As a transfusion medicine physician, I must know if I can trust my staff’s interpretation of immunohematology testing. I may be called at night and they will provide me with results and I must use these to make a medical judgment. If their interpretation is flawed, I might make a decision that harms the patient.
I really don’t like multiple-choice questions, but nowadays this is often the norm. For my staff, especially senior staff and those who want to be promoted to senior staff, I have developed a series of projective exercises to help me understand their thought processes.
Here is a sample exercise. I have the staff review this panel and tell me to interpret it:
Most of them answer that this is an anti-Cw without hesitation. However, they are basing that on only one Cw-positive cell.
More astute ones indicate it might be anti-Cw but ask to test additional Cw-positive cells and perform an enzyme panel. These are the ones that I will consider for promotion now.