Allison P Wheeler1, Meghan Delaney2, Mark Fung3, Jed Gorlin4, Jose Mauro Kutner5, Joyce Ching Mei Lam6,7, Nancy Robitaille8, Ben Saxon9, Simon J Stanworth10,11,12, Leo Van De Watering13, Ana P H Yokoyama5, Richard L Haspel14. 1. Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA. 2. Division of Pathology and Laboratory Medicine, Children's National Hospital Medical Center, Washington, District of Columbia, USA. 3. Department of Pathology and Laboratory Medicine, University of Vermont, Burlington, Vermont, USA. 4. Transfusion Services, Children's Minnesota, Minneapolis, Minnesota, USA. 5. Hemotherapy and Cell Therapy Department, Hospital Israelita Albert Einstein, Sao Paulo, Brazil. 6. Department of Paediatric Subspecialties, KK Women's and Children's Hospital, Singapore. 7. Duke-NUS Medical School, Singapore. 8. Division of Hematology-Oncology, Department of Pediatrics, CHU Sainte-Justine, Montreal, Quebec, Canada. 9. Women's and Children's Hospital Adelaide, North Adelaide, South Australia, Australia. 10. Department of Haematology, NHS Blood and Transplant/Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK. 11. Radcliffe Department of Medicine, University of Oxford, Oxford, UK. 12. Oxford BRC Haematology Theme, Oxford, UK. 13. Center for Clinical Transfusion Research, Sanquin/LUMC, Leiden, The Netherlands. 14. Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA.
Abstract
BACKGROUND: 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. STUDY DESIGN AND METHODS: 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. RESULTS: 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. DISCUSSION: 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.
BACKGROUND: 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. STUDY DESIGN AND METHODS: 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. RESULTS: 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. DISCUSSION: 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.