Assessing intern doctors’ knowledge of transfusion medicine: A survey

Knowledge of physicians has an important role in optimal use of blood products. This study was carried out to assess Iranian physicians' knowledge in transfusion medicine. In this cross-sectional study, 1242 physicians were selected through multistage sampling method in March 2007. Physicians' knowledge was assessed by the questionnaire comprising of 50 questions addressing basic knowledge, clinical aspects of blood use and transfusion reactions. One point was awarded for each correct answer. Approximately 22%, 37%, and 40% of the questions referring to basic knowledge, clinical aspects of blood use and transfusion reactions, respectively, were replied correctly. Thirty three percent came out to be the average figure for the questions receiving correct answers. Knowledge score of the specialists who were more frequently involved in blood use was not significantly different from other specialists (radiologists or psychiatrics) and general practitioners. Knowledge score decreased with increasing years in practice (P < 0.001). Ninety nine percent of physicians under the study believed that they required special education to raise their transfusion medicine knowledge. Knowledge of physicians was about one-third lower than the expected level. Therefore, educational materials concerning transfusion medicine should be provided for medical students, residents and fellows. For practicing physicians, continuous medical education programmes should be offered so that the level of transfusion medicine knowledge can be improved.

This study was conducted to assess transfusion knowledge between different specialty board residents and to identify areas of need for further education. Physicians' knowledge of transfusion medicine (TM) is critical for patients' safety. Many clinicians who are involved in day-to-day transfusion practice have little or no formal training in TM. There are no studies to assess physician's TM knowledge locally. A comprehensive anonymous survey was developed to assess baseline TM knowledge of all the residents. The survey is composed of different sections, including a questionnaire on resident's demographics, resident's self-reflection on their TM knowledge and 30 multiple choice questions addressing basic and clinical TM knowledge in two major domains: component selection and transfusion practice and transfusion safety and transfusion reactions. Finally, the residents' opinion on educational needs was assessed. A total of 130 residents were surveyed. The lowest score obtained among the two major domains assessed was in the transfusion safety and transfusion reaction domain, with a mean score of 4·34 of 15 (SD±3·27). The mean score obtained on component selection and transfusion practice was 7·1 of 15 (SD±3·74). A substantial proportion of the residents (74·7%) admitted minimal baseline knowledge in the field of TM. Finally, 94·5% of the residents admitted the need for more education during residency, whereas 49·5% thought additional education is required during the first year of practice. This survey shows serious TM knowledge deficiency and indicates the need for additional education among all physicians during training.

Hospital Medicine Providers' Transfusion Knowledge: A Survey Study.

CONTEXT:Transfusion medicine is critical for patient care, yet its knowledge among house officers remains under-researched. Adequate training and confidence in prescribing blood products and managing acute transfusion reactions are essential for improving patient outcomes.AIMS:This study aims to assess the level of transfusion medicine knowledge among house officers and explore influencing factors such as demographic characteristics and confidence in clinical practice.SETTINGS AND DESIGN:A cross-sectional study was conducted from April 2020 to May 2021 at both a teaching hospital and a tertiary hospital in Kelantan, Malaysia.SUBJECTS AND METHODS:Validated assisted self-administered questionnaires were used to collect data. The questionnaire was divided into three sections: demographic characteristics, transfusion medicine knowledge, and confidence levels. A total of 393 house officers participated in the study.STATISTICAL ANALYSIS USED:Descriptive statistics, including mean and percentages, were used to summarize the data. Logistic regression was employed to determine the association between continuous medical education (CME) and transfusion medicine knowledge, calculating odds ratio (OR) and 95% confidence interval (CI).RESULTS:Of the 393 house officers surveyed, 61.6% were female, with an average service duration of 12.52 months. Most (60.3%) had attended CME, and 57.3% had donated blood. Only 28.5% demonstrated good knowledge in transfusion medicine, with the highest proficiency in understanding transfusion risks (45.3%). House officers who attended three or more hours of cumulative CME were significantly more likely to possess good transfusion medicine knowledge (adjusted OR: 17.31; 95% CI, 6.35–47.19; P 0.001).CONCLUSIONS:There is a notable deficit in transfusion medicine knowledge among house officers. Intensive CME throughout housemanship can effectively address these knowledge gaps, enhancing medical expertise and patient care.

Residents' knowledge in transfusion medicine and educational programs: A pilot study.

Assessment of physicians in training's knowledge of transfusion medicine at a university hospital

Knowledge of transfusion medicine is the key element of better transfusion practices. This deficit observed at the blood bank end on daily basis exposing the patients for redundant risk. We assessed the knowledge of transfusion medicine among post intern doctors. To assess the knowledge of transfusion medicine among post intern doctors in working in our hospital. Self administrated questionnaire was used. 45 questions of transfusion medicine included in the questioner. A total 57 post internship doctors participated in the survey. Statistical analysis was done using SPSS. In overall survey average score was 41.45%. Lowest score 19.8% was for the area of lab result interpretation. Highest score 56.63% obtained for the administration of blood component. Differences among the medical officers of various specialties were not statistically significant. Transfusion medicine knowledge among post internship doctors in our hospital need to be upgraded.

Blood transfusion is the most common hospital procedure performed in the United States. While inadequate physician transfusion medicine knowledge may lead to inappropriate practice, such an educational deficit has not been investigated on an international scale using a validated assessment tool. Identifying specific deficiencies is critical for developing curricula to improve patient care. Rasch analysis, a method used in high-stakes testing, was used to validate an assessment tool consisting of a 23-question survey and a 20-question examination. The assessment tool was administered to internal medicine residents to determine prior training, attitudes, perceived ability, and actual knowledge related to transfusion medicine. A total of 474 residents at 23 programs in nine countries completed the examination. The overall mean score of correct responses was 45.7% (site range, 32%-56%). The mean score for Postgraduate Year (PGY)1 (43.9%) was significantly lower than for PGY3 (47.1%) and PGY4 (50.6%) residents. Although 89% of residents had participated in obtaining informed consent from a patient for transfusion, residents scored poorly (<25% correct) on questions related to transfusion reactions. The majority of residents (65%) would find additional transfusion medicine training "very" or "extremely" helpful. Internationally, internal medicine residents have poor transfusion medicine knowledge and would welcome additional training. The especially limited knowledge of transfusion reactions suggests an initial area for focused training. This study not only represents the largest international assessment of transfusion medicine knowledge, but also serves as a model for rigorous, collaborative research in medical education.

Over the past decades, the fields of activity and knowledge in transfusion medicine have evolved into an array of diverse areas and sub‐specialities including immunohaematology, blood component production, haemapheresis, pathogen detection, methods of cell and tissue collection and manipulation, cell conservation and banking, transplant immunology and haemostaseology. Physicians in most clinical disciplines require basic or more advanced knowledge in these fields to meet the requirements of modern medicine. Specialist physicians in transfusion medicine are valuable and competent partners for these related disciplines when it comes to safe, effective and tailored haemotherapy. Transfusion medicine is thus an important qualification at the interfaces of analytical laboratory medicine, pharmaceutical production and clinical disciplines such as internal medicine, anaesthesiology or surgery. In the past, blood transmittable diseases like HIV and hepatitis and adverse reactions to blood and cellular products have led to a complex system of regulatory and technical requirements. Good laboratory practice (GLP), good manufacturing practice (GMP), quality management systems and quality control on the pharmaceutical manufacturer’s level are only a few examples of the standards in today’s blood banking. European directives in the field of blood products, stem cell preparations and tissue have harmonized national regulation and led to higher uniform quality standards for biological preparations in a unified Europe, which is the desired outcome, but which also increases the complexity of this field. By contrast, directives 93/16/EEC, 2001/19/ EC, and 2005/36/EC, the directives of the European Parliament and of the Council on the mutual recognition of professional qualifications of European doctors currently in force, do not include transfusion medicine, blood transfusion or immune haematology at all. Other medical specialities, which like our field, are not common to all member states of the European Union, are listed in the above mentioned directives with the minimum length of training and minimal requirements for the qualifications. Bearing in mind the regional particularities of the medical speciality of transfusion medicine – caused by historical developments, rigidified by national legislations and the urgent need for quality standards also on the educatory level – we support a levelled approach in transfusion medicine education. Irrespective of the required day‐to‐day responsibilities in the blood field, which may range from basic level experience in haemotherapy, over specific knowledge of immunohaematology and clinical haemopathology, as needed for local blood bank management, up to the highest skill level required to direct a complex transfusion service and/or blood bank at an academic medical centre, transparent service quality requires defined minimum educational standards, which could then be adapted to fit specific national requirements. A long‐term objective might be to introduce the transfusion medicine specialisation into the above‐mentioned EC directives in order to guarantee quality and facilitate mutual recognition of transfusion medicine qualifications throughout Europe.

Transfusions are a common intervention within pediatrics and require unique considerations to optimize patient care. Poor knowledge of evidence-based transfusion practice can lead to misuse of transfusion therapy and harm. While there have been assessments of transfusion medicine knowledge of physicians caring for adult patients, there is little data regarding pediatricians. Using a published transfusion medicine knowledge exam for internal medicine physicians as a backbone, pediatric transfusion medicine experts, using an iterative process, developed a pediatric-specific examination. Pilot testing and Rasch analysis, a method used in high-stakes testing, was used to validate the exam. The exam and a previously validated survey on transfusion medicine training, attitudes, and perceived ability were administered to pediatric residents. Analysis consisted of descriptive statistics as well as comparisons of exam scores based on survey responses. 330 pediatric residents from 19 sites in 6 countries participated in the study. The vast majority (91%) of residents had obtained blood product consent. The mean exam score was 37.1% (range 9.5%-71.4%) with no statistical differences based on amount or perceived quality of transfusion medicine education or perceived ability. A rigorously validated exam has now been developed that can be used to assess pediatric transfusion medicine knowledge. A large international group of pediatric residents performed poorly on the exam demonstrating a pressing need for improved transfusion medicine education to ensure safe and appropriate administration of blood components to infants and children.

Knowledge of transfusion medicine (TM) has profound impact on transfusion outcomes. Variations from the standards in practices of TM may jeopardize patient care. We assessed the awareness of TM in resident doctors. Our aims was to assess the essential knowledge of TM among resident doctors. The study was carried in a tertiary care hospital. It was a descriptive cross- sectional study using a self-administered, questionnaire comprising of 35 items which was developed to assess the essential knowledge of TM for resident doctors. A total of 85 residents responded from various clinical specialties. Results of correct response were put as Mean±SD using SPSS. Survey revealed an overall mean score of 48.53 % for correct responses. Lowest knowledge score of 32.94 % was found for blood bank procedures. The differences between the knowledge of residents from various specialities were not statistically significant. Our study shows that majority of resident doctors have inadequate knowledge of TM. More studies are required from different parts of the country to create data on this issue. The implementation of two weeks training for all residents from clinical specialties in TM department will improve the situation and help to connect our clinician to TM better.

Optimal use of blood and blood components requires theoretical and practical knowledge in transfusion medicine. While the importance of education in transfusion medicine has long been recognized, a vacancy is widely felt in this regard in Iran. In this study, the current status of transfusion medicine education in Iran is evaluated using a review of studies conducted in this field. To access articles related to transfusion medicine education in Iran, an electronic search was performed in databases, including Magiran, SID, IranMedex, Google Scholar, PubMed, ScienceDirect, and Scopus and the related articles were evaluated. Knowledge of transfusion medicine was not optimal in various medical groups and there was no effective theoretical and practical education and training for transfusion medicine in medical universities. Almost all the studies concluded that transfusion medicine curricula should be implemented for both undergraduate and postgraduate students, because of its great importance in clinical practice. Educational program of transfusion medicine is a basic need of medical education for medical students, interns, residents, nursing, and midwifery students in Iran. Considering our status and capacities and by using educational programs in the world, curricula are suggested for different educational levels. Implementation of these training programs plays a vital role in improving patients' safety and also reduces the high costs of treatment with blood products.

Previous studies have shown clinicians' knowledge and practice are suboptimal across all major steps in the clinical transfusion process. Like other settings, limited information is available in Ethiopia. Therefore, we conducted a study to assess clinicians' transfusion medicine knowledge and clinical practice. A cross-sectional study was conducted at two academic hospitals to examine the correlation between transfusion medicine knowledge and clinical use of blood. Clinicians (n = 232), selected using a random sampling technique, completed a self-administered, structured knowledge assessment. A sampled (n = 152) subset of these clinicians was assessed for appropriate clinical use of blood using a predefined checklist. Student's t-test, one-way analysis of variance (ANOVA) and chi-square test were used. Statistical significance was assessed by 95% confidence intervals (CIs) and p values <0.05. Clinicians' mean knowledge score increased significantly by level of specialization. Out of a maximum score of 80, the mean ± standard deviation (SD) score for general practitioners was 38.1 (SD: ±6.2) while the score for specialists was 45.1 (SD: ±5.8), p = 0.001. Clinicians trained on transfusion guidelines had higher scores (46.6, SD: ±7.2) compared to untrained clinicians (40.3, SD: ±7.0), p = 0.001. Clinical use of blood was deemed appropriate in 41.4% [95% CI: 33.6%-49.2%] of cases. Appropriate clinical use of blood was associated with a higher mean knowledge (43.7, SD: ±7.1) than observed in inappropriate clinical use (40.7, SD: ±8.3) in 58.6%, p = 0.02. Better knowledge of transfusion medicine is associated with better transfusion medicine practice. This underscores the importance of implementing transfusion medicine training in Ethiopia.

There is evidence that physicians lack adequate transfusion medicine knowledge. To design needs-based educational interventions to address this gap, a validated assessment tool is required. Previously published exams have not been created or validated using rigorous psychometric methods. A modified Delphi method was used to achieve consensus regarding the essential knowledge and skills for physicians who transfuse blood products. To ensure content validity, members of an international organization of transfusion medicine experts (Biomedical Excellence for Safer Transfusion [BEST] Collaborative) participated in the exam design process. An exam, based on the most highly rated topics, was created and administered to individuals with a priori expected basic, intermediate, and expert levels of transfusion medicine knowledge. Rasch analysis, a psychometric technique used in high-stakes medical licensure and board testing, was used to determine exam accuracy and precision. Thirty-six topics achieved ratings sufficient to be considered for inclusion in the exam (content validity index > 0.8). A 23-question exam was administered to 49 individuals. Mean scores for individuals with expected basic, intermediate, and expert knowledge were 42, 62, and 82%, respectively (p < 0.0001). The exam achieved good fit with the Rasch model. A validated exam has now been created to accurately assess transfusion medicine knowledge. This exam can be used to determine knowledge deficits and assist in the design of curricula to improve blood product utilization.

Due to the non-availability of formal training during residency for clinicians in transfusion medicine, there is a prevalent knowledge gap for transfusion practices, which leads to increased patient risks and elevated healthcare costs. There is no indigenous questionnaire available, which could be used for knowledge assessment. This study aims to develop and validate an Indigenous questionnaire to assess clinicians' knowledge of transfusion medicine and bedside transfusion practices. The questionnaire was designed using a nominal group technique involving subject experts, considering the type of information required, themes, appropriate wording, layout, and presentation. The questionnaire consisted of 25 knowledge-based questions and 4 general questions. Piloting of the questionnaire was done to check for feasibility, validation, and reliability. Content validity was assessed by six experts using the Content Validity Index (CVI). Reliability was assessed using test-retest and split-half methods, with a sample of 56 participants. Cronbach's alpha and Kappa statistics were used to measure internal consistency and agreement, respectively. The questionnaire displayed acceptable feasibility with a mean difficulty score of 6.93 on a scale of 1-10, with test-retest responses showing near-perfect agreement (kappa value 0.8-0.99). All experts gave more than 70% agreement on the relevance of content, with a mean CVI of 85%. Test-retest reliability showed near-perfect agreement (Kappa 0.8-0.99, p = 0.008) and good internal consistency (Cronbach's α = 0.806). The split-half method yielded a Cronbach's α of 0.89 and an intraclass correlation coefficient of 0.88 (95% CI 0.57, 0.97, p = 0.001) Construct validity was confirmed through factor analysis. The developed indigenous questionnaire is a reliable and valid tool for assessing the knowledge of clinicians towards transfusion medicine and bedside transfusion practices. The detailed, methodical strategy used to prepare and validate the questionnaire ensures its applicability and relevance in various clinical settings and can be easily adopted by others intending to prepare similar questionnaires. The questionnaire is available with the author and, on demand, may be provided for knowledge assessment.