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Kidney Week

Abstract: FR-PO010

Nephrology Program Director and Fellow Home Hemodialysis (HHD) Curriculum Survey

Session Information

Category: Educational Research

  • 1000 Educational Research

Authors

  • Gupta, Nupur, Indiana University School of Medicine, Indianapolis, Indiana, United States
  • Howard, Andrew J., Walter Reed National Military Medical Center, Bethesda, Maryland, United States
  • Yuan, Christina M., Walter Reed National Military Medical Center, Bethesda, Maryland, United States
Background

Home hemodialysis (HHD) patients are a minority of those receiving chronic dialysis, and unevenly distributed geographically. Nephrology fellows may not encounter many (if any) HHD patients. The Accreditation Council for Graduate Medical Education (ACGME) requires fellows receive enough HHD training to achieve competence. We performed a survey of US Nephrology program directors and their fellows regarding their HHD curriculum.

Methods

Anonymous on-line survey (12/4/2023-2/4/2024) of 150 US nephrology program directors, who were asked to forward a survey link to their fellows, and indicate the number of fellows to whom they forwarded the link.

Results

55 program directors responded (37%), 80% completed the survey. 37 forwarded the survey to their fellows (25% of US programs). Respondent program directors and fellows were from programs of similar size and geographic distribution to those nationally. 93% (42/45) of programs had an HHD curriculum or were developing one. 86% (37/43) reported that fellows attend a longitudinal HHD clinic either routinely or during a block rotation. The predominant barrier to incorporating HHD into the curriculum was lack of HHD patients in the area (50%).
237 fellows were forwarded the survey link; 53 (22%) responded and 50/53 completed the survey (94%). 80% (40/50) reported receiving HHD training and of those 24/50 (48%) had followed HHD outpatients. Those who saw HHD outpatients (n=24) were more likely than those who did not (n=26) to be confident in managing specific HHD tasks, and perceived a significantly greater degree of preparation to care for HHD patients after graduation (p=0.0003. Fisher exact test).

Conclusion

The majority of nephrology programs have or are developing an HHD curriculum, but the greatest barrier was lack of HHD patients available to the program. Fellows who had experience following HHD outpatients were significantly more likely to be feel prepared and confident in their ability to care for HHD patients.

Disclaimer: The views expressed are those of the authors and do not necessarily reflect the official policy of the Department of Defense or the U.S. government.