Survey: Fellowship programs remain unable to provide adequate home dialysis training
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Key takeaways:
- Most respondents recommend fellows attend 10 to 12 home dialysis clinic sessions before providing treatment without supervision.
- Most surveyed program directors requested a virtual mentorship program.
Most nephrology program directors and division chiefs surveyed said their fellowship programs were unable to provide adequate home dialysis training to fellows, according to data published in Kidney Medicine.
Further, most respondents reported fellows require at least 10 to 12 dialysis clinic sessions before being ready to provide care to patients without supervision.
Yuvaram N.V. Reddy, MBBS, MPH, and colleagues surveyed 43 program directors and 31 division chiefs of nephrology fellowship programs to determine the current state of fellowship training in home dialysis, the minimum home dialysis training fellows should receive and what resources the American Society of Nephrology could create to support the training. Respondents were derived from the ASN database.
Two surveys were developed, both of which asked respondents to describe the amount of home dialysis training fellows should receive and if fellows could practice home dialysis independently after graduation. Then, program directors were asked to explain the training they use and training resources they would like to be created. Division chiefs were asked to rank the value of training resources on a scale of one to five, with five being the most important. Researchers delivered surveys through REDCap from March 4, 2022, to April 5, 2022.
Overall, 30% of program directors reported that every fellow in their program could provide home dialysis without supervision upon graduation. While program directors and division chiefs did not share a consensus on the ideal amount of home dialysis training, analyses revealed that the attendance of 10 to 12 home hemodialysis clinic sessions would meet the expectations of 82% and 78% of those surveyed, respectively.
Moreover, 74% of program directors responded with a need for a virtual home dialysis mentorship program.
“Although this study sought to establish a minimum quantity of home dialysis training for fellows, quantity alone does not ensure competency,” Reddy and colleagues wrote. “Future research should evaluate whether raising the minimum amount of training to clinic sessions improves attainment of core competencies in home dialysis, such as the management of fungal peritonitis and catheter dysfunction. Other survey limitations include the low response rates, though these response rates are higher than recently published ASN surveys.”
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