title: Improving transfusion education for junior doctors; exploring UK experiences.
abstract: OBJECTIVE
  To provide evidence-based guidance on how transfusion education should be delivered to junior doctors by employing established qualitative research methodology.
  
  
  BACKGROUND
  There is a global call for increased transfusion education for doctors to support the delivery of evidence-based practice. Education is reported as an effective measure to improve transfusion practice, although there is a paucity of research evaluating how this should be effectively delivered.
  
  
  METHODS
  Serial focus groups with junior doctors and relevant healthcare professionals explored experiences of, and reactions to, education and competency assessments in transfusion, which were audio-recorded and transcribed. Temporal and final analysis, performed by two independent assessors, informed subsequent recruitment, analysis and challenging of emerging theories - until saturation was reached.
  
  
  RESULTS
  Eight focus groups were held involving 53 personnel, 77% of whom were junior doctors. Current transfusion education for doctors in the UK is reliant on e-learning and 'cascade training' (on-the-job from senior clinicians/nursing staff). E-learning is viewed as a 'tick box exercise'. There is a call for relevant and practical continuing education delivered face to face by good educators in an environment away from clinical practice. Preferred methods include small group and simulation learning based on real-life cases. In contrast to practical competency, the assessment of clinical competency is deemed unfeasible.
  
  
  CONCLUSIONS
  Current methods of transfusion education employed in the UK are unsatisfactory to ensure safe transfusion practice. Ongoing education is deemed necessary throughout career progression, and suggested improvements include increased emphasis on face-to-face teaching and simulation training. Employed educational methods and decision support tools require appropriate evaluation.
authors.affiliation: Department of Haematology, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, UK.
authors.forename: J E
authors.initials: JE
authors.lastname: Graham
authors.affiliation: Manchester Blood Centre, NHS Blood & Transplant, Manchester, UK.
authors.forename: S
authors.initials: S
authors.lastname: Narayan
authors.affiliation: Manchester Blood Centre, NHS Blood & Transplant, Manchester, UK.|Department of Haematology, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK.
authors.forename: K
authors.initials: K
authors.lastname: Pendry
mesh_terms: D001782:Blood Donors / Q000193:education*; D001803:Blood Transfusion; D004502:Education, Medical, Continuing; D055317:Evidence-Based Practice / Q000193:education*; D005260:Female; D006801:Humans; D008297:Male; D006113:United Kingdom
keywords: blood component transfusion; competency assessment; education; focus groups; grounded theory; patient blood management; qualitative research; simulation; training; transfusion; transfusion medicine