Competencies for
Smear Taker Training
June 2009
NCSP Competencies for Smear Taker Training
Published in June 2009 by the National Screening Unit, Ministry of Health
PO Box 5013, Wellington, New Zealand
www.nsu.govt.nz
IBSN 978-0-478-31957-6 (Online)
1
NCSP Competencies for Smear Taker Training
CONTENTS
INTRODUCTION ............................................................................................................ 2
TRAINING PROGRAMME PROVIDERS ....................................................................... 3
ENTRY TO A SMEAR TAKER TRAINING PROGRAMME ............................................ 3
PROGRAMME COMPONENTS ..................................................................................... 4
REQUIRED TEXTS ........................................................................................................ 4
ASSESSMENT OF TRAINEES ...................................................................................... 5
SMEAR TAKER COMPETENCIES ................................................................................ 6
PREPARING WOMEN FOR CERVICAL SCREENING ................................................. 7
COMPETENCY 1: OVERVIEW OF CERVICAL SCREENING IN NEW ZEALAND .................... 7
COMPETENCY 2: INTERPERSONAL SKILLS FOR CERVICAL SCREENING ......................... 9
COMPETENCY 3: CULTURAL COMPETENCE FOR CERVICAL SCREENING ...................... 10
COMPETENCY 4: INFORMATION FOR WOMEN ............................................................. 11
TAKING CERVICAL SMEARS ..................................................................................... 12
COMPETENCY 5: PROVIDING A SUITABLE ENVIRONMENT FOR SMEAR TAKING.............. 12
COMPETENCY 6: KNOWLEDGE OF CERVICAL PATHOPHYSIOLOGY .............................. 12
COMPETENCY 7: SMEAR TAKING PRACTICE............................................................... 13
INTERPRETING CERVICAL SMEAR RESULTS, INITIATING FOLLOW UP ACTION,
AND COMPLETING DOCUMENTATION..................................................................... 14
COMPETENCY 8: SMEAR TAKER DOCUMENTATION .................................................... 14
COMPETENCY 9: FOLLOW-UP RESPONSIBILITIES ....................................................... 15
SMEAR TAKER APPROVAL........................................................................................ 16
MAINTAINING COMPETENCE.................................................................................... 17
APPENDIX 1 – DEFINITION OF TERMS..................................................................... 18
1
NCSP Competencies for Smear Taker Training
INTRODUCTION
The National Cervical Screening Programme (NCSP) Operational and Quality
Standards require all smear takers to have completed a recognised educational course
in smear taking through one of the following training programmes:
•
•
•
Standard 401
an NZQA accredited course for non-medical smear takers,
training as part of a medical degree, or through
an NZQA midwifery training programme.
All smear takers will complete a recognised educational course in
smear-taking practice prior to providing a smear-taking service for
women.
These competencies have been developed by the NCSP to provide detail of the skills,
knowledge and attributes expected of a cervical smear taker. They replace the NCSP
Training Standards for Smear Takers 2002. The competencies have been developed to
closely align with New Zealand Qualifications Authority (NZQA) Unit Standard 1098
Perform cervical screening and cervical smear taking, revised in 2008 and registered
on the National Qualifications Framework.
Primarily the competencies are intended for use by trainees, supervisors and
accredited providers of NZQA Unit Standard 1098, which is most commonly used by
non-medical smear takers. Employers, NCSP Regional Services and medical and
midwifery students and their educators will also find them useful. Smear takers already
trained under earlier standards, but who may need to check the currency of their skills,
should also refer to these new competencies.
The proportion of cervical smears taken by non-medical smear takers is increasing. In
2008 nurses took approximately 38% of smears within the NCSP (compared with 34%
in 2006 and 31% in 2005). These competencies help to ensure that smear takers
provide a consistently high standard smear taking service for the women under their
care.
Completion of the smear taker training programme should normally take no more than
one year.
This document draws on the continued experience of training course providers and
other key stakeholders and we are grateful for their input.
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NCSP Competencies for Smear Taker Training
TRAINING PROGRAMME PROVIDERS
To ensure nationally consistent teaching and assessment standards, providers of
training programmes are required to be registered and accredited by New Zealand
Qualifications Authority (NZQA) to deliver Unit Standard 1098. An accredited provider
is required to engage in the NZQA moderation system for Unit Standard 1098. Training
programme providers will need to maintain close liaison with NCSP Regional Service
managers.
ENTRY TO A SMEAR TAKER TRAINING PROGRAMME
Entry to smear taker training is restricted to individuals who meet the following criteria.
Is either:
(a)
a New Zealand registered nurse, midwife, nurse practitioner, or doctor
• employed within the health sector where smear taking is part of the
service delivery; and
• supervised by a nominated clinical supervisor who meets the
definition outlined in Appendix I
(b)
an enrolled nurse or nurse assistant
• employed within the health sector where smear taking is part of the
service delivery;
• undertaking nursing practice under the direction and supervision of a
registered nurse or medical practitioner and
• supervised by a nominated clinical supervisor who meets the
definition outlined in Appendix I.
or
Non-New Zealand registered health practitioners intending to practice smear
taking either in New Zealand or overseas
Under exceptional circumstances, persons without current New Zealand nursing or
medical registration will be considered to be eligible for smear taking training.
Applications will be considered on a case by case basis by the NCSP, by contacting
the NCSP Programme Manager. Criteria will include:
•
demonstrated strong community support and need for screening service intended
to be provided
•
evidence of an employment background in the health sector (references must be
provided)
•
evidence of English language competency, if necessary
•
evidence of ongoing supervision by a permanent clinical supervisor.
Recognition of prior learning
Training providers may at their discretion and/or in collaboration with the NCSP, adapt
the course requirements in recognition of prior learning.
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NCSP Competencies for Smear Taker Training
PROGRAMME COMPONENTS
Theoretical Component
This component shall be a minimum of 20 hours theory teaching as set out in Section
6: Competencies.
Practical Component (undertaken in clinical practice with supervision from an
appointed colleague)
The objective of practical training is to ensure that the student:
•
attains confidence and expertise in the smear taking process
•
is able to recognise normal from abnormal clinical findings
•
recognises the limitations of their knowledge and experience and when to consult
with/refer to a medical practitioner.
It is recommended that the clinical component be completed within one year of
commencement of the training programme.
REQUIRED TEXTS
•
NCSP Operational Policy and Quality Standards with particular emphasis on
sections 1, 2, and 4
•
The Health (National Cervical Screening Programme) Amendment Act 2004
•
The Code of Health and Disability Services Consumers' Rights
•
Bethesda 2001 New Zealand Modified codes; Systematised Nomenclature of
Medicine (SNOMED) codes
•
NCSP Guidelines for Cervical Screening in New Zealand, 2008
•
NCSP resources for women including:
-
Prevention of cervical cancer. A guide for women in New Zealand (detailed
booklet revised in 2009)
-
What women need to know
-
What wahine need to know
-
What Pacific women need to know
-
Understanding cervical smear test results
-
Colposcopy: Information for women who have abnormal smear test results.
Recommended additional reading
It is recommended that smear takers are familiar with the NCSP six monthly and
annual monitoring reports. These can be found at: www.nsu.govt.nz/HealthProfessionals/1063.asp
•
Duffy A, Barrett DK, Duggan MA. 2001. Report of the Ministerial Inquiry into the Under-reporting of
Cervical Smear Abnormalities in the Gisborne Region
•
Sadler L, Priest P, Peters et al. 2004. New Zealand Cervical Cancer Audit. Screening of Women with
Cervical Cancer: 2000-2002
•
Nursing Council of New Zealand. 2005. Guidelines for Cultural Safety, the Treaty of Waitangi and
Māori Health in Nursing Education and Practice, or
•
Medical Council of New Zealand. 2006. Statement or Cultural Competence
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NCSP Competencies for Smear Taker Training
ASSESSMENT OF TRAINEES
Assessment will take two forms.
1. Knowledge as per the theoretical component may be assessed either in writing
involving assignments based on case studies or orally using an assessment tool
developed for the purpose.
2. The practical application of skills and application of knowledge in the practice
setting will be by a clinical assessor using an assessment tool developed for the
purpose.
A minimum of 15 cervical smears is required to be taken before a smear taker is eligible
to be recommended for assessment against the standards of competency in this
document by their clinical supervisor.
Note: Direct supervision by the clinical supervisor is required for at least the first 10
cervical smears that the trainee performs during /following attendance at the smear taker
training programme. The supervisor and trainee should then decide whether the student
may proceed without further direct supervision. The trainee may then take cervical
smears without direct supervision, but must have ready access to his/her nominated
clinical supervisor.
After the first 15 smears, a formative assessment of the trainee smear taker’s practice
could be offered (ie: a mock version of the final assessment) by a clinical assessor (see
Appendix 1 for definition). A final assessment will occur after a minimum of 15 smears
have been completed in accordance with the competencies in this document and which
are within the NCSP specified adequacy rate 1 .
Training providers should have a strategy for review where the competencies are not
met.
1
The accepted adequacy rate for smear takers is 80% or higher (NCSP OPQS).
The 2008 targets for unsatisfactory samples by sample taker are:
•
conventional sample: not less than 1% and not more than 8%
•
liquid based cytology: not less than 1% and not more than 5%
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NCSP Competencies for Smear Taker Training
SMEAR TAKER COMPETENCIES
There are nine areas of competency expected of the smear taker. The competencies
have been aligned with the three elements of NZQA Unit Standard 1098 Perform
cervical screening and cervical smear taking.
Preparing women for cervical screening
•
•
•
•
Competency 1: Overview of cervical screening in New Zealand
Competency 2: Interpersonal skills for cervical screening
Competency 3: Cultural competence for cervical screening
Competency 4: Information for women
Taking cervical smears
• Competency 5: Providing a suitable environment for smear taking
• Competency 6: Knowledge of cervical pathophysiology
• Competency 7: Smear taking practice
Interpreting cervical smear results, initiating follow up action, and
completing documentation
• Competency 8: Smear taker documentation
• Competency 9: Follow-up responsibilities
Where there are relevant NCSP Operational Policy and Quality Standards these are also
indicated (note that these are to be reviewed).
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NCSP Competencies for Smear Taker Training
Preparing women for cervical screening
NCSP Smear Taker Training Competencies 1-4 correspond to NZQA Unit Standard
1098, element 1.
NZQA Unit Standard 1098, element 1:
Prepare women for cervical screening and participation in the National
Cervical Screening Programme (NCSP) in accordance with legislative
requirements and the NCSP Operational Policy and Quality Standards.
1.1
Clients are treated with dignity and respect, in a culturally appropriate
manner.
1.2
Clients are advised of the reasons for having a cervical smear taken,
the process of having a cervical smear taken and the manner in which
they will receive their results.
1.3
Methods of encouraging women (in particular high priority women) to
participate in the NCSP are identified.
Competency 1: Overview of cervical screening in New Zealand
Outcome: Women will have cervical smears taken by a person with sound knowledge
of cervical screening in New Zealand.
Competency statement
Performance Requirements
Demonstrates knowledge •
of cervical screening
•
Can explain the principles of population based screening.
Demonstrates knowledge of the overall NCSP including:
-
objectives
the Cartwright Inquiry and Cervical Screening Inquiry
the screening pathway
recent developments in the Programme.
•
Demonstrates knowledge of smear taking in the context
of women’s health and sexuality, and HPV vaccination.
•
Identifies normal screening age range and interval and
the reasons for avoiding:
- routine screening of under 20 year olds
- short interval re-screening.
•
Identifies barriers to screening coverage and smear taker
strategies for recruitment, retention and achieving equity
in screening.
•
Demonstrates a knowledge of:
-
smear taking services
NCSP-Register function, forms, and reports
relevant NCSP indicators and targets
the NCSP Guidelines for Cervical Screening in New
Zealand, 2008.
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NCSP Competencies for Smear Taker Training
Demonstrates knowledge •
of cervical screening
Demonstrates a knowledge of:
-
smear taking services
NCSP-Register function, forms, and reports
relevant NCSP indicators and targets
the NCSP Guidelines for Cervical Screening in New
Zealand, 2008.
•
Identifies the roles and responsibilities of: smear taker;
clinical assessor; peer support; clinical supervisor;
employer; the NCSP.
•
Demonstrates knowledge of the role of Regional
Services, Independent Service Providers, laboratories,
colposcopy services and the National Screening Unit.
•
Shows a good working knowledge of relevant legislative
requirements, in particular:
- the Health (National Cervical Screening Programme)
Amendment Act 2004
- the Heath Practitioners Competence Assurance Act
2003
- the Health Information Privacy Code 1994
- the Code of Health and Disability
Services
Consumers’ Rights.
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NCSP Competencies for Smear Taker Training
Competency 2: Interpersonal skills for cervical screening
Outcome: Women will have cervical smears taken by a person who demonstrates
effective interpersonal skills
Competency statement
Performance Requirements
Demonstrates effective
interpersonal skills for
screening
•
Introduces a woman to the idea of having a smear and
invites participation in the NCSP.
•
Demonstrates
active
listening
and
effective
communication skills with women in relation to cervical
screening.
•
Demonstrates the ability to put women at ease and
discusses sexuality in a way that is comfortable for the
woman.
•
Responds sensitively to the special needs a woman
may have.
•
Demonstrates that informed consent and confidentiality
is ensured.
•
Acts as an advocate or provides support for a woman.
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NCSP Competencies for Smear Taker Training
Competency 3: Cultural competence for cervical screening
Outcome: Women will be treated by the smear taker with dignity and respect for their culture.
Competency statement
Performance Requirements
Ensures that the particular
cultural needs of women are
met.
•
Practises smear taking in accordance with Nursing
Council of New Zealand and/or Medical Council of New
2
Zealand guidelines for cultural safety .
•
Acknowledges and respects the importance of the
woman’s culture, and understands the implications her
culture may have for her health care needs.
•
Acknowledges the possible limitations of her/his own
knowledge in relation to the woman’s culture.
•
Maintains a culturally appropriate environment for smear
taking (eg, language and culturally appropriate key
messages and invitation letters).
•
Helps the woman observe her own cultural practices – for
example, allowing support people (eg, whanau) during
smear taking.
•
Informs the woman of other cultural networks for her
health needs and support.
OPQS Standard 404: Smear taking providers will ensure that Māori women are given information about
other options for smear taking, including services provided by Māori.
2
Guidelines for Cultural Safety, the Treaty of Waitangi and Māori Health in Nursing Education and Practice (Nursing
Council of New Zealand, 2005)
Statement on Cultural Competence (Medical Council of New Zealand, 2006)
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NCSP Competencies for Smear Taker Training
Competency 4: Information for women
Outcome: The woman has an understanding of the reasons for and the process of
having a cervical smear (and/or HPV test)
Competency statement
Performance Requirements
Demonstrates the ability
to build on each woman’s
knowledge base of
cervical screening in a
way that she can
understand
• Conforms with the Health (National Cervical Screening
Programme) Amendment Act 2004
Section 112L
Duties of persons taking specimens for screening tests
by providing information for women on:
- the importance of regular screening
- the objectives of the NCSP
- the benefits and limitations of screening
- the risks and benefits of participation in the NCSP
- who has access to information on the NCSPRegister and the uses to which that information
may be put, including evaluation of the Programme
- informing women about how the Programme is
evaluated, including evaluators’ ability to access
personal health records.
- how they can withdraw from the NCSP.
• Provides appropriate
regarding:
information
for
women
- choice of smear taker and location
- how specific needs, such as disability, can be met
- how all results will be provided
- the letters and information women will receive from
the NCSP.
• Provides clinical information for women (including
through NCSP resources) including:
- the preventive function of having a smear (ie,
detecting pre-cancerous changes to cervical cells)
-
the causes and risk factors of cervical cancer
- sexually transmissible infections
relevance to cervical screening
-
and
their
the procedure, equipment and the anatomy
involved (in appropriate detail)
- the difference between a conventional and liquid
based cytology (LBC) smear
- human papillomavirus (HPV) testing – reasons for
a test
- the HPV vaccine
- the importance of reporting symptoms to their health
professional immediately.
• OPQS Standard 403 Smear taking providers will ensure that women have access to information about
a range of smear taking providers.
• OPQS Standard 405: Smear takers including specialists will ensure women have been provided
with the required information prior to taking a smear or a histology sample.
• OPQS Standard 409 Smear takers will ensure that 100% of women know how they will be notified of
their results.
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NCSP Competencies for Smear Taker Training
Taking cervical smears
Competencies 5 -7 correspond with NZQA Unit Standard 1098, element 2:
NZQA Unit Standard 1098, element 2:
Take cervical smears in accordance with National Cervical Screening
Programme Operational Policy and Quality Standards.
2.1 A client’s health history is obtained and considered and a clinical assessment
is made in respect of any signs and symptoms indicating possible
abnormalities.
2.2 The technique used for taking the cervical smear is likely to produce an
optimal smear result and avoid unnecessary discomfort to the client.
Competency 5: Providing a suitable environment for smear
taking
Outcome: Women will have cervical smears taken in an environment that is private, safe
and comfortable.
Competency statement
Provides an appropriate
environment for smear taking.
Performance Requirements
•
Ensures the privacy of the woman at all times.
•
Creates a comfortable environment for the woman.
Competency 6: Knowledge of cervical pathophysiology
Outcome: Women will have cervical smears taken by a person with good knowledge of
the pathophysiology of cervical cancer.
Competency statement
Performance Requirements
Demonstrates good
knowledge of
pathophysiology of cervical
cancer.
• Demonstrates knowledge of anatomy and physiology of
the female genital tract, the menstrual cycle, and
changes in the cervix throughout a woman’s life.
• Demonstrates knowledge of the natural history and
epidemiology of cervical cancer.
• Can identify causative factors and ways to minimise the
risk of cervical cancer, including an understanding of the
HPV vaccine.
• Demonstrates knowledge of cervical cytology, both
normal and abnormal.
• Demonstrates understanding of the use of HPV testing
and identifies when HPV testing is appropriate
(according to NCSP Guidelines for Cervical Screening in
New Zealand).
• Identifies when a vaginal vault smear is appropriate.
• Can identify common methods of treatment for precancer.
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NCSP Competencies for Smear Taker Training
Competency 7: Smear taking practice
Outcome: Women will have cervical smears taken by a person who is competent in
smear taking clinical practice.
Competency statement
Demonstrates a smear
taking technique likely to
produce an optimal smear
result and avoid
unnecessary discomfort to
the woman.
Performance Requirements
• Ascertains the woman’s health history and can obtain a
screening history from the NCSP-Register.
• Offers women a choice of position for smear taking.
• Demonstrates procedures for exposing the cervix and
identifying the transformation zone, including dorsal and
left lateral positioning.
• Utilises practices to prevent cross-infection.
• Adequately visualises the cervix.
• Knows how to take vaginal vault smears when
appropriate.
• Recognises characteristics of normal and abnormal
cervices and range of normality. Knows the limitations of
smear taking, including the boundaries of her/his own
skills and knowledge, and refers appropriately.
• Selects appropriate sampling instruments for both
conventional Pap and LBC smears.
• Uses technique most likely to collect sufficient cervical
cells and minimise false negative smears.
• Prepares cytology sample using both conventional
smears and LBC in a way that is in accord with
manufacturer’s instructions and allows accurate
cytological analysis.
NCSP OPQS Standard 405: The smear taker’s practice will have appropriate infection control
procedures and facilities.
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NCSP Competencies for Smear Taker Training
Interpreting cervical smear results, initiating follow up
action, and completing documentation
Competencies 8 and 9 correspond with NZQA Unit Standard 1098, element 3:
NZQA Unit Standard 1098, element 3:
Interpret cervical smear results, initiate follow up action, and complete
documentation.
3.1 Results are interpreted according to laboratory recommendations, NCSP
Operational Policy and Quality Standards and clinical indications.
3.2 All clients, from whom a cervical smear has been taken, are appropriately followed
up according to NCSP recommendations.
3.3 Accurate and confidential record-keeping systems are maintained including an
effective recall and transfer system.
3.4 An effective interface with the NCSP-Register is maintained in accordance with
NCSP requirements
Competency 8: Smear taker documentation
Outcome: Women will have documentation and records concerning their cervical
screening accurately and confidentially maintained by the smear taker.
Competency statement
Performance Requirements
Demonstrates the ability
to keep accurate and
confidential
documentation and
records.
• Accurately completes details on the lab referral forms.
• Identifies minimum information requirements.
• Demonstrates understanding of the importance of
providing accurate ethnicity information - asks women
to self-identify ethnicity.
•
Demonstrates a good knowledge of:
- effective and accurate record-keeping systems
- transfer of information to the NCSP-Register
- measures to ensure the confidentiality of records
and storage according to legislative requirements
- setting up and maintaining an effective recall and
referral system.
- an effective system for transfer of clients when a
smear taker relinquishes her/his services.
• OPQS Standard 402: Smear takers will invite or recall women and provide a smear taking service
in accordance with the Guidelines for Cervical Screening in New Zealand (2008)
• OPQS Standard 407: Smear takers will provide the woman’s family name or surname and initials
of first or given names, and date of birth or NHI on all cytology slides or liquid based vials.
• OPQS Standard 408: Prior to sending the form and the specimen to the laboratory, smear takers
must ensure that either of the following are completed:
- the minimum information (outlined in Section 4 of the NCSP OP&QS) on a generic laboratory
referral form, or
- all details on the NCSP laboratory form.
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NCSP Competencies for Smear Taker Training
Competency 9: Follow-up responsibilities
Outcome: Women will have accurate, timely and sensitive follow-up of their results.
Competency statement
Demonstrates the ability
to maintain accurate,
timely, confidential and
sensitive follow-up of
results
Performance Requirements
• Follows up with laboratory when necessary to ensure
results are received in a timely manner.
• Initiates a review when there is doubt about the
findings.
• Sights and accurately interprets smear reports in
conjunction with clinical findings according to the NCSP
Bethesda Coding Standards.
• Sights and accurately interprets HPV testing results.
• Appropriately communicates abnormal results to the
woman and advises on the need for further
investigation according the NCSP Guidelines for
Cervical Screening in New Zealand (2008).
• Recalls women according to the laboratory
recommendations, NCSP Guidelines for Cervical
Screening in New Zealand (2008) and clinical
indications.
• Demonstrates an understanding of colposcopy and
histology results and treatment processes and liaises
with colposcopy service.
• Ensures processes are in place so that all women are
appropriately followed up, including contacting women
who do not attend.
• Maintains confidentiality of client records
confidential systems of transmission of results.
and
• OPQS Standard 410: Smear takers will have processes in place to ensure that results are
obtained from the laboratory within 14 working days of sending the cervical cytology to the
laboratory.
• OPQS Standard 411:
Smear takers will recall women in accordance with laboratory
recommendations on smear results and clinical indications.*
• OPQS Standard 412: Smear takers will have processes in place which ensure all women with an
abnormal smear result are appropriately followed up.
* Smear takers should recall women in accord with NCSP Guidelines for Cervical Screening 2008.
15
NCSP Competencies for Smear Taker Training
SMEAR TAKER APPROVAL
The NZQA accredited training provider for Unit Standard 1098 will submit the following in
writing to the NCSP Regional Service of the region where the trainee is practising.
•
At the commencement of each training programme, a list of names of the smear
taker trainees inclusive of the registration/enrolment number of the trainee as
appropriate.
•
Within 12 months of the commencement date, a list of names, a copy of the NZQA
Record of Learning, and other relevant written evidence of the smear taker trainees
successful completion and assessment against the theory and practical requirements
of Unit Standard 1098 Cervical Screening – Perform Cervical Screening and Cervical
Smear Taking.
•
Annually, a list of names of the smear taker trainees who have not completed the
components of Unit Standard 1098 Cervical Screening – Perform Cervical Screening
and Cervical Smear Taking.
The NCSP Regional Service will:
•
At the commencement of each training programme, record each smear taker’s
unique registration number/ Health Practitioner Index number with training status
onto the NCSP-Register (according to NCSP-Register User Guide).
•
Notify in writing HealthPac and the relevant laboratory/ies of each smear taker’s
number.
•
Follow-up with trainees who have not completed the training programme after 18
months.
Note:
• Trainees need to notify their local Regional Service to obtain and receive regular
Quality of Smear reports.
• All smear takers must practice under their own ID number.
• It is the responsibility of every individual smear taker and/or their employer to arrange
appropriate indemnity insurance.
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NCSP Competencies for Smear Taker Training
MAINTAINING COMPETENCE
Smear takers are expected to maintain their competence by:
• monitoring their smear adequacy rate via their Quality of Smear report. This is
issued 6-12 monthly, however, smear takers can request this from the NCSPRegister at any time
• taking smears on a regular basis (a minimum of 30 per year recommended)
• reading current information from the NCSP and relevant journal articles
• attending regular clinical updates run by relevant professional bodies, NCSP
Regional Services and/or the NSU - one smear taker update session a year is
recommended.
Where a smear taker has not been taking smears for an extended period of time, it is
recommended that he or she have a clinical supervisor for the first few smears (eg, 35) and attend a smear taker update session.
Where a smear taker’s adequacy rate is consistently below the standard it is
recommended that he/she seek the advice of a peer supervisor or the NCSP Clinical
Leader.
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NCSP Competencies for Smear Taker Training
APPENDIX 1 – Definition of terms
Smear taker
A smear taker is a registered health professional, such as a medical
practitioner, registered nurse, enrolled nurse, nurse assistant or
registered midwife. The smear taker has successfully completed a
course of training as a smear taker, which may be part of their clinical
training, and has demonstrated competency against the national
standards.
Clinical supervisor
An experienced smear taker chosen by the trainee. The clinical
supervisor will provide continuing support to the trainee smear taker by
explaining and demonstrating solutions for any problem areas the
smear taker encounters. This person must be delivering a cervical
smear taking service according to NCSP OPQS requirements. He/she
must have a current smear taker ID number and have been taking at
least 30 cervical smears per year at the accepted adequacy rate for at
least one year (this is a minimum, three years is preferable).
Clinical assessor
A smear taker designated by a training provider to carry out
assessments in the practical component of the training course. This
person must meet the same requirements as for clinical supervisor
(above). It is preferable that the clinical assessor not also be a trainee
smear taker’s clinical supervisor.
Clinical Placement
(Client base)
Access to 30 smears per year (recommended), under normal
circumstances.
18