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Transfusion medicine knowledge in Postgraduate Year 1 residents


  • The views expressed are those of the authors and do not reflect the official policy of the Department of the Army, the Department of Defense, or the US Government.

Kerry L. O'Brien, MD, Department of Pathology, Madigan Army Medical Center, 9040 Fitzsimmons, Tacoma, WA 98431; e-mail:


BACKGROUND: Transfusion medicine is a complex important subspecialty of pathology. A transfusion carries measurable risks and benefits. Although fellowship training exists in transfusion medicine, the majority of transfusion decisions are made by clinicians without formal training.

STUDY DESIGN AND METHODS: A total of 116 recently graduated medical students entering 10 residency programs at a single medical center over 2 years were evaluated using a standardized patient encounter to determine baseline knowledge. Transfusion medicine knowledge was assessed during the encounter by obtaining verbal consent for red blood cell transfusion, answering patient questions, and completing a written quiz. Final performance was scored using a peer-reviewed data collection sheet.

RESULTS: Scores ranged from 24.0% to 67.1%. Postgraduate Year 1 (PGY-1) residents graduating from allopathic medical schools had higher scores than those from osteopathic schools (mean, 41.3% vs. 37.5%; p = 0.036). There was no significant difference between PGY-1 residents entering primary care versus surgical specialties (38.2% and 41.6%; p = 0.10). Although not significant, PGY-1 residents with previous transfusion medicine education demonstrated a trend toward better performance than those without prior education (47.0% vs. 43.0%; p = 0.057). A total of 17.2% of PGY-1's could define transfusion-related acute lung injury, 6.0% knew the transfusion transmission rate of human immunodeficiency virus, 5.2% knew the transfusion transmission rate of hepatitis C virus, and 0% knew the indication for blood product irradiation.

CONCLUSIONS: Marked knowledge deficits in transfusion medicine were noted. If the results of this study could be reproduced at other training institutions, medical schools may be willing to donate more resources into transfusion medicine education.