Colposcopy training and assessment across the member countries of the European Federation for Colposcopy.

OBJECTIVES: Colposcopy training and assessment is not uniform across Europe with individual countries determining their own required standards and regulations. In light of the significant changes in colposcopic practice that have occurred over the past decade and the expansion of the European Federation for Colposcopy (EFC) membership, a study was conducted firstly, to assess the current requirements for training in each of the member countries and secondly, to review an EFC-approved core training curriculum for colposcopy. STUDY DESIGN: A questionnaire survey of the EFC representatives from all member countries investigating their country's current practices/requirements with regard to training, assessment and accreditation for colposcopy. A two-round Delphi consultation with representation from the full, associate and three potential member countries was conducted using a 5-point Likert scale for scoring opinions. The results were analysed with respect to each country's population size and World Bank economic classification. RESULTS: For the questionnaire survey, responses were received from 31/34 countries invited to participate. Training programmes were reported to be in place in 21 of the 31 countries but only 17 of the 21 countries had a committee overseeing the training programme. An assessment was part of the training programme in 20 countries with multiple choice questions and portfolios the most common assessment tools. Countries with a population size less than 2 million have a statistically significant lower probability of having a structured training/assessment programme, 1/5 compared to 20/26 for a populations greater than 2 million, p=0.013. For the Delphi study, responses were received from 34/39 countries invited to participate. Of the 51 competencies previously identified only 2 did not receive full support: 'perform bacterial swabs' and 'provide data to national body'. There was no significant difference in the responses given by member, associate member or potential member countries. CONCLUSIONS: There is considerable variation in colposcopy training and assessment across Europe. This study has enabled consensus opinion with the EFC on the contents of an EFC core curriculum. The revised curriculum has a mandate from the EFC member countries to be implemented across Europe as the standard for colposcopic training.

Treating sexually abused children with posttraumatic stress symptoms: a randomized clinical trial.

OBJECTIVE: To evaluate the efficacy of child and caregiver participation in the cognitive-behavioral treatment of sexually abused children with posttraumatic stress symptoms. METHOD: Thirty-six sexually abused children (aged 5-17 years) were randomly assigned to a child-alone cognitive-behavioral treatment condition, a family cognitive-behavioral treatment condition, or a waiting-list control condition. RESULTS: Compared with controls, children who received treatment exhibited significant improvements in posttraumatic stress disorder symptoms and self-reports of fear and anxiety. Significant improvements also occurred in relation to parent-completed measures and clinician ratings of global functioning. In general, parental involvement did not improve the efficacy of cognitive-behavioral therapy. Maintenance of improvement was evident at a 12-week follow-up assessment. CONCLUSIONS: Cognitive-behavioral treatment was useful, but further research is required on caregiver involvement.

Importance of components of postgraduate education in obstetrics and gynaecology: surveys of trainees and trainers.

Postgraduate medical education has many elements. Some are long-established while others such as formal teaching programmes and computer-aided learning are relatively new. The opinions of trainees and trainers differ as to which elements have the most educational value. Information technology is not highly rated by either group.

Cognitive-behavioral treatment of school-refusing children: a controlled evaluation.

OBJECTIVE: To evaluate the efficacy of a 4-week cognitive-behavioral treatment program for children who refuse to go to school. METHOD: Thirty-four school-refusing children (aged 5 to 15 years) were randomly assigned to a cognitive-behavioral treatment condition or a waiting-list control condition. Treatment consisted of individual child cognitive-behavioral therapy plus parent/teacher training in child behavior management skills. Measures taken before and after treatment included school attendance, child self-report of emotional distress and coping, caregiver reports on emotional and behavioral problems, and clinician ratings of global functioning. RESULTS: Relative to waiting-list controls, children who received cognitive-behavioral therapy exhibited a significant improvement in school attendance. These children also improved on self-reports of fear, anxiety, depression, and coping. Significant improvements also occurred in relation to caregiver reports and clinician ratings. Maintenance of therapeutic gains was demonstrated at a 3-month follow-up assessment. CONCLUSIONS: Cognitive-behavioral treatment of school refusal was efficacious and acceptable. The relative contributions of child therapy and parent/teacher training require further study.

Obsessive-compulsive behaviour in children and adolescents: a cross-sectional Australian study.

OBJECTIVE: To examine the reliability of the survey form of the Leyton Obsessional Inventory-Child Version (LOI-CV), ascertain the prevalence of self-reported obsessive-compulsive behaviour together with age and sex differences and identify the most common obsessive-compulsive behaviours and their associated level of interference. METHODOLOGY: The survey form of the LOI-CV was administered to a large sample of children and adolescents attending regular schools. Participants were aged between 8 and 16 years (n = 1602). RESULTS: We found the survey instrument to have adequate internal consistency and test-retest reliability. There was an age-related decline in self-reported obsessive-compulsive behaviour and girls reported a higher level of obsessive-compulsive behaviour than boys. The most common obsessive-compulsive behaviours included: repeated thoughts or words, having trouble making decisions, having to do certain things and doing things in the exact manner and having a bad conscience. For the most part, these behaviours were associated with low levels of interference. However, for a significant minority of youth (5 to 14%), these behaviours did cause problems and significantly interfered with their lives. CONCLUSIONS: Although many obsessive-compulsive behaviours are part of normal development, they may still be problematic for some children and adolescents.

Test-retest reliability of the survey form of the Leyton Obsessional Inventory-Child Version.

The test-retest reliability of the survey form of the Leyton Obsessional Inventory-Child Version was examined over a 2-wk. interval. Three age groups of children participated in the study, 8- to 10-year-olds, 11- to 13-year-olds, and 14-to 16-year-olds (N = 106). For the total Obsessive scores, the test-retest Pearson correlation coefficients for the three age groups were .51, .75, and .83, respectively, which suggest that the temporal stability of the instrument is a function of age.