The use of an objective structured clinical examination to assess internal medicine residents' transfusion knowledge

Background Previous studies have indicated that medical trainees receive inadequate instruction in transfusion medicine and that this translates into insufficient transfusion knowledge throughout medical practice. We undertook to assess transfusion knowledge among internal medicine trainees in a single institution using a standardized oral examination case. Study Design and Methods A case of an adult with clear requirement for red blood cell transfusion was created. The case was reviewed by content experts and pilot tested on hematology trainees in their fifth postgraduate training year. The case was administered to internal medicine trainees in their first to fourth postgraduate years as part of a larger examination that is mandatory for all internal medicine trainees in our center. Scores on the transfusion case were assessed for each examinee. Results Seventy-three residents participated in the examination and completed the transfusion objective structured clinical examination (OSCE) case. The mean score on this case was 6.6 of 10 with 31.5% of examinees failing this case. Scores did not differ as a function of increasing years of training. Conclusion This study again indicated that transfusion knowledge is poor among internal medicine trainees and that this does not improve with increasing number of years of training. Innovative strategies for transfusion education are urgently needed and should be rigorously assessed for efficacy.