title: A novel objective structured clinical examination for the assessment of transfusion practice in anaesthesia.
abstract: BACKGROUND
  In 2008 there were 262 episodes of incorrect blood component transfusion. Safer Practice Notice 14, Right patient, right blood, introduced a mandatory requirement for all clinical staff involved in the blood transfusion process to be assessed against competencies developed on a national basis. It was recommended that the assessment should be an observed, formalised process. The National Patient Safety Agency (NPSA) produced an assessment framework, but this has never been validated. We developed the Nottingham Anaesthesia Transfusion OSCE (NATO). This consists of an interactive clinical scenario that examines the key aspects of transfusion medicine.
  
  
  METHODS
  After gaining informed consent, the NATO assessments of 12 anaesthetists were filmed. Three experienced assessors independently viewed the recorded material and scored the candidates. Cronbach's alpha was subsequently calculated. All participants were asked to complete a feedback form.
  
  
  RESULTS
  The pass rate during the study was 58 percent (7/12). Cronbach's alpha for NATO was 0.929. Seventy-five percent of candidates judged NATO to be a fair assessment of transfusion competency.
  
  
  CONCLUSIONS
  NATO allows the objectives detailed by the NPSA to be assessed formally in a format that is pertinent to anaesthetic practice. Internal reliability and face validity evaluation are the first steps in utility assurance of this assessment tool.
authors.affiliation: University Department of Anaesthesia and Intensive Care, University of Nottingham, UK. corrie@nottingham.ac.uk
authors.forename: Kathryn
authors.initials: K
authors.lastname: Corrie
authors.forename: Matt
authors.initials: M
authors.lastname: Wiles
authors.forename: Jessica
authors.initials: J
authors.lastname: Flack
authors.forename: Joanne
authors.initials: J
authors.lastname: Lamb
mesh_terms: D000758:Anesthesia; D001803:Blood Transfusion / Q000379:methods*; D002983:Clinical Competence / Q000706:statistics & numerical data*; D004521:Educational Measurement / Q000379:methods*; D004522:Educational Status; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D019300:Medical Errors / Q000517:prevention & control*; D005791:Patient Care; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012449:Safety; D011795:Surveys and Questionnaires; D014481:United States