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定义住院医师输血医学核心能力:多专业德尔菲共识研究。

Defining core competencies in transfusion medicine for resident physicians: A multi-specialty Delphi consensus study.

机构信息

University of California San Francisco School of Medicine, San Francisco, California, USA.

Department of Laboratory Medicine, University of California San Francisco School of Medicine, San Francisco, California, USA.

出版信息

Transfusion. 2021 Mar;61(3):939-947. doi: 10.1111/trf.16249. Epub 2021 Jan 7.

Abstract

BACKGROUND

Although resident physicians across disciplines are responsible for ordering blood products and managing sequelae of blood product transfusion, no designated set of competencies in transfusion medicine has been established for postgraduate trainees. The primary goal of this study was to determine core transfusion-related competencies that such residents should possess.

STUDY DESIGN AND METHODS

A modified Delphi method was used to achieve consensus among a panel of clinical faculty and program leadership in six medical specialties to establish core transfusion-related competencies for resident physicians. Review of transfusion education literature, relevant clinical responsibilities, and specialty licensing requirements facilitated generation of an initial transfusion medicine topic list and additional topics were considered if suggested by experts. In two Delphi rounds, experts rated the clinical significance of initial topics on a 5-point Likert scale. Select topics were deemed core competencies if identified as Extremely Important or Moderately Important by at least 75% of panelists to meet a minimum content validity index (CVI) of 0.75 and if topics achieved a minimum content validity ratio (CVR) of 0.5.

RESULTS

Nineteen invited clinical experts completed both Delphi rounds with 100% completion across the two rounds. Twenty transfusion medicine topics achieved minimum CVI 0.75 and minimum CVR 0.5. Highest-ranked topics by level of importance include Red Blood Cell (RBC) Transfusion Indications, Platelet Transfusion Indications, and Pulmonary Reactions.

CONCLUSIONS

Multispecialty panelists across six medical specialties reached consensus in identification of core transfusion-related competencies for resident physicians. Such consensus-driven core competencies may inform the development of transfusion medicine curricula and assessments to improve transfusion safety.

摘要

背景

尽管各学科的住院医师都负责开具血液制品医嘱并管理输血的后续问题,但尚未为研究生培训医师制定专门的输血医学能力标准。本研究的主要目标是确定住院医师应具备的核心输血相关能力。

研究设计与方法

采用改良 Delphi 法,在六个医学专业的临床教师和项目负责人小组中达成共识,确定住院医师的核心输血相关能力。对输血教育文献、相关临床职责和专业许可要求的审查有助于生成初始输血医学主题列表,如果专家建议,还会考虑其他主题。在两轮 Delphi 中,专家根据 5 分制 Likert 量表对初始主题的临床意义进行评分。如果至少有 75%的小组成员认为某个主题非常重要或比较重要,且满足内容效度指数(CVI)至少为 0.75和内容效度比(CVR)至少为 0.5,则认为该主题为核心能力。

结果

19 名受邀临床专家完成了两轮 Delphi,两轮的完成率均为 100%。20 个输血医学主题达到了最小 CVI 0.75 和最小 CVR 0.5。重要性排名最高的主题包括红细胞(RBC)输血指征、血小板输血指征和肺部反应。

结论

六个医学专业的多学科小组成员在确定住院医师的核心输血相关能力方面达成了共识。这种基于共识的核心能力可能为制定输血医学课程和评估标准提供信息,以提高输血安全性。

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