Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Division of Pathology and Laboratory Medicine, Children's National Hospital Medical Center, Washington, District of Columbia, USA.
Transfusion. 2021 Aug;61(8):2487-2495. doi: 10.1111/trf.16439. Epub 2021 May 10.
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.
输血是儿科常见的干预措施，需要特殊考虑以优化患者护理。对基于证据的输血实践知识的了解不足可能导致输血治疗的滥用和危害。虽然已经评估了治疗成人患者的医生的输血医学知识，但关于儿科医生的相关数据很少。
使用已发表的内科医生输血医学知识考试作为基础，儿科输血医学专家通过迭代过程，开发了儿科专用考试。试点测试和 Rasch 分析（一种用于高风险测试的方法）用于验证考试。考试和以前验证过的输血医学培训、态度和感知能力调查在儿科住院医师中进行。分析包括描述性统计以及根据调查答复比较考试成绩。
来自 6 个国家 19 个地点的 330 名儿科住院医师参加了该研究。绝大多数（91%）住院医师获得了血液制品同意书。平均考试成绩为 37.1%（范围 9.5%-71.4%），根据输血医学教育的数量或感知质量或感知能力，考试成绩没有统计学差异。
现在已经开发出一种经过严格验证的考试，可以用来评估儿科输血医学知识。一大群国际儿科住院医师在考试中表现不佳，这表明迫切需要加强输血医学教育，以确保安全、适当地向婴儿和儿童输注血液成分。
