D1. Who must take this proficiency test?
D2. If I only screen non-gynecologic cytology specimens, must I participate in this cytology proficiency test?
D3. What is considered a passing score on a proficiency test?
D4. Will my proficiency test be unannounced or will I know in advance when to anticipate my proficiency test?
D5. What happens if I miss the testing event in my laboratory?
If the test is missed for an excused absence, laboratories must contact the proficiency testing program to determine when and where the make-up examination will take place. Examples of “excused” absences include prior scheduled leave, natural disasters, hospitalization, death in the family, etc.
D6. If I fail a proficiency test, will I have to stop screening Pap smears?
- If an individual passes the first 10-slide test, he/she has successfully participated for the year and need not be tested again until the following year.
- If the individual fails the first 10-slide test, he/she must take a 10-slide retest within 45 days after notification of test failure.
- When an individual passes the second 10-slide test, he/she has successfully participated for the year and need not be tested again until the following year.
- If the individual fails the second 10-slide retest:
- The individual must obtain documented, remedial training in the area of test failure, which will be noted on the test results letter.
- All Pap smears screened by the individual subsequent to the notification of failure must be reexamined, and
- The individual must successfully participate in a 20-slide proficiency test within 4 hours.
- If the individual fails the second 10-slide retest:
- If the individual fails the third 20-slide test:
- He/she must cease examining Pap smears immediately upon notification of failure;
- The individual must obtain at least 35 hours of documented, formally structured, continuing education in diagnostic Cytopathology which focuses upon the examination of gynecologic cytology; and
- The individual must successfully participate in another 20-slide proficiency test.
- This final cycle would continue until the individual successfully participates in another 20-slide proficiency test. Please see Attachment A at the end of this document for an overview of the testing process.
D7. How much time will I have to take a 10-slide test? A 20-slide test?
D8. How will cytotechnologists and physicians be tested?
D9. Who will receive a copy of my test results and will they be kept confidential?
CMS will make every attempt to maintain the confidentiality of the test scores. See Section H, Confidentiality, of this document for further details on the recordkeeping system.
D10. How are the slides referenced by the proficiency testing program?
D11. Will the test sets be comparable?
D12. What diagnostic categories are used in the test sets?
- Unsatisfactory samples (i.e., scant cellularity, air drying, and obscuring material (blood, inflammatory cells or lubricant));
- Normal or Benign Changes (i.e., normal, negative, or otherwise within normal limits, infections other than Human Papilloma virus (HPV) (e.g., Trichomonas vaginalis, changes or morphology consistent with Candida spp., Actinomyces spp., or Herpes simplex virus),
- Low Grade Squamous Intraepithelial Lesions – includes: Cellular changes associated with HPV, Mild Dysplasia/CIN-1,
- High Grade Squamous Intraepithelial Lesion and Carcinoma – includes moderate dysplasia/CIN-2 and severe dysplasia/carcinoma in-situ/CIN-3, Squamous Cell Carcinoma, Adenocarcinoma and other malignant neoplasms.
NOTE: These diagnostic categories are consistent with those listed in the 2001 Bethesda Conference report.
D13. Are cytotechnologists and physicians scored the same way?
Technical Supervisors (Pathologist):
The highlighted areas (in bold) on the grids demonstrate those diagnostic categories where the cytotechnologist’s and technical supervisor’s score would differ. The red highlighted areas demonstrate where there is interpretive agreement with the Correct Diagnosis and that of the Participant. To determine the final score of a testing event, each slide is given a numerical value, as specified on the scoring grids. Cytotechnologists receive a score based on the “Cytotechnologist Grid” and the Technical Supervisor’s score is based on the “Technical Supervisor Grid”. The Cytotechnologist’s and Technical Supervisor’s diagnosis can be found along the X-axis. The Proficiency Testing Program diagnosis, based upon 100% consensus of at least 3 physicians board certified in anatomic pathology and tissue biopsy confirmation of cases in the premalignant and malignant categories can be found along the Y-axis. Both Cytotechnologists and Technical Supervisors begin with a score of zero. Points are accumulated based on the accuracy of their diagnosis to the diagnosis specified by the Proficiency Testing Program.
D14. If I miss a high-grade lesion or a cancer, will I pass the test?
D15. What would happen in a laboratory if the cytotechnologist passes the test and the technical supervisor fails the test?
D16. May I enroll in another cytology proficiency testing program when one becomes available?
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