Cervical most cancers screening carried out by a student-led clinic: medical college students’ views on studying development, Pap smear high quality, and girls’s visiting expertise: a mixed-methods research | BMC Medical Schooling

Qualitative knowledge

The analyzes have been carried out by one of many authors with professional information in qualitative academic analysis within the area of well being professions training (MAD). The findings describe college students’ views on how medical internship on the SLC-CCS supported their studying. Three totally different themes have been generated, illustrating reflections on lived achievements, in addition to lived issues or shortcomings.

The themes have been: rising confidence within the medical state of affairs, embodied consciousness of variation in anatomy, doubting the accuracy of 1’s efficiency.

Rising confidence within the medical state of affairs

A typical theme, repeatedly encountered all through the discussions, was the expertise of rising confidence in dealing with each the encounters with the ladies and the gynecological examination and process. Experiences of authenticity and accountability for the state of affairs have been singled out as necessary contributors to rising belief. One of many FG3 attendees expressed this as.

M:1 It was like… even when there was employees accountable there, it was as much as us, if one in every of us was sick, one other scholar needed to step in instead… So it was like being an strange employees member, and thus contributed to the system. (FG3).

The sensation of being a part of the accountable staff and the variety of affected person conferences and exams collectively made the scholars really feel comfy in an in any other case usually awkward and delicate state of affairs that medical college students hardly ever get to observe. The next excerpts from the main focus discussions (FG1 and FG 2) illustrate the theme.

W1: I feel a very powerful factor was…getting all that hands-on coaching…(my colleague) and I noticed, like 50 sufferers that morning, and it was very nice to get the method and extra importantly the dealing with conferences with sufferers, to really feel comfortable in that state of affairs. (FG1).

M1: I agree, examination method and affected person encounters, that is what you introduced with you probably the most… Personally, I feel I made big progress between the primary affected person and the final, it was a sense actually rewarding (FG1).

Embodied consciousness of variation in anatomy

A second recurring theme within the discussions was the significance of experiencing regular anatomical variation. The numerous repeated gynecological examinations carried out by the scholars gave them an embodied consciousness and studying expertise that each human physique is exclusive. The worth of constructing a reference financial institution for variation of regular anatomy, studying to find totally different anatomical buildings, and being delicate to what it seems like to take action are points which have been emphasised in targeted discussions.

Kv:1 Everybody appears to be like totally different, in several methods… and naturally I did not be taught all of the other ways, however a minimum of I received an even bigger financial institution of pictures, or say, how individuals look… (FG2 ).

M: I did not have a lot expertise with gynecological exams earlier than this…so constructing a baseline of regular anatomy and the way it can differ, meant loads…That, in itself, made the exams simpler and simpler, and also you it made assembly the sick particular person safer; you dared to make selections, discovered to acknowledge how uncomfortable you felt, or if you happen to wanted to name the supervisor, or if you happen to felt you could possibly do it your self (FG1).

Doubt the accuracy of your personal efficiency

The third theme, recognized in some discussions, is that of self-criticism. Whereas college students have felt their self-confidence develop and their means to handle affected person encounters and examinations broaden, there have been common expressions of doubt concerning the accuracy of their very own efficiency, as there was no rapid suggestions as as to if or not the pattern taking.

W:2… and after… are you questioning… did I get good samples from everybody… or did not I get any good samples…? you continue to did not know if it was appropriate… FG2.

Quantitative knowledge

Through the research interval, which lasted from February 1, 2021 to Might 31, 2021, a complete variety of 80 SLC-CCS have been carried out. Sixty-one medical college students had these SLC-CCS, and thus every scholar averaged 1.3 (80/61) receptions of SLC-CCS every.

Pap smear high quality

Through the aforementioned outpatient visits, 3617 Pap smears have been taken from the scholars or typically when the scholar wanted them, with the assistance of the employees current. On common, 45 (3617/80) Pap smears have been taken for every SLC-CCS. The standard of the Pap smears is introduced in Desk 1.

Desk 1 Pap smear high quality

Just one Pap smear lacked ample materials to be examined, and a pair of.0% (No= 78/3616) lacked cells from the squamous epithelium. When knowledge from August 1, 2020 to December 31, 2020 previous to the beginning of SLC-CCS was evaluated, it was discovered {that a} complete of 11,575 Pap smears have been taken, three lacked ample materials to be analyzed, and a pair of.0% (No= 217/11572) lacked squamous epithelial cells. There was no distinction between the 2 time intervals relating to the variety of Pap smears that lacked cells from the squamous epithelium (P= 0.28).


Questionnaires have been supplied to all girls who attended a Pap smear go to on the outpatient clinic since 4th of April till 17th of June 2021, i.e. two months throughout the SLC-CCS interval and thereafter. In complete, 177 girls responded to the questionnaire and all have been eligible for evaluation; 78 (44.1%) girls responded that the Pap smear was carried out by a healthcare skilled, 30 (16.9%) said that the check was carried out by a feminine medical scholar, and 64 (36.2%) they didn’t know who carried out the check. 5 girls (2.8%) reported that each a healthcare skilled and a medical scholar have been examined; these 5 questionnaires have been added to the group of samples taken from the scholars, i.e. a complete of 35 (19.8%) girls who had answered the questionnaire have been examined by the scholars. There have been no variations in age, training stage, self-reported well being standing, or within the variety of girls who claimed Swedish was their native language between the three teams (Desk 2).

Desk 2 Traits of the ladies who answered the questionnaire

Almost 9 out of ten girls (No= 154, 88.5%) have been glad with the pre-exam data supplied through invitation letter, brochure, or from the healthcare skilled no matter who reviewed them.

There was a query relating to the general go to expertise when taking the Pap smear. Responses didn’t differ considerably between teams of examiners. Nevertheless, general, 96% (No= 170) of ladies rated the go to expertise general as superb or good (Fig. 1A).


Ac. The ladies’s experiences of the go to to the SLC-CCS.Group seek advice from the one who had the Pap smear, *NS,** P= 0.005

There was a query asking whether or not girls have been handled respectfully and kindly by the examiner. Each girls (No= 78) who have been screened by well being care suppliers reported being handled with complete compliance in contrast with 95.3% (No= 61) of ladies who didn’t know who the examiner was and 88.6% (No= 31) of ladies surveyed by college students (P= 0.005). Just one lady reported that she was not handled with respect, however she didn’t know who examined her (Fig. 1B).

As regards inquiries to the examiner, two thirds of ladies (No= 61; 34.5%) had no questions and just one lady reported not daring to ask. There have been no important variations relating to who was the examiner (P= 0.322).

In complete, 115 girls requested the examiner questions and 109 girls (94.8%) have been glad with the reply, no matter who was the examiner; 4.3% (No= 5) of the ladies who requested have been partially glad with the reply; and just one lady (0.9%), who didn’t know who the examiner was, was in no way glad with the reply (Fig. 1C).

A “satisfaction index” was calculated by combining the outcomes of three questions (proven above individually in Fig. 1 AC) into the go to questionnaires (Fig. 2).

Determine 2
figure 2

Satisfaction of ladies with the go to to the SLC-CCS. Group refers to the one who carried out the *NS Pap smear

On the go to, 115 girls questioned the examiner. Since one of many questions within the “satisfaction index” was whether or not they received solutions to questions they understood, the outcomes are primarily based on these 115 questionnaires. We discovered no variations in “satisfaction ranking” between totally different teams of ladies examined by a medical scholar, a well being care skilled, or girls who didn’t know who the examiner was (P= 0.112).

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