title: Web-based instrument to assess skills in visual inspection of the cervix among healthcare providers.
abstract: OBJECTIVE
  To validate a web-based instrument for assessing healthcare providers' skills in visual inspection with acetic acid or Lugol iodine (VIA/VILI) for the diagnosis and management of cervical intraepithelial neoplasia.
  
  
  METHODS
  An observational cross-sectional study enrolled healthcare providers in a web-based assessment of VIA/VILI skills between August and November 2014. Participants participated in a four-module training course, followed by a multiple-choice test with 70 questions based on cervical photographs of HPV-positive women participating in cervical screening. Logistic regression was used to identify relationships between independent variables and success on the test.
  
  
  RESULTS
  Overall, 255 participants completed the test and 99 (38.8%) passed. No correlation was found between age or sex and test performance. Compared with other healthcare workers, physicians (odds ratio [OR] 1.91, 95% confidence interval [CI] 1.01-3.63; P=0.048), and participants with more colposcopy experience (OR 3.62, 95% CI 1.91-6.85; P<0.001) and postgraduate VIA/VILI training (OR 1.95, 95% CI 1.16-3.29; P=0.012) were more likely to pass the test. Participants who repeated the test (31/255 [12.2%]) were five times more likely to succeed on their second repeat (OR 5.89, 95% CI 1.46-23.73; P=0.013).
  
  
  CONCLUSIONS
  Web-based training for VIA/VILI is feasible and can identify healthcare workers who are proficient in this technique.
authors.affiliation: Division of Gynecology, Department of Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland. Electronic address: negulescu.raluca@gmail.com.
authors.forename: Raluca-Anca
authors.initials: RA
authors.lastname: Negulescu
authors.affiliation: Division of Gynecology, Department of Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland.
authors.forename: Rosa
authors.initials: R
authors.lastname: Catarino
authors.affiliation: International Agency for Research on Cancer, Lyon, France.
authors.forename: Hugo
authors.initials: H
authors.lastname: De Vuyst
authors.affiliation: Division of Gynecology, Department of Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland.
authors.forename: Manuela
authors.initials: M
authors.lastname: Undurraga-Malinverno
authors.affiliation: Division of Gynecology, Department of Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Meyer-Hamme
authors.affiliation: Division of Gynecology, Department of Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland.
authors.forename: Milena
authors.initials: M
authors.lastname: Alec
authors.affiliation: Geneva Foundation for Medical Education and Research, Geneva, Switzerland.
authors.forename: Aldo
authors.initials: A
authors.lastname: Campana
authors.affiliation: Geneva Foundation for Medical Education and Research, Geneva, Switzerland.
authors.forename: Pierre
authors.initials: P
authors.lastname: Vassilakos
authors.affiliation: Division of Gynecology, Department of Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland.
authors.forename: Patrick
authors.initials: P
authors.lastname: Petignat
mesh_terms: D019342:Acetic Acid / Q000032:analysis; D000328:Adult; D000368:Aged; D002983:Clinical Competence / Q000592:standards*; D003127:Colposcopy / Q000193:education; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D006282:Health Personnel / Q000193:education*; D006801:Humans; D038622:Internationality; D020407:Internet / Q000706:statistics & numerical data*; D007454:Iodides / Q000032:analysis; D016015:Logistic Models; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D015999:Multivariate Analysis; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D014944:World Health Organization; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis*
chemical_list: D007454:Iodides; D019342:Acetic Acid; C010389:Lugol's solution
keywords: Cervical cancer screening; Low-resource setting; VIA; VILI; Web-based education