Taking a Smear

Cervical cytology, or smear tests, form part of the UK screening programme.  It is an intimate investigation to obtain cells from the cervix (neck of the womb).  It can be performed at any time (previously not within 10 days of period) however it is best if the women is not menstruating.

It is known that Human Papillomavirus (HPV) increases the risk of abnormal smear results, including cervical carcinoma and as such UK guidance has recently changed to include HPV analysis.  In 2008 the HPV vaccination was also introduced in the UK. For more info on this see Paediatric Immunisation.

For the purpose of examinations you will be provided with a mannequin to perform this skill, however you should pretend it is a real patient and talk to it as such, which will also form part of the marking scheme.

Subject steps

  1. Introduce yourself to the patient and clarify her identity.  Explain what you would like to do and obtain consent.  Explain she should feel little, if any, discomfort and that the examination should be over fairly quickly.  A chaperone IS required for this examination.

     

  2. The patient should be exposed from the waist down. Ask her to lie on the bed with her ankles together and allow her knees to spread apart as much as possible.

  3. Offer the patient some tissue, cover the patient, and thank her. You should explain to the patient that her smear results will be sent to them in approximately 6 weeks thus ensuring appropriate follow-up.

  4. An extension to this station could be interpretation of cytology results.  Guidance has recently changed and includes HPV analysis. You should be familiar with these.