Postgraduate Diploma in Transfusion Medicine

Purpose

The purpose of this diploma is to enable the learners to practice medicine with a more in-depth knowledge on the appropriate use of blood and blood products. The diploma will also give the learner the ability to manage risk for the patient population in a country through utilising a scarce resource optimally. It will enable them in making informed decisions regarding benefit versus risk for each transfusion episode, choosing the right product for the right patient and thereby improving the cost-effectiveness of transfusion medicine practice. The diploma might also serve as a stepping stone for a formal qualification in blood banking. The course will however, concentrate on the practical aspects of medical transfusion practices at the bedside rather than supplying a blood transfusion service.

The aim is to help the students enhance their competences in the administration and management of a blood transfusion service, the basic principles underlying blood transfusion, the administration of blood and blood products, its clinical applications, complications and new developments in the field.

This programme serves as an adjunct as well as an extension of the current programme in clinical and laboratory hematology that is delivered both on a under- and a postgraduate level.

It serves as an important interface with many other programmes and specialties where blood transfusion forms a major part of day to day clinical practice, for example anaesthesia, pediatrics, internal medicine, surgery, obstetrics and gynecology, oncology, haematology, etc.

Blood is a scarce resource and needs to be managed cost-effectively and appropriately in the larger context of limited resources in the healthcare setting as a whole.

Rationale

Students receive minimal undergraduate and postgraduate training in the use of blood and blood products, yet many doctors are actively involved in the application of transfusion medicine on a daily basis.

This programme endeavours to provide postgraduate education that is characterized by high quality, excellence, relevance to community needs and the development of scarce skills and capacity in the country in general and in the region specifically.

Learners will be empowered to use blood, a scarce resource, cost-effectively and appropriately in the larger context of limited resources in the healthcare setting as a whole.

• Minimal requirement is a basic medical degree, MBChB or MBChB equivalent.

Recognition of Prior Learning

As this diploma is focused on transfusion medicine in the context of South Africa and Africa, and there are no other similar programmes available in Africa, it does not really lend itself to RPL. In very exceptional cases, previous learning may be taken into consideration and a mechanism is in place whereby international qualifications are verified via SAQA and RPL applications via the RPL office of the Free State Higher Education Consortium.

Access to the Qualification

The minimal requirement is a basic medical degree, MBChB or MBChB equivalent. MBChB is ranked as NQF Level 7; therefore students should not have any difficulty in meeting the academic challenges of this programme.

Students that will partake in this course, are mostly in full-time clinical practice, therefore this programme aims to accommodate them by providing a one-year course over two years.

The University of the Free State should be able to manage 30-50 students every two years in the programme. We do not foresee that we will have more applications than this. If we do, we believe that it will be appropriate to give preference to candidates from South Africa and those working actively in the application of transfusion medicine in their daily practice.

Level, credits and learning components assigned to the qualification.

This programme is a postgraduate diploma for students who have already obtained an MB ChB at NQF Level 7. This diploma is pitched at NQF Level 7.

The diploma is assigned 120 credits according to the breakdown given below.

Year 1

Core

Module/Course name; Credits

• Organization and management of a transfusion service; 16 Credits.
• Principles of blood banking and fractionation of blood; 16 Credits.
• Administering blood products; 16 Credits.

Year 2

Core

Module/Course name; Credits

• Clinical application of blood products; 36 Credits.
• Complications of transfusion; 20 Credits.
• Developments in transfusion medicine; 16 Credits.

Learning Components

All the learning components are considered to be core. It was decided not to add electives or fundamentals, because the diploma is on NQF Level 7 and all students have an MB ChB or MB ChB equivalent as a basic requirement.

The purpose of this diploma is to enable the learners to practice medicine with a more in-depth knowledge on the appropriate use of blood and blood products. The diploma will also give the learner the ability to manage risk for the patient population in a country through utilising a scarce resource optimally, making an informed decision on benefit versus the risk for each transfusion episode; i.e. "Choosing the right product for the right patient" and reduce the costs of transfusion by appropriate transfusion practices. The diploma also serves as a stepping stone towards a formal qualification in blood banking. The main aim of the diploma is to improve transfusion medicine at the bedside rather than training staff to run a blood service.

In order to achieve the above the diploma will aim to achieve the following outcomes

1. The learner will be able to give a consultation service to colleagues regarding the effects of blood and blood products on the recipients.
2. The learner will be able to treat and give consultation regarding patients with general and specific transfusion needs.
3. The learner will be able to assist hospital management with the establishment and maintenance of a programme that will monitor the appropriate use of blood products in a community as well as manage quality assurance systems regarding the administration of blood products.
4. The learner will be able to manage and give consultation on the management and prevention of the various types of transfusion reactions.
5. The learner will be able to give consultation on the appropriate use of alternatives to blood products.
6. The learner will understand the new developments in transfusion medicine and the role these will play in the management of patients.
7. The learner will be able to give an opinion on macro, meso and micro ethical aspects of supplying a blood service to communities/patients.
8. The learner will understand the basic concepts of Blood transfusion legislation, policy, administration and management, as well as service delivery under normal circumstances and during times of disaster. The learner will be able to assist policy makers with regards to the delivery of a blood transfusion services.
9. The learner will be able to assists with legislators with the setting up and management of a disaster plan in regard to delivering of blood product in crisis situations.
10. The learner will understand the blood supply chain process as well as internal and external factors influencing it.

Learner competency will be assessed in terms of

• Their ability to demonstrate the application of knowledge in given contexts.
• The acquisition of certain attitudes and viewpoints that are demonstrated in the learner's approach to and enunciation of problems.
• The attainment of demonstrable intellectual skills.
• The specification of norms for dealing with these issues.

Learners will demonstrate their acquired competencies via the following assessment opportunities

Associated Assessment Criteria for Exit-Level Outcome 1

• An assignment in which the various effects of blood will be explained in terms of purpose of product, optimal preparation and storage of products, compatibility and effect of the product on the human body.

Associated Assessment Criteria for Exit-Level Outcome 2

• Demonstrate at the hand of case studies how various clinical situations should be handled and what advice would be given to colleagues.

Associated Assessment Criteria for Exit-Level Outcome 3

• Forming an (imaginative) consulting team to facilitate and coordinate management's assessments for the appropriate utilisation of blood products taking into account the appropriate level of ethical, logistical and clinical issues.

Associated Assessment Criteria for Exit-Level Outcome 4

• Projects to illustrate that sufficient clinical skills have been acquired to deal with transfusion reactions, whether acute or delayed.

Associated Assessment Criteria for Exit-Level Outcome 5

• Demonstrate at the hand of case studies how various clinical situation should be handled and what advice would be given to colleagues.

Associated Assessment Criteria for Exit-Level Outcome 6

• A report on the various new developments in blood transfusion and the impact of these on patient care, taking into account the appropriate utilisation of these new developments as well as pertinent ethical issues.

Associated Assessment Criteria for Exit-Level Outcome 7

• A debate on the depiction and application of principles and viewpoints in dealing with questions pertaining to the various ethical aspects in transfusion medicine.

Associated Assessment Criteria for Exit-Level Outcome 8

• A strategic plan where informed recommendations are made regarding the need for a national blood service, appropriate supportive policies and structures to deliver such a service.

Associated Assessment Criteria for Exit-Level Outcome 9

• A policy document with the appropriate second level documentation (standard operational procedures) that will provide management with the insights and perspectives to manage a potential disaster and utilise blood products optimally in such a situation.

Associated Assessment Criteria for Exit-Level Outcome 10

• A report on the blood supply chain in which the role of the various stakeholders; principles, technologies, and resources are identified, analysed, described and evaluated.

Integrated Assessment

This programme is run as a cooperative venture between many different role-players and disciplines, which ensure that assessment takes into account the total scope of transfusion practice, and is not limited to uni-disciplinary preferences. The programme will be run according to university policies and within the framework of HPCSA guidelines.

As the students who complete the programme will be required to apply their knowledge on a larger than regional scale, taking into account regional differences in practices, and also for quality assurance purposes, external moderation will be essential.