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

English: In this research, an in-depth study was done to construct a model for the academic development and implementation of a Postgraduate Diploma in Transfusion Medicine in the School of Medicine at the University of the Free State. Transfusion medicine as a discipline has experienced major advances over the past few decades with an emphasis on increased blood safety and the improvement of systems, technology and administrative processes. Unfortunately, attention has largely been focused on laboratory aspects and clinical transfusion medicine has lagged behind. This has resulted in the present situation where clinical transfusion medicine has become totally underrepresented in medical curricula, despite the fact that many doctors are involved in administering blood and blood products. This has led to a number of studies and publications on the increasing rate of preventable transfusionassociated deaths resulting from errors on the part of medical personnel. Many researchers have made the link between these errors and the inadequate education and training received by doctors in respect of transfusion medicine. This begs the question as to how this gap in the knowledge market can adequately be bridged and further what a model for the academic development and implementation of a Postgraduate Diploma in Transfusion Medicine should look like. Against this background, the problem that was addressed in this study was the absence of such a model. As far as the researcher could ascertain, no such model existed prior to his embarking upon this research. The goal of the research was thus to develop a model for the academic development and implementation of a Postgraduate Diploma in Transfusion Medicine – specific to the South African context – with a view to contributing to safer and more cost-effective transfusion practice by clinicians. A further aim of the study was to develop this model specifically in the School of Medicine at the University of the Free State. Both qualitative and semi-quantitative research methods were employed and used in a complementary fashion. The methods used included a study of the literature, semi-structured questionnaires and a Delphi survey. The literature review provided insights into the current status of education in transfusion medicine with special reference to the changing arena of transfusion practice. Also, a perspective was provided on some of the key issues that should be taken into account during the development and implementation of a model for a Postgraduate Diploma in Transfusion Medicine. Semi-structured interviews were conducted with experts in transfusion medicine from all over the world. Open-ended questions were asked, which allowed for an interactive discussion between the researcher and the interviewees. Prior to the interviews, a letter of request and explanation was provided to the participants and formal, informed consent obtained. The purpose was to collect information on a number of issues related to clinical transfusion medicine practice. As well as wanting to determine the nature of the challenges with which clinicians are faced, the researcher set out to delineate their scope of practice. Questions dealt with the roles, tasks, functions, skills, deficiencies, areas of clinical knowledge and competences practised by doctors involved in transfusion medicine. An attempt was furthermore made to determine not only the relevant outcomes of a Postgraduate Diploma in Transfusion Medicine but also the relevant academic, educational and sustainability factors. The results of the semi-structured interviews were analysed and collated in tables. These, combined with the findings from the literature review, formed the basis of the statements used in compiling the Delphi survey. The Delphi survey was used to test the criteria derived from both the literature review and the semi-structured interviews qualitatively and semiquantitatively. The Delphi questionnaire was provided to South African doctors with appropriate experience in transfusion medicine and medical education subsequent to their receiving an information letter and giving informed consent. The Delphi questionnaire was divided into sections corresponding to the main themes in the semi-structured interviews. After analysis by the researcher, the findings of the Delphi survey were presented in the form of a description of the findings, a discussion and recommendations. Aspects discussed in the model comprised the premises for the development of the model, the points of departure, the key internal and external role players who could potentially influence the model and the different elements that should be included and/or addressed in the model. Perspectives were provided on the model and its implementation, including some thoughts on procedural, policy and management issues. The researcher proposed that, before anything else, a situational analysis had to be done to identify the needs, deficiencies and challenges related to transfusion medicine practice and education. This needed to be done in consultation with all the relevant role players. Subsequently, the educational, academic and sustainability factors relevant to the programme had to be identified. Careful planning was required within the context of a qualified and motivated team. Once the structure, programme content, timeframe, target audience and funding streams had been identified, and the appropriate approvals for the programme obtained, the programme would have to be marketed. Cooperation and networking with all role players through continuous dialogue would allow for the linkage of resources and lay the foundation for long-term collaborative relationships. Finally, continuous feedback from role players, including students would be required to determine whether goals had been achieved and if not, to use this as the basis for continuous improvement. In that the stated problem was addressed and the goal and objectives of the research were met, this study makes a unique contribution to transfusionmedicine education by providing a model for the academic development and implementation of a Postgraduate Diploma in Transfusion Medicine. Final conclusions were drawn and the limitations and recommendations of the study were highlighted. It is hoped that this study will make a contribution to the better education of clinicians in the clinical aspects of transfusion medicine and that this will, in turn, translate into patients’ receiving better and safer transfusions.