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Blood donation is the primary method of ensuring an adequate supply of blood for various medical purposes. The demand for blood exceeds the availability because of the birthrate decline, dearth of young donors, and aging recipient population. In addition, a decrease in blood donation participation owing to the social distancing measures implemented to curb the spread of coronavirus disease 2019 (COVID-19) has been commonly observed worldwide [1]. Similarly, recent statistics from the Korean Statistical Information Service revealed the severity of blood shortage in Korea in the aftermath of the COVID-19 pandemic. A continuous decline in blood donors has been observed, from 1.48 million donors in 2018 to 1.42 million in 2019 and further down to 1.28 million and 1.27 million in 2020 and 2021, respectively [2]. According to a survey by the Korean Red Cross during the COVID-19 pandemic, the monthly average stockpile of red blood cell products was insufficient to meet the adequate supply level of a five-day reserve for the entire year of 2020, except in August [3].
We introduced an on-site education program termed the Blood Donation Center Visiting Program within the clerkship program for final-year medical students. The program aimed to promote knowledge about blood donation and transfusion through on-site education and increase awareness regarding the significance of blood donation in medical students and future physicians in an era of insufficient blood supply. We conducted this study to evaluate the educational outcomes and changes in the perception of medical students after the Blood Donation Center Visiting Program over three years based on a survey.
In total, 287 final-year medical students completed the clerkship at Soonchunhyang University Seoul Hospital, Seoul, Korea, between January 2021 and July 2023. All students participated in the Blood Donation Center Visiting Program during their clerkship.
The program was conducted once a week by the hematology and oncology clerkship. Each group consisted of 4–5 students. On the morning of the visit, the students received an orientation to the program from their supervisor. Subsequently, the students visited the blood donation center and received a brief practical education on blood donation from the center’s staff. Students could participate in blood donation according to their wishes and availability. After the visit, students engaged in discussions with the responsible professor on the same day, reflecting on their experiences and reviewing their understanding of blood donation and transfusion.
This program was conducted in collaboration with the Gangnam Center of the Korean Red Cross, which is the nearest blood donation center to Soonchunhyang University Seoul Hospital (Fig. 1).
After completing the program, an online survey was distributed to 287 eligible participants by sending URL links via mobile phone messages during one week in August 2023. The survey questionnaire comprised 24 questions, with the first eight focusing on demographic and personal information. The subsequent sections included blood donation experiences and perceptions, and subjective feedback on the program (Supplemental Data Fig. S1).
Data were collected and analyzed using Microsoft Excel. This study was approved by the Institutional Review Board (approval No 2023-08-010-001).
Of the 287 students, 203 (N=38 in 2021, 65 in 2022, and 100 in 2023) participated in the survey. Supplemental Data Table S1 presents their demographic characteristics. Ninety students (44.3%) had no prior experience with blood donation.
The reasons for not having donated blood prior to participating in the Blood Donation Center Visiting Program (Supplemental Data Table S2) were, in order, “lack of interest” (N=37, 41.1%), “ineligible for blood donation” (N=37, 41.1%), “lack of time/opportunity” (N=31, 34.4%), “phobia of needles or blood” (N=9, 10.0%) and “fear of potential side effects” (N=7, 7.8%). Supplemental Data Table S3 presents the reasons for participants having donated blood before participating in the program. The most common reason was “being aware of the importance of donating blood” (N=51, 45.1%), followed by “having donated as a group (e.g., school, military)” (N=40, 35.4%).
Of the 203 students, 126 (62.1%) donated blood during their visit to the blood donation center. Of these, 48 students (23.6%) donated blood for the first time through the program. The main reasons for blood donation deferral during the visit were as follows: “current medication”, which accounted for the highest proportion, followed by “other inadequate eligibility criteria”, “COVID-19-related issues”, “low body weight”, “having visited a restricted area for blood donation”, “underlying disease”, “not feeling well”, “alcohol intake in the last 24 hrs”, “phobia of needles or blood”, and “fear of potential side effects” (Table 1).
The self-reported “average knowledge level” and “perception of the importance” of blood donation were rated as 5.80 and 7.86, respectively (on a scale of 1–10). Among the program participants, 180 students (88.7%) reported that their knowledge had deepened after participation, and 171 (84.2%) stated that they understood the importance of blood donation after participating in the program. After the program, 64 students (31.5%) chose to participate in repeated blood donation. Among them, 33 (16%) donated once, 13 (6%) donated twice, 10 (5%) donated thrice, and eight (4%) generously donated on more than four occasions. Of the 64 repeat donors, 14 had never donated blood before the program, reportedly for the following reasons: “lack of interest” (N=11), “ineligible for blood donation” (N=1), and “lack of time/opportunity” (N=1) (Table 2).
Most students believed that the program’s greatest strength was providing them with “an opportunity to donate blood” (N=129, 63.5%) (Supplemental Data Table S4).
Our study demonstrated that field experience at a blood donation center improved students’ awareness about blood donation. A “lack of interest” was the predominant reason for not donating blood before participating in the program. Participation in this program considerably improved students’ perception of blood donation, with the willingness to donate increasing from 71.4% to 90.1%. Of the 64 students who were repeat donors after the program, 14 had never donated blood before the program. Although this was a temporary project conducted by a single medical school department, the program had positive outcomes in terms of raising the perception of blood donation among medical students and contributing to the supply of healthy, young blood donors. Therefore, introducing such programs into formal medical school curricula may be worthwhile. This study was the first to evaluate an educational program on blood donation among medical students in Korea.
Studies with similar concepts regarding blood donation education have been conducted in other countries [4, 5]. In a study in North India assessing willingness among medical students to donate blood before and after an interactive awareness session on voluntary blood donation using a PowerPoint presentation, the overall willingness for blood donation increased from 91% to 97.5% [5]. However, the education in these studies was limited to theoretical training on blood donation and transfusion, integrated as a component of internal medicine and pediatrics. Although a direct comparison is difficult, our program appears to be more effective because we combined on-site education with field trips to a blood donation center. Such educational programs may bridge the gap between textbook knowledge and clinical practice.
This study had certain limitations inherent to the use of an online survey. First, the distribution of participants over the years was not uniform. Second, online surveys may raise concerns regarding the reliability of the responses compared with other survey methods. Third, participants in 2021 and 2022 had longer follow-up periods than those in 2023, which may have resulted in a bias in repeat donors. Further, earlier participants may have been more susceptible to recall bias. These potential biases may have affected the data.
In summary, we conducted an on-site educational Blood Donation Center Visiting Program, which differed from traditional theoretical training, and it appeared to generate positive changes in students’ perceptions and enhanced their knowledge of blood donation. Further studies are warranted to determine whether incorporating such blood donation education programs into the medical curriculum is worthwhile.
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