The Eurocytology Project A uniform platform for education, training and development of transferable skills in clinical cytology screening and diagnosis R Dina 1, M.Totsch, A. Fassina, J. Duskova, B. Onnal, A. Capitanio, Interfase SrL, A Badger ( call) DV Coleman 1, L Vass, W Olszweski, W Domegala, M Chosia, A Capitanio, G Morgan, A Bondi ( call) 1 Imperial College Healthcare NHS Trust London, EFCS, Czech Cytology Society, Turkish Cytology Society, Interfase Srl, Inbrook Ltd Impereial College London, Hungarian Society of Cytology, Polish Society of Cytology, Pomeranian Medical University, University College London, Karolinska Hospital and Institute, Swedish Society of Cytology, Italian Society of of Cytopathology

Eurocytology  What it was meant to be  What we have created  Who uses it and where  What is peculiar to it  Where do we want to go

The Eurocytology Website The Eurocytology website is a unified platform for the vocational training and professional education of both cytotechnologists and cytopathologists. The project is supported by the EU Leonardo da Vinci program. The website was hosted on Imperial College website and was password protected during validation by EACC Has gone live as a public domain in December 2007 and is free to access

Partner institutions call call  I mperial College, UK (Lead)  Karolinska Institut, Stockholm, Sweden  Pomeranian Medical University, Szeczin, Poland  Hungarian Society for Clinical Cytology  Swedish Society for Clinical Cytology  Polish Cytology Society  Italian Society of Anatomic Pathology & Cytology  Inbrook Ltd  Imperial College NHS Trust (RxEye) (Lead)  EFCS (EACC)  Turkish Society of Cytology  Czech Society of Cytology  Interfase Srl  Inbrook Ltd

Target groups  Trainee cytotechnologists  Cytopathologists in training  Cytology teachers and instructors  Medical students

Contents The training comprises of:  A series of teaching packages  A small reference library of cytology slides  A cervical cytology self assessment test

Aims of the project  Increasing access to training in clinical cytology  Harmonising training in cytology throughout the EU  Improving standards of training  Encouraging continuing professional development  Promoting equal opportunities for employment in the EU

Validation  The training program has been independently validated by the European Advisory Committee on Cytotechnology (EACC)

Average monthly traffic

What is peculiar to this project?  Transnationality  Validation through a European Network  Dinamic tests through the use of a specific software and image database  Use of virtual slides  Translated in several languages

The new Eurocytology Project  The website was originally developed with Leonardo funding. Its use has significantly exceeded expectations. It is now the most used cytology e-learning training platform on the web. The platform is interactive, available in 6 languages (English, Spanish, Italian, Greek, Polish and Hungarian) and can be accessed on In 2012 it received on average 37,000 visits and 56,000 pages downloaded/ month.  There is now a need for further work. More EU countries wish to become involved, with their own training priorities and curricula and the whole training platform needs to be expanded to reflect their particular professional and competence requirements. The materials need to be updated and enhanced. The architecture of the website will become dynamic rather than static.  EFCS, our European Federation, is looking to the website to provide the platform for a European recognised accredited professional training programme; particularly as the European Union of Medical Specialists (UEMS) Oct 2012 ratified that sector training must follow an approved curriculum with individual nations regularly assessed and national variations approved.

The new Eurocytology Project  Our aims and objectives are to ensure that we deliver EU wide improvements in the quality of the training available for curriculum development, increase further website use, particularly in countries currently not readily using the website and provide a universally accepted and relevant accredited training tool. This to support both initial and continuous training needs, provide for a shift to learning outcomes, competence-based systems and the validation of prior non-formal and informal learning.

Eurocytology Partners  Imperial College Healthcare NHS Trust  European Federation of Cytology Societies  Turkish Cytology Society  Czech Cytology Society  Inbrooks Ltd  Interfase

Eurocytology  Successful in applying for another EU grant  Move platform from static to dynamic architecture  EFCS is a partner (already linked to website)  Linked to IAC website  Translate into Turkish, Czech, Portuguese and German  Incorporate translations and adaptations into national curricula (Turkey, Czech Republic)  Increase interactivity by devising online assessment and testing tools  Maintain an editorial committee  Validate it as a European Accreditation Scheme Platform Through QUATE

Traffic

World

European countries

Return visits  Visits visit86.4%74.7%  2 visits 9% 15%  3 visits2.1%5%  4 visits 1% 2.1%  5 visits 0.5%1%

Conclusions  The traffic is increasing year on year by approximately 11%  More countries are using the platform  More languages are being added  Return visits have increased by 2 fold between 2012 and 2014

Chapters Editorial contentAcademic contentPractical valueComments The female genital tract Anatomy,physiology and histology of cervix Cervical cancer: epidemiology, aetiology, pathogenesis and main histological types HPV in cervical cancer The Pap test: principles of collection and preparation of specimens…… Normal cell contents of cervical smears, contaminants and aretefacts.. Inflammatory changes,specific infections reactions,repair and iatrogenic changes Squamous carcinoma, SIL and ASCUS Glandular lesions and management of women with abnormal smears Quality Assurance Health and safety in the laboratory Automation and liquid based cytology Self Test Virtual Slides library

ADDITIONAL PLANNED CHAPTERSYesModeratelyNo Colposcopy Self assessment for each chapter 10 Virtual slides for each chapter Immunocytochemistry in cytology Molecular diagnostic tests in cytology Flow Cytometry The role of Cytotechnologists in FNA cytology CSF cytology Joint Fluid cytology On line examination in cervical cytology On line examination in diagnostic cytology QUATE mock examination on line

EACC Questionnaire responses AdditionsUsefulness (only very useful) Colposcopy 19/32 (1 NO) Self assessment each ch.30/32 10 virtual slides for each ch.29/32 ICC in cytology25/32 Molecular diagn. tests in cytology25/32 Flow cytometry16/32 (5 NO) The role of Cytotechnologists in FNAC 18/32 (1 N0) CSF cytology25/32 Joint Fluid cytology21/32 (1 NO) On line examination in cervical cyt25/32 (2 NO

Update on the project  Dissemination is strong (European tutorials, Turkish Cytology Society meetings, Czech Cytology Society workshops, European Cytology Congress in Geneva)  Quate is an active participant  French Society (Christine Bergeron and Beatrix Cochand-Priollet) agreed to translate in French  Rumanian translation starting (Anamaria Pop-Bucuresti)  Russian translation (Russian Society of Cytology)  EFCS to co-ordinate German translation  EACC to validate editorial content  20 Thinprep samples and 70 conventional smears have been digitally scanned, Surepath to follow.  By end September 2014, 120 non gynae cytology cases have been scanned  Collaboration with RxEye (MDT cases and digital slides)  Editorial update by September 2015  QUATE mock exam being uploaded