CONSULTATION DOCUMENT

Options for the organisation and delivery of ongoing cytology training in New Zealand

This Document is published here (17 Feb 2004) for the benefit of the NZ cytology/screening programme community as part of the ongoing consultation process about the future of training and development in cytology.
- NZSC Webmaster

1. CERVICAL CYTOLOGY WORKFORCE TRAINING

The National Screening Unit (NSU) of the Ministry of Health is developing options for the co-ordination and development of ongoing training programmes in cervical cytology for all sectors of the laboratory workforce in New Zealand. An independent training group with the flexibility to provide training at a variety of sites is the preferred model, after consultation with the sector to date.

This paper outlines various options currently being considered, with a view to obtaining wide sector consultation. The advice on which of these options to adopt will be made following this round of consultation and further discussion with the Cytology Training Working Group. Your response with your preferences would be very helpful during this process.

The current interim Cytology Training Working Group finishes at the end of June 2004, by which time decisions about the training model and its implementation should be complete. Establishment of a training programme should then follow, in the latter half of 2004.

2. AIMS

The essential benefit being sought is that all individuals involved in cervical cytology have ready access to relevant, affordable, appropriate ongoing training that enables them to maintain and develop their skills, and meet the requirements specified by the National Cervical Screening Programme (NCSP) Operational Policy and Quality Standards. Other benefits should include:

3. PRINCIPLES

The following principles would apply regardless of the training structure.

  1. Participation by the sector is critical to identify needs, priorities, content and education and training methodology for professional groups.
  2. Flexibility is vital regarding training locations, training modalities and changes within the sector with time.
  3. Training is available to all personnel who process or interpret cervical smears.
  4. Training courses are accredited with the relevant professional bodies for continuing professional development programmes.
  5. Training courses comply with the NCSP Operational Policy and Quality Standards and relevant New Zealand statutory requirements e.g. Health Practitioners' Competency Assurance Act (2003).
  6. Commercial neutrality is preserved as far as possible in developing and running all aspects of training.
  7. All training personnel including instructors and tutors are current practitioners in cervical cytology.
  8. NZ training resources are used as far as possible. Overseas expertise is incorporated when this is beneficial to NZ e.g. courses for advanced practitioners.

4. TRAINING ORGANISATION AND DELIVERY

Three options for the organisation and delivery of cytology training have been identified.

  1. A National Cytology Training Co-ordinator.
  2. A National Cytology Training School.
  3. A National Cytology Training Committee.

The NSU would implement the preferred training model through a contractual arrangement, which would include establishment funding. There would be accountabilities to both the NSU and the cytology sector. The site from which training would be coordinated could vary with time and personnel, with courses and workshops run at various locations according to demand and training facilities. Clerical / secretarial assistance would be required with each option. All models would rely on the co-operation of established laboratories to provide case slide material for training purposes. The three options are outlined below with some suggested advantages and disadvantages to stimulate discussion.

4.1 A National Cytology Training Co-ordinator

A National Cytology Training Co-ordinator would lead the development of cytology training in New Zealand. The appointed co-ordinator would be a current practitioner with a background in cytology education and training, and would need to develop a relationship with all relevant parties. The appointment would probably need to be about 0.5 FTE, to allow enough other time to maintain a professional career.

Advantages Disadvantages
  • Simple structure.
  • One clearly identified person for the sector to contact.
  • Lines of responsibility very clear.
  • Probably the cheapest.
  • Direct communication with NSU.
  • Efficient decision making.
  • Large workload and responsibility for one individual, particularly as this person would also need to be practising.
  • A scientist / cytotechnologist would not be readily conversant with pathologists' requirements and vice versa.
  • Effectiveness of the programme very reliant on the personal and professional strengths and weaknesses of one individual.
4.2 A National Cytology Training School

This option is based on the British Cytology Training Schools model. The Training School would lead the development of cytology training in New Zealand. If based on the UK model, personnel would consist of approximately a 0.2 FTE pathologist director, a 0.3 FTE scientist / cytotechnologist training centre manager and a 0.5 FTE training tutor. Although the UK model is based at a specific location, this need not be the case in NZ i.e. courses could be run around the country, rather than the participants having to travel to one location.

Advantages Disadvantages
  • Structure still relatively simple so people to contact would still be clear for sector and the NSU.
  • Includes pathologist and scientific / technical staff.
  • Decision making relatively efficient, a "tried and tested" approach elsewhere.
  • Still sizeable workloads especially initially.
  • More costly than one co-ordinator, especially if personnel spread around country.
4.3 A National Cytology Training Committee

A National Cytology Training Committee could be formed with membership representing pathologists, scientists and technical staff. One possibility is for the multidisciplinary NZSC to take a lead role, as discussed at the 2002 annual general meeting. This would require at least some key people with dedicated tenths. The role and responsibilities of any members without dedicated tenths (time) would need to be well defined.

Advantages Disadvantages
  • Greater representation and input from the sector
  • Greater pool of personal and professional strengths to call on
  • Workload can be spread out more
  • May mean easier access to slide material as personnel from more labs are directly involved.
  • Communication and decision-making more complex
  • Progress may be slower
  • Most costly option, especially if face to face meetings need to occur regularly.
5. YOUR FEEDBACK

The Cytology Training Working Group is intending discussing these options on 2 March 2004. Feedback from the sector will be seriously considered when advice is given on which option to pursue for NZ. We are interested in any comments you have to make, particularly which of the above options you favour. Other ideas or models that could be considered are also welcome.

Please send your response with your reactions and preferences by: Friday 27 February, via email or in writing to:

The laboratory sector representatives on the Cytology Training Working Group are given below, if you wish to discuss these matters directly with them.

Many thanks for your time and attention. The Cytology Training Working Group look forward to your participation and feedback.