Consensus recommendations on peripheral blood smear review: defining curricular standards and fellow competency

Area of Science:

• Medical Education
• Hematology
• Diagnostic Cytology

Background:

• Graduate medical education in hematology requires competency in peripheral blood smear (PBS) review.
• Current training lacks standardized guidelines for PBS interpretation, education, and competency assessment.
• This deficiency impacts diagnostic accuracy and patient care.

Purpose of the Study:

• To develop consensus recommendations for peripheral blood smear (PBS) review education and competency assessment in hematology.
• To address the absence of standardized guidelines in graduate medical education.
• To inform future curriculum development and research in visuospatial diagnostic tasks.

Main Methods:

• A multi-institutional focus group of eight academic hematologists was convened.
• Constructivist grounded theory and a modified nominal group technique were employed.
• Mixed-methods analysis of focus group data identified emerging theory and generated consensus recommendations (CR).

Main Results:

• Strong consensus was achieved on multiple aspects of PBS education, emphasizing a systematic approach.
• Discussions focused on red and white blood cell disorders, particularly acute leukemia and thrombotic microangiopathies.
• Key recommendations address the need for prompt recognition of critical diagnoses.

Conclusions:

• Consensus recommendations for PBS education and competency were successfully generated.
• These recommendations provide a foundation for future research and curriculum development in hematology training.
• Standardized PBS review training is crucial for ensuring diagnostic proficiency and patient safety.