The manufacturers of Nexplanon^®, the subdermal contraceptive implant (SDI), recommend a technique for insertion and removal. This is endorsed by the UK Faculty of Sexual & Reproductive Healthcare (FSRH; the Faculty) who provide Letters of Competence following completion of an e-learning programme (e-SRH),1 practice on a dummy ‘arm’ and practical training by a Faculty registered trainer (FRT).2 Insert superscript reference number 2 here. Unfortunately, the trainee may have more than one trainer, who may utilise varying techniques, which may be confusing to the learner. I decided to ask FRTs how they insert and remove SDIs when teaching in order to assess the magnitude of any differences.

In May 2012, the FSRH e-mailed on my behalf a questionnaire to 980 FRTs on the Faculty's database. I asked questions about implant insertion and removal, asked for a free text description of removal and whether this had changed over time, and views on e-SRH. I defined a large difference if 75% or fewer respondents perform a manoeuvre differently from the recommended technique.

Some 980 questionnaires were sent out and 198 returned. Table 1 shows the responses obtained to …