From the Department of Anesthesiology, UMass Chan Medical School-Baystate, Baystate Medical Center, Springfield, Massachusetts.
Department of Anesthesiology, Perioperative and Pain Medicine; Texas Children's Hospital, Houston, Texas.
Anesth Analg. 2024 Mar 1;138(3):655-663. doi: 10.1213/ANE.0000000000006327. Epub 2022 Dec 12.
Transfusion of blood products is a common practice in anesthesiology. Inadequate transfusion medicine knowledge may lead to inappropriate transfusion practices and patient risk. Using a validated assessment tool modified for anesthesiology, we conducted a survey of anesthesiology residents in the United States to assess transfusion medicine knowledge.
A validated transfusion medicine examination and accompanying survey were forwarded by program directors to residents for anonymous completion on May 5 and closed on June 30, 2021. The outcome of interest was the mean examination score. Secondary areas of interest were performance by year of training and previous educational experience in transfusion reported by the trainees. Rasch analysis was performed on the examination quality and individual question performance. Kruskal-Wallis H tests were used to identify differences between mean scores. Post hoc comparisons were used to assess specific pairwise differences between mean test scores by survey variable.
Four hundred twenty-three anesthesiology residents in 37 programs completed the examination. The mean score was 45.5% ± 12.6%. There was a significant difference in mean cumulative examination scores between different resident training levels ( P < 0.001). There was a significant difference in scores between clinical anesthesia (CA)-1 and CA-2 residents ( P = 0.011) and CA-1 and CA-3 residents ( P = 0.012). No significant difference in examination scores was observed between CA-2 and CA-3 residents ( P = 0.95). All these subgroups scored below 50% on the examination. Significant differences between the residency training programs and cumulative scores were identified ( P < 0.001).
This examination highlights gaps in transfusion medicine knowledge within US anesthesiology residents. Targeted education may improve knowledge in this area and patient care.
输血是麻醉学中的常见做法。输血医学知识不足可能导致不适当的输血实践和患者风险。我们使用经过验证的、适用于麻醉学的评估工具，对美国的麻醉住院医师进行了输血医学知识调查。
项目主任于 2021 年 5 月 5 日向住院医师发送了经过验证的输血医学考试和配套调查，并于 6 月 30 日截止匿名填写。关注的结果是平均考试成绩。次要关注领域是按培训年限划分的表现和培训生报告的输血方面的先前教育经验。对考试质量和个人问题表现进行了 Rasch 分析。Kruskal-Wallis H 检验用于识别平均分数之间的差异。使用事后比较法根据调查变量评估平均测试分数的特定两两差异。
37 个项目中的 423 名麻醉住院医师完成了考试。平均分数为 45.5%±12.6%。不同住院医师培训水平之间的平均累计考试成绩存在显著差异（P<0.001）。CA-1 和 CA-2 住院医师（P=0.011）以及 CA-1 和 CA-3 住院医师（P=0.012）之间的考试分数存在显著差异。CA-2 和 CA-3 住院医师之间的考试分数没有显著差异（P=0.95）。所有这些亚组的考试成绩均低于 50%。还确定了住院医师培训计划和累计分数之间的显著差异（P<0.001）。
本次考试突出了美国麻醉住院医师在输血医学知识方面的差距。有针对性的教育可能会提高该领域的知识水平并改善患者护理。
