Development and validation of a pediatric transfusion medicine education assessment tool

Pediatric transfusion medicine presents unique challenges due to differences in pediatric physiology and pathology compared to adults. Research shows that pediatric healthcare professionals have knowledge gaps in transfusion medicine, contributing to suboptimal practice. To address these gaps, Transfusion Camp, a transfusion medicine education program, was adapted to a pediatric-focused curriculum. To assess pediatric learners' knowledge uptake, we aimed to develop and validate the Pediatric Transfusion Knowledge Test.

The BEST TEST-3, a previously validated transfusion medicine knowledge assessment tool, was modified by a multidisciplinary committee of content experts, using a curriculum blueprint for pediatric transfusion medicine consisting of 31 core and 42 extended topics, identified through a previously published national multi-specialty Delphi consensus study. The modified test was administered to 8 novice, 20 intermediate, and 14 expert participants in pediatric transfusion medicine. Data were analyzed using Rasch psychometric modeling to finalize test content.

The finalized assessment tool included 25 multiple-choice questions, with balanced representation across the cognitive processes outlined in Bloom's taxonomy. Twenty-four questions demonstrated good fit statistics with infit average 0.99 (0.8-1.2) and outfit average 0.96 (0.78-1.22). One question required revision. Question difficulty ranged from -2.78 to 1.61 on the logit scale, with gaps observed for higher-ability test-takers.

Developing the Pediatric Transfusion Knowledge Test represents a systematic approach to adapting and validating an assessment using a curriculum blueprint and ensuring alignment with educational materials. It adapts an existing assessment and incorporates evidence-based pedagogical principles. This framework can be applied to develop other assessments within medical education.