Abstract: FR-PO003
A Qualitative Study of Trainee Experiences with Home Dialysis Education in US Nephrology Fellowship Programs
Session Information
- Classroom to Bedside: Transforming Medical Education
October 25, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Educational Research
- 1000 Educational Research
Authors
- Ye, Wen Qing Wendy, University of Toronto Temerty Faculty of Medicine, Toronto, Ontario, Canada
- Saxena, Anjali B., Stanford University School of Medicine, Stanford, California, United States
- Leigh, Kerry, American Society of Nephrology, Washington, District of Columbia, United States
- Reddy, Yuvaram N.V., University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States
Background
Home dialysis has clinical benefits over in-center hemodialysis (HD) yet its use remains low. One barrier is a lack of comfort in clinical management among graduating nephrology fellows. Prior surveys suggest that fellows desire more training in home dialysis, yet little is known about the best approach to systematically enhance training. To identify opportunities to enhance in-person trainee experiences, we sought to better understand current home dialysis training experiences in US nephrology fellowship programs.
Methods
Using a qualitative approach, we conducted one-on-one semi structured interviews with nephrology trainees who attended Home Dialysis University (HDU) and the American Society of Nephrology Home Dialysis Virtual Education Program (ASN-HDU). Using a constant comparison approach, we developed and refined a codebook to identify themes describing participant’s interest and exposure to home dialysis during training, and their comfort with managing patients on home dialysis.
Results
10 semi-structured interviews were completed between Dec 2023 – Mar 2024. 5 of 10 participants attended the ASN-HDU program. Participants were from a variety of training programs and locations. We identified 3 main themes: (1) Home dialysis education during training is serendipitous rather than systematically built into existing curriculum. Opportunities to increase exposure to home dialysis exist, but trainees must be internally motivated to seek out these opportunities due to their serendipitous nature. (2) There is limited exposure to outpatient management of PD, resulting in a spectrum of comfort levels, which causes concern as trainees envision transitioning to independent practice. (3) Home HD exposure is sparse leading to an overwhelming lack of comfort.
Conclusion
Home dialysis training during nephrology fellowship remains serendipitous, suggesting the need for systematic efforts. There is limited exposure to outpatient PD and home HD resulting in a lack of comfort. Although the American Board of Internal Medicine requires 8 PD clinics to graduate, trainee experiences suggest that fellowship programs may not be able to meet this requirement. The results of our study should inform curriculum changes, while fellowship programs identify new opportunities to enhance trainee comfort in home dialysis.
Funding
- Other U.S. Government Support