title: The influence of ASCCP guideline changes on family medicine residency colposcopy training.
abstract: OBJECTIVE
  The study objective was to determine the influence of the 2001 and 2006 American Society for Colposcopy and Cervical Pathology (ASCCP) guidelines changes on colposcopy training at one family medicine residency.
  
  
  METHODS
  We conducted a retrospective chart review from January 1, 2000 to October 31, 2009. The 2001 ASCCP guidelines were fully implemented into our practice in June 2002 and the 2006 guidelines in June 2008. Data were extracted from our electronic medical records and delineated into three groups: 2000-2002 (pre-2001 guideline changes), 2003-2007 (post-2001 and pre-2006 update), and 2008-2009 (post 2006 changes) for total female patient visits aged 18-75 years, pap smears, and colposcopies. An ANOVA post-hoc comparison test was performed on the three data groups to test significance.
  
  
  RESULTS
  After the 2001 guidelines, there was a 28.6% significant decrease in colposcopies (CI=0.20-0.37). An additional, 16.5% significant decrease occurred after the 2006 revisions (CI=0.06-0.28). Consequently, residents performed 45.1% fewer colposcopies. The total number of pap smears remained relatively unchanged.
  
  
  CONCLUSIONS
  Implementation of the 2001 and 2006 ASCCP guidelines significantly reduced the number colposcopies performed, resulting in greater difficulty training competent family medicine residents in colposcopy.
authors.affiliation: Florida Hospital Family Medicine Residency, Winter Park, FL, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Keehbauch
authors.forename: Lizina
authors.initials: L
authors.lastname: Green
authors.forename: Nadia
authors.initials: N
authors.lastname: Lugo
authors.forename: Julie
authors.initials: J
authors.lastname: Pepe
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D003127:Colposcopy / Q000193:education* / Q000706:statistics & numerical data; D005194:Family Practice / Q000193:education*; D005260:Female; D005431:Florida; D019983:Guideline Adherence; D006801:Humans; D007396:Internship and Residency; D008485:Medical Audit; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D012955:Societies, Medical / Q000592:standards; D055815:Young Adult