Champion Caitlin, Saidenberg Elianna, Lampron Jacinthe, Pugh Debra
Division of General Surgery, Department of Surgery, The Ottawa Hospital, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Division of Hematopathology and Transfusion Medicine, Department of Pathology and Laboratory Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada.
Transfusion. 2017 Apr;57(4):965-970. doi: 10.1111/trf.14005. Epub 2017 Mar 16.
Evidence-based transfusion education for surgical residents is crucial to improving practice. A pilot study was undertaken to assess the effectiveness of an education module for improving transfusion knowledge among surgical residents.
Modules were developed and delivered by experts in surgery and transfusion medicine. They were delivered to residents in their first 2 years of training (Surgical Foundations), and to General Surgery residents across all years of training. Premodule and postmodule and retention knowledge assessments were used to assess efficacy. Median assessment scores for each group were compared using a two-sample Wilcoxon rank-sum analysis. Chi-square tests were used to compare each group's correct response rates for each question across the three tests.
Median assessment scores of residents in the Surgical Foundations program improved from a mean of 60% premodule to 80% postmodule and remained at 80% in the retention assessment (p < 0.01). Improvements were seen in the areas of transfusion dose, preoperative blood management, management of reactions, and informed consent (p < 0.01). Assessment scores of General Surgery residents also improved from 59%, to 73%, and to 82%, with significant improvement (p < 0.01) between premodule and postmodule scores. Improvements in correct response rates were seen in the areas of management of anemia and permissive hypotension in trauma (p < 0.01).
Transfusion knowledge of surgical residents was improved by a collaborative educational initiative. This could serve as a model for other training programs to improve resident knowledge of evidence-based transfusion practices. The efficacy of such interventions in changing practice remains untested.
对外科住院医师进行基于证据的输血教育对于改善临床实践至关重要。开展了一项试点研究，以评估一个教育模块在提高外科住院医师输血知识方面的有效性。
这些模块由外科和输血医学领域的专家开发并授课。它们被传授给处于培训前两年的住院医师（外科基础阶段）以及各培训年份的普通外科住院医师。使用课前和课后以及知识留存评估来评估效果。使用两样本Wilcoxon秩和分析比较每组的中位数评估分数。使用卡方检验比较三组测试中每组对每个问题的正确回答率。
外科基础项目住院医师的中位数评估分数从课前的平均60%提高到课后的80%，在知识留存评估中保持在80%（p < 0.01）。在输血剂量、术前血液管理、反应处理和知情同意等方面有改善（p < 0.01）。普通外科住院医师的评估分数也从59%提高到73%，再提高到82%，课前和课后分数之间有显著改善（p < 0.01）。在贫血管理和创伤性允许性低血压方面的正确回答率有提高（p < 0.01）。
一项合作性教育举措提高了外科住院医师的输血知识。这可以作为其他培训项目提高住院医师基于证据的输血实践知识的一个范例。此类干预措施在改变临床实践方面的效果仍未得到检验。
