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 another exercise, usually given to base medical technologists. I have the staff review this panel and tell me to interpret it:
Many staff called this anti-E and anti-c. They did not note that there is no E-positive c-negative cell. Also, many did not see that one c-positive cell had no reaction—they did not notice that the c was heterozygous (C+c+ not c+c+).
A medical technologist must not be sloppy, but rather very meticulous. If there are discrepancies in the panel, they must rule out dosage, zygosity, etc. They should not name an antibody specificity with only one antigen-positive cell.
To Be Continued: