Fevziye Burcu ŞİRİN, Giray KOLCU
Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi - 2026;33(3):305-314
Objective: Since the majority of errors in the medical laboratory testing process occur in the pre-analytical phase and unnecessary test ordering adversely affects patient safety and healthcare system costs, this study aimed to assess the knowledge and awareness levels of sixth-year medical students (medical interns) regarding the laboratory pre-analytical phase and rational test ordering, and to contribute to the development of pre-internship training programs based on the findings. Material and Method: This cross-sectional survey study included 167 medical interns from the 2024-2025 (n = 57) and 2025-2026 (n = 110) academic years. Data were collected using an online questionnaire. Descriptive statistics are expressed as frequencies, percentages, and mean +/- standard deviation. Pearson's chi-square test was used to compare categorical variables between cohorts. Total pre-analytical knowledge scores and total rational test ordering scores were calculated by summing the correct responses to the relevant items. Statistical significance was set at p < 0.05. Results: No statistically significant differences were observed between the 2024-2025 and 2025-2026 cohorts across all knowledge domains (Cramer's V: 0.01-0.05). Although nearly all participants reported phlebotomy experience, formal education about pre-analytical processes and rational laboratory use was limited, and awareness of national policies was low. Significant deficiencies were identified for technical pre-analytical topics, including order of draw, diurnal variation, tube handling, and coagulation sample analysis time limits. Knowledge of minimum test repetition intervals was generally insufficient, with higher accuracy for HbA1c and lower accuracy for commonly requested tests such as AST, ALT, TSH, and CRP. Overall knowledge scores indicated low competency, with no differences between cohorts. Conclusion: Practical experience alone does not ensure standardized knowledge. Structured, compulsory, and scenario-based training focused on pre-analytical quality management and evidence-based test repeat intervals should be integrated into internship education to improve patient safety and resource utilization.
