title: Cervical cancer screening and treatment training course in El Salvador: experience and lessons learned.
abstract: BACKGROUND
  Visual inspection with acetic acid (VIA) is a simple, low-cost alternative to traditional Pap smears that could greatly benefit the amount of screening and treatment available in low-resource areas, such as rural El Salvador. The objective of this study was to train Salvadoran health providers in VIA and cryotherapy using a week-long competency course.
  
  
  METHODS
  Health providers participated in the VIA training course, which consisted of 1 half-day of didactics, followed by 4 and 1 half days of clinical training. Pretests and posttests were administered. A 1-day didactic refresher course was administered to assess the quality of services being provided.
  
  
  RESULTS
  Sixty-eight nurses and physicians completed the training course. Each trainee screened approximately 120 women and performed, on average, seven cryotherapy treatments. The average trainee improved his or her score by 15% on the theoretical test and 16.7% on the image test. At the completion of the 1-day refresher, average test scores were the highest among all the courses. The final assessment was based on 41 providers.
  
  
  CONCLUSIONS
  The course proved a successful tool for training healthcare providers in methods of cervical cancer screening and treatment. The course is replicable in other low-resource settings in different countries. It also provided trainees with the opportunity to adapt their clinical skills in their realistic work setting.
authors.affiliation: Department of Obstetrics and Gynecology, Beth Israel Medical Center, New York, New York, USA.
authors.forename: Rachel
authors.initials: R
authors.lastname: Masch
authors.forename: Lauren R
authors.initials: LR
authors.lastname: Ditzian
authors.forename: Ayana K
authors.initials: AK
authors.lastname: April
authors.forename: Mauricio
authors.initials: M
authors.lastname: Maza
authors.forename: Ethel
authors.initials: E
authors.lastname: Peralta
authors.forename: Miriam L
authors.initials: ML
authors.lastname: Cremer
mesh_terms: D019342:Acetic Acid; D002584:Cervix Uteri / Q000473:pathology; D017679:Cryotherapy; D004521:Educational Measurement; D004544:El Salvador; D005260:Female; D058869:Gynecological Examination; D006176:Gynecology / Q000193:education; D006801:Humans; D007202:Indicators and Reagents; D008403:Mass Screening; D009726:Nurses; D010820:Physicians; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000628:therapy*
chemical_list: D007202:Indicators and Reagents; D019342:Acetic Acid