Graham Jane, Hayes Conrad, Pendry Kate
Department of Clinical Haematology, University Hospitals of North Midlands NHS Trust, Royal Stoke University Hospital, Newcastle Road, Stoke-on-Trent, Staffordshire ST4 6QG UK.
School of Medicine, Keele University, Staffordshire, UK.
Med Sci Educ. 2019 Dec 3;30(1):631-642. doi: 10.1007/s40670-019-00844-9. eCollection 2020 Mar.
There is global need for evidence-based methodologies to effectively deliver transfusion training. This research critically assesses both efficacy and the practicalities of introducing team-based learning (TBL) to deliver transfusion medicine education to UK postgraduate doctors (residency equivalence).
One TBL orientation session and three transfusion medicine sessions, mapped to the 2012 Foundation Programme curriculum, were designed adhering to TBL principles. These were delivered by one tutor during 'compulsory' (except rota commitments and leave) educational sessions. Team continuity plus trainee reaction, knowledge acquisition and behaviour were evaluated.
Forty-eight doctors received a mean 2.5 TBL sessions. Five teams were developed with average team membership of 5.85 doctors per session. Overall team continuity (total team members attending/potential team members × 100) was 65% over the four sessions. Qualitative and quantitative trainee reaction to TBL was positive. Objective knowledge acquisition showed improved team knowledge over individual knowledge. Mean team readiness assurance testing (RAT) score exceeded maximum individual RAT score in 90% of cases. Subjective knowledge acquisition significantly improved, although confidence concerning prescribing declined. The reported time spent preparing for sessions correlated with enjoyment, subjective knowledge gain and clinical confidence. Preparation time was reported as 'adequate' or 'excellent' in 86% of anonymous feedback.
TBL is an enjoyable and effective approach to deliver transfusion education to doctors, particularly when preparation is adequate. Team continuity is poor despite 'compulsory' education sessions. This must be considered when designing and delivering TBL sessions in the UK postgraduate medical setting.
全球都需要基于证据的方法来有效开展输血培训。本研究严格评估了引入基于团队的学习（TBL）为英国研究生医生（等同于住院医师）提供输血医学教育的有效性和实用性。
根据TBL原则，设计了一次TBL入门课程和三次输血医学课程，这些课程与2012年基础课程相匹配。由一名导师在“必修”（除排班任务和请假外）教育课程中授课。评估了团队连续性以及学员的反应、知识获取和行为。
48名医生平均接受了2.5次TBL课程。共组建了5个团队，每次课程平均团队成员为5.85名医生。在这四次课程中，总体团队连续性（实际参加的团队成员总数/潜在团队成员总数×100）为65%。学员对TBL的定性和定量反应均为积极。客观知识获取方面，团队知识比个人知识有所提高。在90%的案例中，团队准备度保证测试（RAT）的平均得分超过了个人RAT的最高得分。主观知识获取有显著改善，尽管处方开具方面的信心有所下降。报告的准备课程所花费的时间与学习乐趣、主观知识收获和临床信心相关。在86%的匿名反馈中，准备时间被报告为“充足”或“非常好”。
TBL是一种为医生提供输血教育的有趣且有效的方法，尤其是在准备充分时。尽管是“必修”教育课程，但团队连续性较差。在英国研究生医学环境中设计和开展TBL课程时必须考虑这一点。
