Engagement in Free Open Access Medical Education by US Nephrology Fellows

Current State and Future Direction of Vascular Access Training in the United States

Key Points

Hands-on training is crucial for vascular access training. A multidisciplinary approach to vascular access training is paramount. Creation of a multifaceted vascular access curriculum is needed in all training programs.

Background

This study seeks to provide insights into the current state of vascular access education in adult nephrology fellowship programs in the United States and to identify areas for improvement.

Methods

A total of 63 adult nephrology programs and 71 second-year adult nephrology fellows were randomly selected for participation in a roundtable. Virtual roundtable discussions preceded by a survey were conducted to gather information on the delivery of vascular access education. Descriptive statistics were used for analysis.

Results

Among the respondents invited to the roundtable discussions, 42 individuals (30 faculty and 12 fellows) completed the survey, while 21 individuals (13 faculty and eight fellows) also participated in the roundtable discussion. Of these respondents, most (67%) didactic lectures on vascular access in fellowship programs were delivered by general nephrologists, with 57% provided by interventional nephrologists, 36% by surgeons, and 17% by interventional radiologists (respondents were able to select multiple disciplines). The respondents reported limited exposure to proceduralists, including interventional nephrologists and vascular access surgeons during fellowship training. Faculty and fellows were less comfortable with physical examination skills related to vascular access, particularly in using point-of-care ultrasound and interpreting vascular imaging as compared with naming and identification of vascular access. Both groups emphasized the importance of hands-on modalities in vascular access education.

Conclusion

Roundtable discussions highlighted the need for enhanced hands-on training, multidisciplinary collaboration, and standardized curricula in vascular access education. Recommendations were formulated in alignment with the three levels of competency outlined by the American Society of Nephrology Task Force on the Future of Nephrology, aiming to address gaps and improve the quality of vascular access education in nephrology fellowship programs. This study underscores the importance and need for a comprehensive vascular access education in nephrology fellowship training. By implementing the identified recommendations, programs can better prepare fellows to manage vascular access-related challenges in clinical practice.

Perceived impact of physiotherapy-related debates on the social platform "X" on physiotherapists' professional development and knowledge acquisition: a cross-sectional study

BACKGROUND

In Saudi Arabia, the social media platform "X" (formerly known as "Twitter") is widely utilized by healthcare professionals. This study aimed to assess the perceived impact of physiotherapy-related debates on X on the professional development and knowledge acquisition of physiotherapists.

METHODS

A cross-sectional, online survey-based study was conducted among licensed physiotherapists in Saudi Arabia. The study followed established international reporting guidelines, including the Strengthening the Reporting of Observational Studies in Epidemiology, Checklist for Reporting Results of Internet E-Surveys, and Checklist for Reporting Results of Internet E-Surveys.

RESULTS

A total of 188 physiotherapists participated, with the majority (n = 143;76.1%) actively using X. Many participants indicated positive impacts on their perspectives or approaches to physiotherapy, enhancement of their critical thinking skills, and acquisition of new knowledge or insights (n = 73; 51.0% agreed, n = 26; 18.2% strongly agreed). Furthermore, participants reported gaining knowledge of research findings (n = 45; 31.5% agreed, n = 44; 30.8% strongly agreed) and new treatment techniques (n = 48; 33.6% agreed, n = 42; 29.4% strongly agreed). Additionally, 30.1% (n = 43) agreed and 6.3% (n = 9) strongly agreed that these debates influenced their professional development, whereas 46.2% (n = 66) remained neutral.

CONCLUSIONS

Physiotherapy-related debates on the social media platform X positively impacted physiotherapists' perspectives by enhancing critical thinking and knowledge acquisition. Such online debates may serve as valuable tools for professional development in physiotherapy practice.

Renal Physiology Education via Podcast: Channel Your Enthusiasm

Renal physiology is considered one of the most challenging medical disciplines to understand and to teach. Eight academic nephrologists have come together to produce a podcast devoted to helping learners at any level improve their understanding of this difficult topic. Using Dr Burton D. Rose's classic textbook: Clinical Physiology of Acid-Base and Electrolyte Disorders, the podcast faculty systematically attack each chapter of the book in a didactic yet fun-flowing interactive discussion. This education model is unique and helps demystify complex topics.

Embracing the (r)evolution of social media and digital scholarship in pediatric nephrology education

Free Open-Access Medical Education (FOAMed) has transformed medical education in the past decade by complementing and substituting for traditional medical education when needed. The attractiveness of FOAMed resources is due to their inexpensive nature, wide availability, and user ability to access on demand across a variety of devices, making it easy to create, share, and participate. The subject of nephrology is complex, fascinating, and challenging. Traditional didactic lectures can be passive and ineffective in uncovering these difficult concepts and may need frequent revisions. Active teaching methods like flipped classrooms have shown some benefits, and these benefits can only be multifold with current social media tools. Social media will inspire the involvement of students and allow them to create and share educational content in a "trendy way," encouraging the participation of their peers and thus building an educational environment more conducive to them while promoting revision and retainment. FOAMed also promotes asynchronous learning, spaced learning, microlearning, and multimodal presentation with a meaningful variation. This article discusses the evolution of digital education, social media platforms, tools for creating and developing FOAMed resources, and digital scholarship.

Trainee Love and Breakup Letters to NephSIM: A Free, Mobile-Optimized, Nephrology Teaching Tool

BACKGROUND

It is not known how learners feel about free open access medical education (FOAMed) as they progress through their training from medical school to fellowship. Love and breakup letter methodology (LBM) is a technique that has been used extensively in user experience technology-based research but has not previously been used in evaluating medical education tools. LBM asks participants to creatively write a "love" or "breakup" letter to a product under study to capture their thoughts and emotions when engaging with it. We conducted qualitative analysis of data from focus groups to explore how attitudes toward a learning platform change at various training stages and to broaden our understanding of how we meet learners' needs through a nephrology FOAMed tool, NephSIM.

METHODS

Three virtual, recorded focus groups were conducted with second-year medical students, internal medicine residents, and nephrology fellows ( N =18). At the start of the focus group, participants composed and read their love and breakup letters. Semistructured discussions were then led by facilitator-driven questions and peer comments. After transcription, inductive data analysis was conducted using Braun and Clarke's six-step thematic analysis.

RESULTS

Four main themes were seen across all groups: attitudes toward teaching tool, perception of nephrology, learning needs and approach, and application to practice. Preclinical students positively viewed the opportunity to simulate the clinical setting and unanimously wrote love letters. Reactions from residents and fellows were mixed. Residents were interested in brevity and speed of learning, preferring algorithms and succinct approaches to meet their practice-based learning needs. Fellows' learning needs were driven by a desire to prepare for the nephrology board examination and review cases uncommonly seen in practice.

CONCLUSIONS

LBM provided a valuable methodology through which to identify trainee reactions to a FOAMed tool and highlighted the challenges of meeting learning needs of a continuum of trainees with a single learning platform.