BEST TEST with MEDIOCRE RESULTS (at best!): a “call to arms” to correct clinician knowledge deficits in transfusion medicine

Education in blood transfusion: Adequacy of the content in the Kenyan undergraduate curricula and medical doctor's perspectives and perceptions

BACKGROUND

Although blood transfusion (BT) service is important in modern health care, blood is scarce, costly, and without risks. Medical education should therefore play a role in equipping medical doctors with the necessary BT knowledge, skills, and attitudes for optimal utilization of blood. This study aimed at determining the adequacy of curriculum content of Kenyan medical schools and the clinicians' perceptions of undergraduate education in BT.

METHODOLOGY

A cross-sectional study was conducted among non-specialist medical doctors and the curricula of Kenyan medical schools. Data was collected using questionnaires and data abstraction forms and analyzed using descriptive and inferential statistics.

RESULTS

Curricula from six medical schools and 150 clinicians were studied. All six curricula covered topics that are essential in BT and had the content integrated into the haematology course taught during the third year. The majority (62%) of the doctors perceived their knowledge of BT as being either fair or poor, and 96% reported that knowledge of BT was important to their clinical practice. The rating of perceived knowledge in BT was significant between the different cadres of clinicians (H (2) = 7.891, p = 0.019), and all participants (100%) acknowledged the usefulness of additional training in BT.

CONCLUSION

The Kenyan medical schools' curricula covered topics that are essential for safe BT practice. However, the clinicians felt that their knowledge of BT was not good enough and that they needed more training in the subject.

Would doctors dream of electric blood bankers? Large language model-based artificial intelligence performs well in many aspects of transfusion medicine

BACKGROUND

Large language models (LLMs) excel at answering knowledge-based questions. Many aspects of blood banking and transfusion medicine involve no direct patient care and require only knowledge and judgment. We hypothesized that public LLMs could perform such tasks with accuracy and precision.

STUDY DESIGN AND METHODS

We presented three sets of tasks to three publicly-available LLMs (Bard, GPT-3.5, and GPT-4). The first was to review short case presentations and then decide if a red blood cell transfusion was indicated. The second task was to answer a set of consultation questions common in clinical transfusion practice. The third task was to take a multiple-choice test experimentally validated to assess internal medicine postgraduate knowledge of transfusion practice (the BEST-TEST).

RESULTS

In the first task, the area under the receiver operating characteristic curve for correct transfusion decisions was 0.65, 0.90, and 0.92, respectively for Bard, GPT-3.5 and GPT-4. All three models had a modest rate of acceptable responses to the consultation questions. Average scores on the BEST-TEST were 55%, 40%, and 87%, respectively.

CONCLUSION

When presented with transfusion medicine tasks in natural language, publicly available LLMs demonstrated a range of ability, but GPT-4 consistently scored very well in all tasks. Research is needed to assess the utility of LLMs in transfusion medicine practice. Transfusion Medicine physicians should consider their role alongside such technologies, and how they might be used for the benefit and safety of patients.

Update in Transfusion Medicine Education

Despite the high frequency with which blood transfusions are performed, transfusion medicine education remains variable in the United States and around the world. Educating medical students and nonpathology physicians is critical for safe and evidence-based transfusion. Many innovative curricula have been published to meet the needs of physicians training in a variety of specialties. Learners' knowledge can be assessed using validated knowledge assessment tools and objective structured clinical examinations. In this review, transfusion medicine curricula and assessment tools are reviewed. Strategies for virtual teaching and learning are also introduced.

Residents' knowledge in transfusion medicine and educational programs: A pilot study

BACKGROUND

Residents' knowledge in transfusion medicine significantly impacts the optimal use of blood and patient safety. Little is known regarding this topic in France in particular. The objectives were to evaluate their basic knowledge, to determine whether the objectives of the curricula were attained and subsequently to suggest ways for improvement.

METHODS

A cross-sectional study was conducted on 50 first year medical and surgical specialty residents rotating in a French university hospital.

RESULTS

Major gaps in the knowledge were noted among residents of various specialties, equally between those with low and sustained transfusion practice. The majority of these young doctors expressed difficulties in prescribing and handling transfusions, identifying and managing its complications and understanding their responsibilities. The roles of hemovigilance practitioners were further somehow unclear for participants.

CONCLUSION

Given these results, action plans appear needed to limit consequences. A special transfusion medicine educational program should be added to the currently available medical education curriculum in order to ensure physicians have adequate knowledge of transfusion basics; at least a practical assisted situation during residency would be of valuable interest.

Medical student education in transfusion medicine: Proposal from the "European and Mediterranean initiative in transfusion medicine"

A large body of observations indicate that there is an inconsistent knowledge of Transfusion Medicine among health care professionals as well as inconsistent knowledge in all aspects of the transfusion process, from blood donation to transfusion on the ward. It is obvious to consider that appropriate education in Transfusion Medicine should be achieved in the education of specialists who will prescribe transfusion on a regular basis (hematologists, critical care specialists, anaethesiologists and others.) However,we also believe that education in Transfusion Medicine should also be delivered to almost all other medical specialists who may prescribe blood components. The variability in education of undergraduates in medical schools is universal most likely due to an absence of a predefined common platform. This paper, therefore, focuses on education at the undergraduate level and advocates coverage of the essential physiology and pathophysiology of blood as applied to blood transfusion as well as the medical and societal aspects of issues related to blood donation. It proposes incremental levels of training in Transfusion Medicine, with what is being therefore referred to as 'A', 'B', 'C' etc. curricula in ascending order of complexity; for example, 'A' and 'B' levels would involve medical, midwifery and nursing students, covering a broad base of the subject: they will be detailed in the present essay; ongoing further curricula will focus on physicians and other professionals working within the area or with responsibility for different aspects of the transfusion chain. It is intended that these courses include aspects of donor care, patient care and the appropriate use, safety and effectiveness of blood products. Next, it is advocated that curricula are addressed not only for high-income countries but also for middle- and low-income ones.