A model for the academic development and implementation of a postgraduate diploma in Transfusion Medicine in the Shool of Medicine at the University of the Free State

[摘要] English: In this research, an in-depth study was done to construct a model for theacademic development and implementation of a Postgraduate Diploma inTransfusion Medicine in the School of Medicine at the University of the FreeState.Transfusion medicine as a discipline has experienced major advances overthe past few decades with an emphasis on increased blood safety and theimprovement of systems, technology and administrative processes.Unfortunately, attention has largely been focused on laboratory aspects andclinical transfusion medicine has lagged behind. This has resulted in thepresent situation where clinical transfusion medicine has become totallyunderrepresented in medical curricula, despite the fact that many doctors areinvolved in administering blood and blood products. This has led to a numberof studies and publications on the increasing rate of preventable transfusionassociateddeaths resulting from errors on the part of medical personnel.Many researchers have made the link between these errors and theinadequate education and training received by doctors in respect oftransfusion medicine.This begs the question as to how this gap in the knowledge market canadequately be bridged and further what a model for the academicdevelopment and implementation of a Postgraduate Diploma in TransfusionMedicine should look like.Against this background, the problem that was addressed in this study wasthe absence of such a model. As far as the researcher could ascertain, nosuch model existed prior to his embarking upon this research. The goal ofthe research was thus to develop a model for the academic development andimplementation of a Postgraduate Diploma in Transfusion Medicine �?specificto the South African context �?with a view to contributing to safer and morecost-effective transfusion practice by clinicians. A further aim of the studywas to develop this model specifically in the School of Medicine at theUniversity of the Free State.Both qualitative and semi-quantitative research methods were employed andused in a complementary fashion. The methods used included a study of theliterature, semi-structured questionnaires and a Delphi survey.The literature review provided insights into the current status of education intransfusion medicine with special reference to the changing arena oftransfusion practice. Also, a perspective was provided on some of the keyissues that should be taken into account during the development andimplementation of a model for a Postgraduate Diploma in TransfusionMedicine.Semi-structured interviews were conducted with experts in transfusionmedicine from all over the world. Open-ended questions were asked, whichallowed for an interactive discussion between the researcher and theinterviewees. Prior to the interviews, a letter of request and explanation wasprovided to the participants and formal, informed consent obtained.The purpose was to collect information on a number of issues related toclinical transfusion medicine practice. As well as wanting to determine thenature of the challenges with which clinicians are faced, the researcher setout to delineate their scope of practice. Questions dealt with the roles, tasks,functions, skills, deficiencies, areas of clinical knowledge and competencespractised by doctors involved in transfusion medicine. An attempt wasfurthermore made to determine not only the relevant outcomes of aPostgraduate Diploma in Transfusion Medicine but also the relevantacademic, educational and sustainability factors.The results of the semi-structured interviews were analysed and collated intables. These, combined with the findings from the literature review, formedthe basis of the statements used in compiling the Delphi survey.The Delphi survey was used to test the criteria derived from both theliterature review and the semi-structured interviews qualitatively and semiquantitatively.The Delphi questionnaire was provided to South Africandoctors with appropriate experience in transfusion medicine and medicaleducation subsequent to their receiving an information letter and givinginformed consent. The Delphi questionnaire was divided into sectionscorresponding to the main themes in the semi-structured interviews. Afteranalysis by the researcher, the findings of the Delphi survey were presentedin the form of a description of the findings, a discussion andrecommendations.Aspects discussed in the model comprised the premises for the developmentof the model, the points of departure, the key internal and external roleplayers who could potentially influence the model and the different elementsthat should be included and/or addressed in the model. Perspectives wereprovided on the model and its implementation, including some thoughts onprocedural, policy and management issues.The researcher proposed that, before anything else, a situational analysishad to be done to identify the needs, deficiencies and challenges related totransfusion medicine practice and education. This needed to be done inconsultation with all the relevant role players. Subsequently, the educational,academic and sustainability factors relevant to the programme had to beidentified. Careful planning was required within the context of a qualified andmotivated team. Once the structure, programme content, timeframe, targetaudience and funding streams had been identified, and the appropriateapprovals for the programme obtained, the programme would have to bemarketed. Cooperation and networking with all role players throughcontinuous dialogue would allow for the linkage of resources and lay thefoundation for long-term collaborative relationships. Finally, continuousfeedback from role players, including students would be required todetermine whether goals had been achieved and if not, to use this as thebasis for continuous improvement.In that the stated problem was addressed and the goal and objectives of theresearch were met, this study makes a unique contribution to transfusionmedicineeducation by providing a model for the academic development andimplementation of a Postgraduate Diploma in Transfusion Medicine. Finalconclusions were drawn and the limitations and recommendations of thestudy were highlighted.It is hoped that this study will make a contribution to the better education ofclinicians in the clinical aspects of transfusion medicine and that this will, inturn, translate into patients' receiving better and safer transfusions.

[发布机构] University of the Free State