ASN survey: Nephrology fellows report successful training during COVID-19 pandemic
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Most current nephrology fellows and 2020 graduates reported their education continued successfully during the COVID-19 pandemic and led to adequate preparation for practice, according to national survey findings.
In addition, the survey showed most of the 425 respondents maintained a positive sense of well-being, with low rates of reported distress.
“Since 2014, the [American Society of Nephrology] ASN has conducted an annual survey of current nephrology fellows to capture the demographics of the incoming workforce, fellows’ perceptions of their training and the specialty, and leading indicators of the status of the local and national nephrology job market,” Kurtis A. Pivert, MS, data science officer for the ASN Alliance for Kidney Health, and colleagues wrote. “Although the 2020 survey (to be distributed in May) was canceled, as the pandemic accelerated there was a need for information on how the pandemic was affecting fellows-in-training. A customized survey — that included select questions from the annual instrument for longitudinal data collection — was distributed in August 2020 to measure COVID-19’s effect on fellows’ education, professional development, career trajectory and personal life.”
When looking at education delivery during the pandemic, results indicated a “massive shift,” according to the researchers, with half of respondents never or rarely having utilized remote learning prior to COVID-19 compared with the 76% who now reported that conferences were held exclusively online.
Significant changes were also seen regarding patient care protocols, with telehealth implemented for most of both inpatient and outpatient consults (approximately 50% reported “some” or “all” consults were done remotely for inpatients, while approximately 90% reported this change for outpatients).
Regarding COVID-19 consultations specifically, 64% of fellows reported no in-person visits; these patients were either managed entirely with telehealth or seen in-person by attending faculty only.
Researchers noted fellows reported other novel methods of patient care (“beyond telehealth”), including iPad rounding, team collaboration via an online networking service and observing patients behind glass or using ICU video feeds.
“Despite the many pandemic-influenced modifications in educational modalities and patient care approaches that trainees experienced, most indicated the changes had minimal effects on their professional development,” Pivert and colleagues wrote.
Findings here showed 84% of fellows and 82% of graduates perceived their training programs “successfully sustained their education during the pandemic,” with most feeling prepared for unsupervised practice (86% and 90%, respectively).
Responses also indicated that although the pandemic had an impact on participants’ overall well-being (42% reported the pandemic negatively affected quality of life and 33% reported a poorer work-life balance), only 15% experienced distress based on the resident well-being index. Among those most likely to experience distress were respondents who “perceived the pandemic had impaired their knowledge base” (odds ratio = 3.04), or who perceived negative impacts on quality of life (OR = 3.47) and work-life balance (OR = 3.16).
“Although 34% of respondents indicated their sense of community within their fellowship had improved since the pandemic began, and has brought forth a sense of unity among fellows, attendings, and allied professionals, strategies to bolster this esprit de corps should be implemented,” Pivert and colleagues concluded. “Programs must continue to balance the needs for safety, service and education, which will allow fellows to develop a foundation of clinical competency, institutions to fulfill their clinical missions, and the field of nephrology to advance through the scholarly and service work of fellows.”
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