Anesthesiology Resident Knowledge of Transfusion Medicine: Results From the Anesthesiology Transfusion Education Study

Neil Roy Connelly; Adam C Adler; Laura E Vanderberg; Frederick Conlin; John D Mitchell; Sheldon Goldstein; Richard L Haspel; ATEST Collaborators

doi:10.1213/ANE.0000000000006327

Anesthesiology Resident Knowledge of Transfusion Medicine: Results From the Anesthesiology Transfusion Education Study

Anesth Analg. 2024 Mar 1;138(3):655-663. doi: 10.1213/ANE.0000000000006327. Epub 2022 Dec 12.

Authors

Neil Roy Connelly¹, Adam C Adler^{2

3}, Laura E Vanderberg⁴, Frederick Conlin¹, John D Mitchell⁵, Sheldon Goldstein^{6

7}, Richard L Haspel⁸; ATEST Collaborators

Collaborators

ATEST Collaborators:
Piotr Aljindi⁹, John H Stroger Jr¹⁰, Benjamin R Beal¹¹, Lee Chang¹², Melissa Ehlers¹³, Lisa Farmer¹⁴, Brian S Freeman¹⁵, Candice Hithe¹⁶, Matthew F Hirschfeld¹⁷, Gillian Isaac¹⁸, J M Ismawan¹⁹, Sandeep Krishnan²⁰, Brian Martin²¹, Charles A Napolitano²², Sara E Neves²³, Mark C Norris²⁴, Sohail K Mahboobi²⁵, Timothy W Martin²⁶, George McKean²⁷, J Ross Renew²⁸, Joy Schabel²⁹, Tina Tran³⁰, Kelly Ural³¹, Bob Weaver³²

Affiliations

¹ From the Department of Anesthesiology, UMass Chan Medical School-Baystate, Baystate Medical Center, Springfield, Massachusetts.
² Department of Anesthesiology, Perioperative and Pain Medicine; Texas Children's Hospital, Houston, Texas.
³ Baylor College of Medicine, Houston, Texas.
⁴ Program for Advanced Learning, Curry College, Milton, Massachusetts.
⁵ Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, and Harvard Medical School, Boston, Massachusetts.
⁶ Department of Anesthesiology, Montefiore Medical Center, New York, New York.
⁷ Albert Einstein College of Medicine, Bronx, New York.
⁸ Department of Pathology, Beth Israel Deaconess Medical Center, and Harvard Medical School Boston, Massachusetts.
⁹ Anesthesiology Program Director, Interim Chair OB Anesthesia Division, Department of Anesthesiology and Pain Medicine.
¹⁰ Hosp. of Cook County, Chicago, IL.
¹¹ Associate Professor, Department of Anesthesiology, University of California San Diego, San Diego, CA.
¹² Associate Professor of Anesthesiology, Department of Anesthesiology, Baylor College of Medicine, Houston, TX.
¹³ Professor of Anesthesiology, Department of Anesthesiology, Albany Medical College, Albany, NY.
¹⁴ Program Director of Anesthesiology, Professor of Anesthesiology, Department of Anesthesiology, University of Texas Medical Branch, Galveston, TX.
¹⁵ Professor of Anesthesiology, Department of Anesthesiology, MedStar Georgetown University Hospital, Georgetown University School of Medicine, Washington, DC.
¹⁶ Kettering Health Dayton, Department of Anesthesiology, Program Director, Dayton, OH.
¹⁷ Associate Professor, Department of Anesthesiology and Perioperative Medicine, Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, NY.
¹⁸ Associate Residency Program Director of Anesthesiology and Critical Care Medicine, Obstetric Anesthesiology Fellowship Program Director, Assistant Professor of Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine, Department of Anesthesiology and Critical Care Medicine, Baltimore, MD.
¹⁹ USN, Associate Anesthesiology Residency Program Director, Chair of CLER Subcommittee on Patient Safety, Associate Intern Advisor, Assistant Clinical Professor, USUHS, Bethesda, MD.
²⁰ Associate Professor, Program Director of Anesthesiology Residency, Wayne State University School of Medicine, Department of Anesthesiology, Detroit, MI.
²¹ Anesthesiology Residency Program Director, Department of Anesthesiology, Assistant Professor, UMASS-Chan Medical School-Baystate, Springfield, MA.
²² Professor and Program Director, Vice Chair of Education and Faculty Development, Director of Cardiothoracic Anesthesia, UAMS, College of Medicine, Department of Anesthesiology, Little Rock, AK.
²³ Assistant Professor, Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA, Program Director, Anesthesia Residency.
²⁴ Clinical Professor of Anesthesiology, Department of Anesthesiology, Boston University School of Medicine, Boston, MA.
²⁵ Vice Chair (Education), Assistant Clinical Professor of Anesthesiology, Department of Anesthesiology and Pain Management, Lahey Hospital & Medical Center, Burlington, MA.
²⁶ Professor and Associate Chair for Education, Anesthesiology Residency Program Director, Chief, Division of Pediatric Anesthesiology, Department of Anesthesiology, University of Florida College of Medicine, Gainesville, FL.
²⁷ Program Director of Anesthesiology, OhioHealth Doctors Hospital, Adjunct Clinical Professor of Anesthesiology, Ohio University College of Osteopathic Medicine, Columbus, OH.
²⁸ Assistant Professor of Anesthesiology, Department of Anesthesiology, Mayo Clinic, Jacksonville, FL.
²⁹ Professor of Clinical Anesthesiology, Department of Anesthesiology, Stony Brook University Medical Center, Stony Brook, NY.
³⁰ Chief of Anesthesia for the Wilmer Eye Institute, Assistant Professor of Anesthesia & Critical Care Medicine, Assistant Professor of Ophthalmology, Taussig Faculty, Colleges Advisory Program, Co-Director of Clinical Preceptorship in Anesthesiology, Johns Hopkins School of Medicine, Department of Anesthesiology and Critical Care Medicine, Baltimore, MD.
³¹ Residency Program Director, Ochsner Health Department of Anesthesiology and Perioperative Medicine, Senior Lecturer, The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA.
³² Assistant Professor, Associate Residency Program Director, Advanced Development Director of Medical Student Education, Department of Anesthesiology, University of Kentucky, Lexington, KY.

PMID: 36729772
DOI: 10.1213/ANE.0000000000006327

Abstract

Background: Transfusion of blood products is a common practice in anesthesiology. Inadequate transfusion medicine knowledge may lead to inappropriate transfusion practices and patient risk. Using a validated assessment tool modified for anesthesiology, we conducted a survey of anesthesiology residents in the United States to assess transfusion medicine knowledge.

Methods: A validated transfusion medicine examination and accompanying survey were forwarded by program directors to residents for anonymous completion on May 5 and closed on June 30, 2021. The outcome of interest was the mean examination score. Secondary areas of interest were performance by year of training and previous educational experience in transfusion reported by the trainees. Rasch analysis was performed on the examination quality and individual question performance. Kruskal-Wallis H tests were used to identify differences between mean scores. Post hoc comparisons were used to assess specific pairwise differences between mean test scores by survey variable.

Results: Four hundred twenty-three anesthesiology residents in 37 programs completed the examination. The mean score was 45.5% ± 12.6%. There was a significant difference in mean cumulative examination scores between different resident training levels ( P < 0.001). There was a significant difference in scores between clinical anesthesia (CA)-1 and CA-2 residents ( P = 0.011) and CA-1 and CA-3 residents ( P = 0.012). No significant difference in examination scores was observed between CA-2 and CA-3 residents ( P = 0.95). All these subgroups scored below 50% on the examination. Significant differences between the residency training programs and cumulative scores were identified ( P < 0.001).

Conclusions: This examination highlights gaps in transfusion medicine knowledge within US anesthesiology residents. Targeted education may improve knowledge in this area and patient care.

MeSH terms

Anesthesia*
Anesthesiology* / education
Blood Transfusion
Clinical Competence
Humans
Internship and Residency*
Surveys and Questionnaires
Transfusion Medicine* / education
United States