The tube method for blood grouping is a standard procedure in blood group serology that requires both technical proficiency and accurate result interpretation. This study aimed to analyze students’ interpretative ability in tube method blood grouping examinations and to identify factors contributing to interpretation errors. A descriptive quantitative design was employed involving students who had completed blood grouping laboratory practice. Data were collected using a closed-ended questionnaire and analyzed descriptively based on technical, procedural, cognitive/analytical, and sample or reagent-related factors. The results showed that technical factors were the most frequent causes of interpretation errors, particularly difficulties in reading weak agglutination and distinguishing true agglutination from sediment or rouleaux. Procedural and cognitive/analytical factors demonstrated relatively low error rates. Sample and equipment conditions, including the quality of student-prepared red blood cell suspensions and the use of tubes that were not completely dried, also affected the clarity of examination results. It is concluded that students’ interpretative ability is influenced by technical skills, pre-analytical conditions, and the laboratory environment; therefore, instructional strategies should emphasize training in interpreting varied results and strengthening simple quality control measures.
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