Evaluation of the Knowledge Levels of Medical Interns at Suleyman Demirel University Faculty of Medicine Regarding the Pre-Analytical Phase of the Laboratory and Rational Test Ordering

Abstract

Objective Since the majority of errors in the medical laboratory testing process occur in the pre-analytical phase and unnecessary test ordering adversely affects patient safety and healthcare system costs, this study aimed to assess the knowledge and awareness levels of sixth-year medical students (medical interns) regard- ing the laboratory pre-analytical phase and rational test ordering, and to contribute to the development of pre-internship training programs based on the findings. Material and Method This cross-sectional survey study included 167 med- ical interns from the 2024–2025 (n = 57) and 2025– 2026 (n = 110) academic years. Data were collected using an online questionnaire. Descriptive statistics are expressed as frequencies, percentages, and mean ± standard deviation. Pearson’s chi-square test was used to compare categorical variables between cohorts. Total pre-analytical knowledge scores and total rational test ordering scores were calculated by summing the correct responses to the relevant items. Statistical significance was set at p < 0.05. Results No statistically significant differences were observed between the 2024–2025 and 2025–2026 cohorts across all knowledge domains (Cramer’s V: 0.01– 0.05). Although nearly all participants reported phle- botomy experience, formal education about pre-an- alytical processes and rational laboratory use was limited, and awareness of national policies was low. Significant deficiencies were identified for technical pre-analytical topics, including order of draw, diur- nal variation, tube handling, and coagulation sample analysis time limits. Knowledge of minimum test rep- etition intervals was generally insufficient, with higher accuracy for HbA1c and lower accuracy for common- ly requested tests such as AST, ALT, TSH, and CRP. Overall knowledge scores indicated low competency, with no differences between cohorts. Conclusion Practical experience alone does not ensure standard- ized knowledge. Structured, compulsory, and sce- nario-based training focused on pre-analytical quality management and evidence-based test repeat inter- vals should be integrated into internship education to improve patient safety and resource utilization.

Keywords

• Laboratory
• Medical interns
• Pre-analyti- cal phase
• Rational test ordering

Supporting Institution

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for- profit sectors.

Ethical Statement

Ethical approval for this study was obtained from the Suleyman Demirel University Health Sciences Ethics Committee (meeting no:105, decision no:8, approval date: November 3, 2025).

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