Preventive health practices in a teaching hospital: house staff attitudes and performance of gynecological screening.

Attitudes toward and the performance of Pap smears by the house staff in nongynecological hospital admissions were evaluated as markers of preventive health practices in a tertiary-care hospital. A major discrepancy between house staff attitudes and behaviors was noted. The residents considered it important to offer a Pap smear to all women on admission. However, a random review of 150 medical and surgical charts revealed a lack of documentation of pelvic examinations in 67 percent of the charts and Pap smears in 33 percent of the charts. Overall, Pap smears were actually performed on only eight of 150 patients. A survey of random hospital floors revealed a lack of equipment and facilities for performing Pap smears. Such factors were thought to be the major contributors to the failure by house staff to perform pelvic exams and Pap smears. Steps to increase the performance of these types of preventive health practices should include the use of a checklist admission form and the maintenance of appropriately equipped facilities on all hospital floors. We suggest a greater emphasis on the development of educational strategies to teach preventive health care principles in residency training programs.