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Updated: Nov 6, 2025
A Precision Medicine Tool for Measurement and Monitoring of Hemoglobin S in Sickle Cell Disease Patients Receiving Transfusion Therapy
Pediatric resident knowledge of transfusion medicine: Results from the BEST-TEST3 international education needs
Allison P Wheeler1, Meghan Delaney2, Mark Fung3
1Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Insights
Pediatric residents demonstrate poor knowledge of transfusion medicine, scoring an average of 37.1% on a new validated exam. This highlights a critical need for enhanced pediatric transfusion education to ensure patient safety.
Area of Science:
- Pediatric Hematology
- Transfusion Medicine
- Medical Education
Background:
- Transfusion therapy is common in pediatrics, requiring specialized knowledge for safe practice.
- Lack of evidence-based knowledge can lead to transfusion misuse and patient harm.
- Limited data exists on pediatricians' transfusion medicine knowledge compared to adult physicians.
Purpose of the Study:
- To develop and validate a pediatric-specific examination to assess transfusion medicine knowledge in pediatric residents.
- To evaluate the current transfusion medicine knowledge levels among international pediatric residents.
Main Methods:
- A pediatric-specific exam was developed from an existing internal medicine exam through an iterative expert process.
- The exam underwent pilot testing and Rasch analysis for validation.
- The validated exam and a survey on training and attitudes were administered to 330 pediatric residents across 19 international sites.
Main Results:
- The mean score on the transfusion medicine exam was 37.1% (range 9.5%-71.4%).
- No significant differences in scores were observed based on the amount or perceived quality of transfusion education received, or perceived ability.
- The majority of residents (91%) reported obtaining blood product consent.
Conclusions:
- A validated exam for assessing pediatric transfusion medicine knowledge is now available.
- Poor performance by international pediatric residents indicates a significant need for improved transfusion medicine education.
- Enhanced education is crucial for the safe and appropriate use of blood components in pediatric patients.
Background:
Transfusions are a common intervention within pediatrics and require unique considerations to optimize patient care. Poor knowledge of evidence-based transfusion practice can lead to misuse of transfusion therapy and harm. While there have been assessments of transfusion medicine knowledge of physicians caring for adult patients, there is little data regarding pediatricians.
Study Design And Methods:
Using a published transfusion medicine knowledge exam for internal medicine physicians as a backbone, pediatric transfusion medicine experts, using an iterative process, developed a pediatric-specific examination. Pilot testing and Rasch analysis, a method used in high-stakes testing, was used to validate the exam. The exam and a previously validated survey on transfusion medicine training, attitudes, and perceived ability were administered to pediatric residents. Analysis consisted of descriptive statistics as well as comparisons of exam scores based on survey responses.
Results:
330 pediatric residents from 19 sites in 6 countries participated in the study. The vast majority (91%) of residents had obtained blood product consent. The mean exam score was 37.1% (range 9.5%-71.4%) with no statistical differences based on amount or perceived quality of transfusion medicine education or perceived ability.
Discussion:
A rigorously validated exam has now been developed that can be used to assess pediatric transfusion medicine knowledge. A large international group of pediatric residents performed poorly on the exam demonstrating a pressing need for improved transfusion medicine education to ensure safe and appropriate administration of blood components to infants and children.
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