title: Assessing transfusion competency in junior doctors: a retrospective cohort study.
abstract: BACKGROUND
  There is scope to further improve the safety of transfusion practice within the United Kingdom. This study aims to identify the current role of junior doctors in the transfusion process and to assess their competency to appropriately prescribe blood and blood products to patients.
  
  
  METHODS
  Transfusion competency in junior doctors training in a single region was addressed through anonymized questionnaires assessing factual knowledge, personal reflection, and documented evidence of competency. Factual knowledge comprised 33 true-false questions (competency score) covering indications for transfusion, special requirements, risks of transfusion, and guidelines for testing in transfusion. Background data on current practice and education in transfusion medicine were addressed using multiple-choice and single-response questions.
  
  
  RESULTS
  A total of 787 newly qualified doctors, comprising 79% of first-year (F1) and 62% of second-year (F2) Foundation doctors, completed the assessment over a 3-week period. There was no improvement in competency score between F1 and F2 doctors (p = 0.1). Competency scores correlated most strongly with undergraduate education in transfusion medicine and attendance at hospital induction (p < 0.01). Junior doctors had a high confidence level with regard to prescribing blood, although only 78% were aware they had been competency assessed against national standards.
  
  
  CONCLUSIONS
  Junior doctors are involved in sampling, prescribing, consenting, and documenting transfusion practice frequently enough to maintain competency. They are rarely involved in the collection, bedside checking, or administration of blood despite current curriculum requirements. There is scope to significantly improve both the training and the assessment of transfusion competency in doctors.
authors.affiliation: School of Medical Specialties, North Western Deanery, Manchester, UK; National Comparative Audit, NHSBT, Oxford, UK; School of Medicine, University of Manchester, Foundation School, North Western Deanery, Manchester, UK; NHSBT, Manchester & Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK.
authors.forename: Jane
authors.initials: J
authors.lastname: Graham
authors.forename: John
authors.initials: J
authors.lastname: Grant-Casey
authors.forename: Robert
authors.initials: R
authors.lastname: Alston
authors.forename: Paul
authors.initials: P
authors.lastname: Baker
authors.forename: Kate
authors.initials: K
authors.lastname: Pendry
mesh_terms: D001803:Blood Transfusion / Q000592:standards* / Q000706:statistics & numerical data; D002983:Clinical Competence; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006405:Hematology / Q000193:education / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D019359:Knowledge; D019300:Medical Errors / Q000706:statistics & numerical data; D008505:Medical Staff, Hospital / Q000592:standards / Q000706:statistics & numerical data; D008511:Medicine / Q000706:statistics & numerical data; D011364:Professional Practice / Q000592:standards / Q000706:statistics & numerical data; D012189:Retrospective Studies; D064826:Transfusion Medicine / Q000193:education* / Q000592:standards