Training Centre

  23. How long will this take? • 10 – 12 weeks

  24. Smear taker training

  25. Smear taker training • Needs to be co-ordinated with laboratory LBC training • All smear takers must undergo training • Roll out of LBC smear taker training to be agreed with PCTs

  26. Smear taker training • Taught course • Cascade training

  27. Taught course • Minimum of 2 hours Content to include:- • Lectures • Interactive sessions • Preparation for clinical practice

  28. Cascade training • Clinical lead or experienced sample taker • Nurse trainers

  29. Training records • PCT should keep a register of primary care sample takers who have undergone training • PCT and laboratory need to agree procedure for signing off practices and clinics when all sample takers have been trained

  30. Ideal situation • Completion of laboratory and smear taker training should coincide

  31. What happens if you change to other preparation system? Need to complete LBC conversion course

  32. LBC system conversion course • One day course at NHSCSP accredited Cytology Training Centre • Minimum of 7 hours • Basic comparison of technical aspects • Lecture on comparative morphology • Multiheaded microscopy discussion • Discussion of interesting / difficult cases • 100 slides done in-house

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