Donor Dilemma: A National Simulation-Based Case Curriculum for Teaching Donor Call Decision-Making in Infectious...

Donor-call decision-making during organ allocation requires clinical reasoning in the setting of uncertainty, time pressure, and evolving information. In transplant infectious diseases (TID), this skill is essential, yet exposure during training is often inconsistent and informal. Educational strategies that allow trainees to practice this type of decision-making remain limited. We aimed to evaluate the feasibility, acceptability, and perceived impact of an asynchronous electronic, case-based progressive disclosure curriculum designed to support clinical reasoning during donor-call decision-making among infectious diseases (ID) trainees.

In this pilot feasibility study, we developed a self-paced, asynchronous donor-call curriculum consisting of 12 case-based modules. Cases reflected real-world donor scenarios. After national dissemination to ID and TID training programs, participants completed all modules and a post-curriculum survey assessing feasibility and perceived educational impact.

Around 29 trainees from 22 academic medical centers completed all 12 modules. Most had little prior donor-call exposure. Eighty-six percent endorsed greater confidence in their clinical reasoning, and 97% reported greater confidence in assessing donor suitability. The curriculum was feasible within clinical workflows, and 97% of participants indicated they would recommend it to their peers. Perceived gains were most pronounced among trainees with minimal transplant experience, with benefit remaining high even among those in dedicated TID training years.

An asynchronous donor-call case-based progressive disclosure curriculum was feasible and valued across diverse ID and TID training programs. This scalable approach may offer a framework for supporting clinical reasoning in other areas of medicine where complex decisions must be made quickly with limited information.