Evaluation of the achievement of hematologists to transfusion medicine education with self-assessment questionnaire in Turkey
Öz
Background: Proper clinical use of blood and blood products requires competent theoretical and practical knowledge of transfusion medicine. The Curriculum Development and Standard Determination System Medical Specialization Board is prepared Hematology Specialist Education Core Curriculum in Turkey. In this study, we aimed to determine the access of hematologists to the learning objectives defined by curriculum for the transfusion medicine and the factors affecting it.
Methods: Hematologists who have been members of Turkish Hematology Society since 2013 have been included in the study, The survey questions were prepared based on the curriculum for transfusion medicine. The study was applied to hematologists with "survey monkey" application. The questionnaire consisted of a competence self-assessment with Likert scale and theoretical multiple-choice knowledge questions.
Results: Of the 213 hematologists, 54 (25%) were included in the study. Hematologists rated their competences in the clinical competence areas as 3,65 ± 0,73 (median 3,60) as "I know but not t a sufficient level". The participants 'perception of competence was "I know, but not at a sufficient level'" with an average of 3.31 ± 0.84 (median3.5) in the blood banking field, while the average in hemapheresis and transfusion medicine was 4.04 ± 0.63 (median 4) as "enough". In interventional procedures, hematologists stated that their vocational competences were 2,79± 0,92 (median 2,93) on average as "I have an idea- I know, but not enough". The correct answer to 13 theoretical questions was an average of 6,96 ± 1,89 (median 7). Hematologists performing blood rotation felt significantly more competent than the physicians who could not do the rotation in the blood bank, blood banking t(52) = -3.9, p < .001 , transfusion medicine and interventional competence t(52) = -2.2, p = .04 . Physicians who believed that they are sufficient in the blood banking area, were more confident in transfusion medicine r(54) = .67, p <.001 and managing interventional procedures r(54) = .85, p <.001.
Conclusion: In this study, hematologists generally felt more competent in subjects such as transfusion and therapeutic apheresis, which they often think of as not having enough knowledge in the area of blood banking. Hematologists have been more confident in the field of transfusion medicine as their years of expertise increased, but they did not feel better equipped in the fields of blood banking and interventional competence. The current results suggested that hematologists who are expected to be the blood bank supervisors do not internalize the area of blood banking, are not strong in their competence, and do not want to work in this area unless they are required.
In hematology education curriculum, positive revisions in education can be achieved by revising blood banking curriculum and learning objectives, standardizing blood center rotations with content and duration, and support from online distance education programs.
Anahtar Kelimeler
hematologist medical education self-assessment questionnaire transfusion medicine
Teşekkür
The authors thank Assistant Professor Hakan Kogar of Akdeniz University, Faculty of Education, Department of Measurement and Evaluation (Antalya) for assessing the suitability of survey questions in terms of measurement and evaluation.
Kaynakça
- References 1. Eichbaum, Q., et al., Global health and transfusion medicine: education and training in developing countries. Transfusion, 2014. 54(7): p. 1893-8.
- 2. Lin, Y., et al., BEST-TEST2: assessment of hematology trainee knowledge of transfusion medicine, in Transfusion2016. p. 304-10.
- 3. Zeller, M.P., et al., Design and Implementation of a Competency-Based Transfusion Medicine Training Program in Canada. Transfus Med Rev, 2016. 30(1): p. 30-6.
- 4. Maiolino, A. and N. Spector, Challenges for medical residency in hematology and transfusion medicine in Brazil. Rev Bras Hematol Hemoter, 2012. 34(5): p. 321-2.
- 5. Gharehbaghian, A., et al., Assessment of physicians knowledge in transfusion medicine, Iran, 2007. Transfus Med, 2009. 19(3): p. 132-8.
- 6. Arinsburg, S.A., et al., A survey to assess transfusion medicine education needs for clinicians. Transfus Med, 2012. 22(1): p. 44-9; quiz 49-51.
- 7. Haspel, R.L., et al., Internal medicine resident knowledge of transfusion medicine: results from the BEST-TEST international education needs assessment. Transfusion, 2015. 55(6): p. 1355-61.
- 8. Graham, J., et al., Assessing transfusion competency in junior doctors: a retrospective cohort study. Transfusion, 2014. 54(1): p. 128-36.
- 9. Rock, G., et al., A pilot study to assess physician knowledge in transfusion medicine. Transfus Med, 2002. 12(2): p. 125-8.
- 10. Panzer, S., et al., Education in transfusion medicine for medical students and doctors. Vox Sang, 2013. 104(3): p. 250-72.
- 11. Hotz, G.A., et al., Developing a trauma critical care and rehab hospital in Haiti: a year after the earthquake. Am J Disaster Med, 2012. 7(4): p. 273-9.
- 12. Liu, Y., et al., Blood transfusion practice: a survey in Sichuan, China. Transfus Apher Sci, 2015. 52(1): p. 105-11.
- 13. Lin, Y., C. Cserti-Gazdewich, and J. Callum, Evaluation of "Transfusion Camp," a postgraduate transfusion medicine education program using the BEST-TEST knowledge assessment tool. Transfusion, 2015. 55(8): p. 2049-51.
- 14. Piassi, F.C.C., R.M. Delbone de Faria, and S.M. Eloi-Santos, Brazilian medical training in Transfusion Medicine: a KAP survey to assess knowledge, attitudes and practice in blood transfusion. Transfus Med, 2019. 29(1): p. 72-74.
Türkiye´de hematologların transfüzyon tıbbı uzmanlık eğitim hedeflerine ulaşımının öz yeterlilik anketi ile değerlendirilmesi
Öz
Giriş: Kan ve kan ürünlerinin uygun klinik kullanımı, transfüzyon tıbbı konusunda teorik ve pratik bilgi birikimini gerektirir. Türkiye'de Müfredat Geliştirme ve Standart Belirleme Sistemi Tıbbi Uzmanlık Kurulu tarafından, Hematoloji Uzmanlık Eğitimi Temel Müfredatı hazırlanmıştır. Bu çalışmada hematologların transfüzyon tıbbı müfredatı ile belirlenen öğrenme hedeflerine ulaşımını ve bu durumu etkileyen faktörleri belirlemeyi amaçladık.
Metot: 2013 yılından bu yana Türk Hematoloji Derneği üyesi olan hematologlara transfüzyon tıbbı için müfredatı esas alınarak hazırlanan anket "Survey Monkey" uygulaması ile uygulandı. Anket, Likert ölçeği ve teorik çoktan seçmeli bilgi soruları ile öz yeterlilik değerlendirmelerinden oluşuyordu.
Sonuçlar: 213 hematologdan 54'ü (%25) çalışmaya katılmıştır. Hematologların yeterlilik algıları klinik yetkinlik alanlarında ortalama 3,65 ± 0,73 (ortanca 3,60) olarak "Biliyorum ama yeterli düzeyde değil"; kan bankacılığı alanında ortalama 3.31 ± 0.84 (ortanca 3.5) puan ile "biliyorum ama yeterli düzeyde değil"; hemaferez ve transfüzyon tıbbı alanında ise ortalama 4.04 ± 0.63 (ortanca 4) "yeterli" olarak ölçüldü. Girişimsel işlemlerde hematologlar mesleki yeterliliklerinin ortalama 2,79± 0,92 (ortanca 2,93) "Bir fikrim var, biliyorum ama yeterli değil" olarak ifade ettiler. 13 teorik sorunun doğru cevabı ortalama 6,96 ± 1,89 idi (ortanca 7). Kan bankası rotasyonu yapan hematologlar yapamayanlara göre kan bankacılığı t(52) = -3.9, p < .001, transfüzyon tıbbı ve girişimsel alanlarda t(52) = -2.2, p = .04 kendilerini çok daha yetkin hissediyordu. Kan bankacılığı alanında yeterli olduğuna inanan hekimler, transfüzyon tıbbında r(54) = .67, p <.001 ve girişimsel işlemlerin r(54) = .85, p <.001yönetiminde de kendilerinden daha eminlerdi.
Tartışma: Bu çalışmada, hematologlar genellikle kan bankacılığı alanında yeterli bilgiye sahip olmadığını düşünürken transfüzyon tıbbı ve terapötik aferez gibi konularda kendilerini daha yetkin hissetmistirler. Hematologlar, uzmanlık yılları arttıkça transfüzyon tıbbı alanında kendilerine daha fazla güvenmeye başlarken, kan bankacılığı ve girişimsel yeterlilik alanlarında kendilerini hala yeterli donanımda hissetmiyorlardı. Mevcut sonuçlar, hematologların kan bankacılığı alanını içselleştirmediklerini, yetkinliklerinde güçlü olmadıklarını ve gerekli olmadıkça bu alanda çalışmak istemediklerini göstermiştir. Transfüzyon tıbbı müfredatının ve öğrenme hedeflerinin gözden geçirilmesi, kan merkezi rotasyonlarının içerik ve süresinin standartlaştırılması ve çevrimiçi uzaktan eğitim programları ile desteklenmesi hematoloji eğitimine olumlu katkılar sağlayabilir.
Anahtar Kelimeler
Kaynakça
- References 1. Eichbaum, Q., et al., Global health and transfusion medicine: education and training in developing countries. Transfusion, 2014. 54(7): p. 1893-8.
- 2. Lin, Y., et al., BEST-TEST2: assessment of hematology trainee knowledge of transfusion medicine, in Transfusion2016. p. 304-10.
- 3. Zeller, M.P., et al., Design and Implementation of a Competency-Based Transfusion Medicine Training Program in Canada. Transfus Med Rev, 2016. 30(1): p. 30-6.
- 4. Maiolino, A. and N. Spector, Challenges for medical residency in hematology and transfusion medicine in Brazil. Rev Bras Hematol Hemoter, 2012. 34(5): p. 321-2.
- 5. Gharehbaghian, A., et al., Assessment of physicians knowledge in transfusion medicine, Iran, 2007. Transfus Med, 2009. 19(3): p. 132-8.
- 6. Arinsburg, S.A., et al., A survey to assess transfusion medicine education needs for clinicians. Transfus Med, 2012. 22(1): p. 44-9; quiz 49-51.
- 7. Haspel, R.L., et al., Internal medicine resident knowledge of transfusion medicine: results from the BEST-TEST international education needs assessment. Transfusion, 2015. 55(6): p. 1355-61.
- 8. Graham, J., et al., Assessing transfusion competency in junior doctors: a retrospective cohort study. Transfusion, 2014. 54(1): p. 128-36.
- 9. Rock, G., et al., A pilot study to assess physician knowledge in transfusion medicine. Transfus Med, 2002. 12(2): p. 125-8.
- 10. Panzer, S., et al., Education in transfusion medicine for medical students and doctors. Vox Sang, 2013. 104(3): p. 250-72.
- 11. Hotz, G.A., et al., Developing a trauma critical care and rehab hospital in Haiti: a year after the earthquake. Am J Disaster Med, 2012. 7(4): p. 273-9.
- 12. Liu, Y., et al., Blood transfusion practice: a survey in Sichuan, China. Transfus Apher Sci, 2015. 52(1): p. 105-11.
- 13. Lin, Y., C. Cserti-Gazdewich, and J. Callum, Evaluation of "Transfusion Camp," a postgraduate transfusion medicine education program using the BEST-TEST knowledge assessment tool. Transfusion, 2015. 55(8): p. 2049-51.
- 14. Piassi, F.C.C., R.M. Delbone de Faria, and S.M. Eloi-Santos, Brazilian medical training in Transfusion Medicine: a KAP survey to assess knowledge, attitudes and practice in blood transfusion. Transfus Med, 2019. 29(1): p. 72-74.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Orjinal Araştırma |
| Yazarlar | |
| Yayımlanma Tarihi | 30 Ağustos 2020 |
| Gönderilme Tarihi | 16 Şubat 2020 |
| Yayımlandığı Sayı | Yıl 2020 Cilt: 19 Sayı: 58 |