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Treml A, Joshi SA, Stephens LD, Zantek ND, Tanhehco YC, Mason HM, Li Y, Srivaths P, Mattiazzi AD, Schwartz J, Wehrli G. Apheresis medicine education during the early phase of the COVID-19 pandemic. Transfusion 2023; 63:1580-1589. [PMID: 37421258 DOI: 10.1111/trf.17481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 05/10/2023] [Accepted: 05/11/2023] [Indexed: 07/10/2023]
Abstract
BACKGROUND The COVID-19 pandemic introduced challenges and disruption across healthcare, including apheresis medicine (AM). In this study, we report findings from a survey conducted among American Society for Apheresis Physician Committee (ASFA-PC) members to describe the impact of the COVID-19 pandemic on AM education practices. STUDY DESIGN AND METHODS A voluntary, anonymous, 24-question, institutional review board-approved survey regarding AM teaching during the pandemic was distributed to ASFA-PC members in the United States between December 1, 2020, and December 15, 2020. Descriptive analyses were reported as number and frequency of respondents for each question. Free text responses were summarized. RESULTS Responses were received from 14/31 (45%) of ASFA-PC members, of whom 12 practiced at academic institutions. Among these, 11/12 (92%) transitioned to virtual platform for AM trainee conferences during the pandemic. A variety of resources were employed to support independent AM learning. While 7/12 (58%) respondents did not change the informed consent process for AM procedures, others delegated this process or introduced remote alternatives. The most common method respondents used to conduct AM patient rounding was a hybrid in-person/virtual model. CONCLUSION This survey describes the adaptations and changes AM practitioners made to trainee education in response to the early phase of the COVID-19 pandemic. The transition to virtual and/or hybrid trainee learning and AM rounds underscores the importance of digital AM resources. Further study of the effects of the pandemic and its impact on AM trainee education, as well as patient care is warranted.
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Affiliation(s)
- Angela Treml
- Versiti WI, Department of Pathology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | | | - Laura Dilly Stephens
- Department of Pathology, University of California San Diego, La Jolla, California, USA
| | - Nicole D Zantek
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Yvette C Tanhehco
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, New York, USA
| | - Holli M Mason
- Department of Pathology, Harbor-UCLA and Olive View-UCLA Medical Centers, Los Angeles, California, USA
| | - Yanhua Li
- Department of Medicine and Department of Pathology, UMass Chan Medical School, Worcester, Massachusetts, USA
| | - Poyyapakkam Srivaths
- Division of Pediatric Nephrology, Baylor College of Medicine, Houston, Texas, USA
| | - Adela D Mattiazzi
- Division of Nephrology and Hypertension and Miami Transplant Institute, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Joseph Schwartz
- Department of Pathology, Moffitt Cancer Center, Tampa, Florida, USA
| | - Gay Wehrli
- University Hospitals Samaritan Medical Center, Ashland OH and Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
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Abstract
PURPOSE OF REVIEW The purposes of this review are to identify population characteristics of important risk factors for the development and progression of diabetic kidney disease (DKD) in the United States and to discuss barriers and opportunities to improve awareness, management, and outcomes in patients with DKD. RECENT FINDINGS The major risk factors for the development and progression of DKD include hyperglycemia, hypertension, and albuminuria. DKD disproportionately affects minorities and individuals with low educational and socioeconomic status. Barriers to effective management of DKD include the following: (a) limited patient and healthcare provider awareness of DKD, (b) lack of timely referrals of patients to a nephrologist, (c) low patient healthcare literacy, and (d) insufficient access to healthcare and health insurance. Increased patient and physician awareness of DKD has been shown to enhance patient outcomes. Multifactorial and multidisciplinary interventions targeting multiple risk factors and patient/physician education may provide better outcomes in patients with DKD.
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Affiliation(s)
- O Kenrik Duru
- Department of Medicine, Division of General Internal Medicine/Health Services Research, David Geffen School of Medicine at the University of California, Los Angeles, 10940 Wilshire Blvd, Suite 700, Los Angeles, CA, 90024, USA.
| | | | | | - Keith Norris
- Department of Medicine, Division of General Internal Medicine/Health Services Research, David Geffen School of Medicine at the University of California, Los Angeles, 10940 Wilshire Blvd, Suite 700, Los Angeles, CA, 90024, USA
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Maursetter LJ, Stern LD, Sozio SM, Patel AB, Rao R, Shah HH, Leight K, Okusa MD, Zeidel ML, Parker MG. Enhancing Nephrology Career Interest through the ASN Kidney TREKS Program. J Am Soc Nephrol 2016; 27:1604-7. [PMID: 27026364 DOI: 10.1681/asn.2015101086] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
The Kidney Tutored Research and Education for Kidney Students (TREKS) Program is a product of the American Society of Nephrology (ASN) Workforce Committee that seeks to connect medical and graduate students to nephrology. This program starts with a weeklong camp-like course introducing participants to renal physiology through classic and modern experiments. Next, each student is matched with a nephrology mentor at his or her home institution to foster a better understanding of a nephrology career. Lastly, the students are encouraged to participate in scholarly activities and attend the ASN Kidney Week. Now in its third year, with a total of 84 participants, survey data suggest early success of the program, with a self-reported 40% increased interest in nephrology fellowship and/or research careers. In addition, students give high ratings to the course components and mentorship pairings. Continued student tracking will be necessary to determine the long-term program effect.
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Affiliation(s)
- Laura J Maursetter
- Division of Nephrology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin;
| | - Lauren D Stern
- Department of Nephrology, Boston University School of Medicine
| | - Stephen M Sozio
- Division of Nephrology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Ankit B Patel
- Division of Renal Medicine, Brigham and Women's Hospital, and
| | - Reena Rao
- Division of Nephrology and Hypertension, University of Kansas Medical Center, Kansas City, Missouri
| | - Hitesh H Shah
- Division of Nephrology, Hofstra Northwell School of Medicine, Hempstead, New York
| | - Katlyn Leight
- American Society of Nephrology, Workforce and Career Development, Washington, DC
| | - Mark D Okusa
- Division of Nephrology, University of Virginia, Charlottesville, Virginia; and
| | - Mark L Zeidel
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachesetts
| | - Mark G Parker
- Division of Nephrology, Maine Medical Center and Tufts University School of Medicine, Portland, Maine
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Berns JS, Ellison DH, Linas SL, Rosner MH. Training the next generation's nephrology workforce. Clin J Am Soc Nephrol 2014; 9:1639-44. [PMID: 24970877 DOI: 10.2215/cjn.00560114] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The subspecialty of nephrology faces several critical challenges, including declining interest among medical students and internal medicine residents and worrisome declines in the number of applicants for nephrology fellowships. There is an urgent need to more clearly define the subspecialty and its scope of practice, reinvigorate meaningful research training and activities among trainees, and ensure that fellows who complete training and enter the practice of nephrology are experts in the broad scope of nephrology. This need requires a critical look at fellowship training programs and training requirements. A new workforce analysis is also needed that is not focused on primarily meeting estimated future clinical needs but rather, ensuring that there is alignment of supply and demand for nephrology trainees, which will ensure that those entering nephrology fellowships are highly qualified and capable of becoming outstanding nephrologists and that there are desirable employment opportunities for them when they complete their training.
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Affiliation(s)
- Jeffrey S Berns
- Renal, Electrolyte, and Hypertension Division, Perelman School of Medicine at the University of Pennsylvania, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania;
| | - David H Ellison
- Division of Nephrology, Oregon Health and Science University and Portland Veterans Affairs Medical Center, Portland, Oregon
| | - Stuart L Linas
- Division of Nephrology, University of Colorado, Denver Health Medical Center, Denver, Colorado; and
| | - Mitchell H Rosner
- Division of Nephrology, University of Virginia School of Medicine, Charlottesville, Virginia
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Arogundade FA, Sanusi AA, Oguntola SO, Omotoso BA, Abdel-Rahman EM, Akinsola A, Balogun RA. Benefits and challenges of starting a new therapeutic apheresis service in a resource-constrained setting. J Clin Apher 2014; 29:194-8. [DOI: 10.1002/jca.21328] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2014] [Accepted: 05/01/2014] [Indexed: 11/10/2022]
Affiliation(s)
- Fatiu A. Arogundade
- Department of Medicine, Renal Unit; Obafemi Awolowo University Teaching Hospitals Complex; Osun State Nigeria
| | - Abubakr A. Sanusi
- Department of Medicine, Renal Unit; Obafemi Awolowo University Teaching Hospitals Complex; Osun State Nigeria
| | - Stephen O. Oguntola
- Department of Medicine, Renal Unit; Obafemi Awolowo University Teaching Hospitals Complex; Osun State Nigeria
| | - Bolanle A. Omotoso
- Department of Medicine, Renal Unit; Obafemi Awolowo University Teaching Hospitals Complex; Osun State Nigeria
- Division of Nephrology; University of Virginia School of Medicine; Charlottesville Virginia 22908
| | - Emaad M. Abdel-Rahman
- Division of Nephrology; University of Virginia School of Medicine; Charlottesville Virginia 22908
- Department of Medicine, Renal Unit and Extracorporeal Therapies; University of Virginia Medical Center; Charlottesville Virginia 22908
| | - Adewale Akinsola
- Department of Medicine, Renal Unit; Obafemi Awolowo University Teaching Hospitals Complex; Osun State Nigeria
| | - Rasheed A. Balogun
- Division of Nephrology; University of Virginia School of Medicine; Charlottesville Virginia 22908
- Department of Medicine, Renal Unit and Extracorporeal Therapies; University of Virginia Medical Center; Charlottesville Virginia 22908
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William JH, Huang GC. How we make nephrology easier to learn: computer-based modules at the point-of-care. MEDICAL TEACHER 2014; 36:13-18. [PMID: 24164578 DOI: 10.3109/0142159x.2013.847912] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Novel educational tools, such as case-based learning in a web-based module format, are an effective approach to teaching clinical concepts to medical trainees, especially if the situations are clinically relevant and the intervention is delivered at the point-of-care. Though studies have evaluated the effectiveness of point-of-care reference materials, limited literature addresses active web-based interventions designed for completion at the point-of-care. AIMS By taking advantage of existing technological resources and integrating an effective learning modality into the clinical environment, we can increase trainee understanding of high-yield topics in clinical nephrology. METHODS We designed interactive, case-based computer-based modules in Principles of Dialysis, Hyponatremia, and Acid-Base abnormalities, with interwoven multiple-choice and free text questions with immediate feedback, supplemental practice questions, and enrichment material to be completed in the clinical environment. All medicine trainees at an urban, academic institution were invited to participate in a needs assessment, pre and post knowledge tests, and module completion. RESULTS Most trainees believed the modules were "very" or "extremely helpful" in understanding the selected topic and that they would likely change their clinical practice. Those who completed the modules performed better on a post-intervention knowledge assessment. Free-text feedback was overwhelmingly supportive of the modules. CONCLUSION Our findings confirmed that a novel, simplified approach to renal content by making it readily applicable to a clinical context and available at the point-of-care improves trainee understanding of high-yield topics in nephrology.
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Arroyo D, Dominguez P, Panizo N, Quiroga B, Calvo M, Álvarez L, Macias N, Menendez D, Blazquez L, Galan I, Reque J. A Spanish multicentric study to evaluate the clinical activity of nephrology fellows during in-hospital on-call shifts. Clin Kidney J 2013; 6:556-60. [PMID: 26064520 PMCID: PMC4438395 DOI: 10.1093/ckj/sft080] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Accepted: 06/21/2013] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Nephrologists develop their work in diverse scenarios. A training programme must qualify trainees to assist different kinds of problems. The aim of this study was to characterize patients and pathologies that Spanish nephrology fellows face while on-call. METHODS This is a descriptive study with clinical and demographic data gathered with a form by 10 nephrology fellows of five university hospitals of Madrid (Spain), throughout their in-hospital 24 h on-call shifts in February and March 2013. RESULTS We collected 409 episodes over 338 patients, through 72 shifts. Among these, 16.7% had previous normal renal function, 24.6% chronic kidney disease, 39.5% were on dialysis and 18.2% had a kidney transplant. Most of the consults came from the emergency room (35.9%) or the previous on-call team (13.7%). Afterwards, the most usual destiny was admittance to a nephrology department (32.8%) or discharge (20.5%). The most frequent reason for consulting was a decline in renal function (31.6%) and the second motive an infection. Thirty-four episodes (8.3%) were related to dialysis access problems. Medical treatment was prescribed in 79.2% of the cases, primarily fluids (47.2%) and antibiotics (42.2%). The fellow had to place a central venous catheter in 24 cases (5.9%). Renal replacement therapy was prescribed in 19.8% of the episodes. CONCLUSIONS Specific renal reasons for consulting nephrologists are common, such as acute kidney injury or dialysis access complications. These patients benefit from a specialized approach to their problems. Clinical activities during in-hospital out-of-hours shifts are a priceless tool as part of the training programme of nephrology fellows.
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Affiliation(s)
- David Arroyo
- Hospital General Universitario Gregorio Marañón , Madrid , Spain
| | | | - Nayara Panizo
- Hospital General Universitario Gregorio Marañón , Madrid , Spain
| | - Borja Quiroga
- Hospital General Universitario Gregorio Marañón , Madrid , Spain
| | - Marta Calvo
- Hospital Clínico San Carlos , Madrid , Spain
| | | | - Nicolás Macias
- Hospital General Universitario Gregorio Marañón , Madrid , Spain
| | | | - Luis Blazquez
- Hospital Universitario de La Princesa , Madrid , Spain
| | - Isabel Galan
- Hospital General Universitario Gregorio Marañón , Madrid , Spain
| | - Javier Reque
- Hospital General Universitario Gregorio Marañón , Madrid , Spain
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Williams ME. Starting a new therapeutic apheresis service: Medical directorship and other matters. J Clin Apher 2013; 28:11-5. [DOI: 10.1002/jca.21258] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2012] [Accepted: 01/15/2013] [Indexed: 11/10/2022]
Affiliation(s)
- Mark E. Williams
- Renal Division, Beth Israel Deaconess Medical Center; Harvard Medical School; Boston; Massachusetts
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Brown RS. Is Nephrology Fellowship Training on the Right Track? Am J Kidney Dis 2012; 60:343-6. [DOI: 10.1053/j.ajkd.2012.04.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2011] [Accepted: 04/04/2012] [Indexed: 11/11/2022]
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Shah HH, Jhaveri KD, Sparks MA, Mattana J. Career Choice Selection and Satisfaction among US Adult Nephrology Fellows. Clin J Am Soc Nephrol 2012; 7:1513-20. [DOI: 10.2215/cjn.01620212] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Jhaveri KD, Shah HH, Mattana J. Enhancing interest in nephrology careers during medical residency. Am J Kidney Dis 2012; 60:350-3. [PMID: 22658638 DOI: 10.1053/j.ajkd.2012.04.020] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2011] [Accepted: 04/04/2012] [Indexed: 11/11/2022]
Abstract
Promoting interest in nephrology as a career is vital to sustain a workforce adequate to meet the projected demand for nephrologists. The educational experiences that internal medicine residents have may play an important role in influencing such choices, and attempts to enrich such experiences could prove a useful strategy to help facilitate interest in careers in nephrology. Like many electives, nephrology rotations typically consist of activities heavily weighted toward inpatient care. This type of elective is unlikely to provide a representative exposure to the breadth of nephrologists' roles and may lack sufficient mentoring opportunities. We describe an innovative design for a nephrology elective that provides residents with educational experiences in both inpatient and outpatient venues and exposure to faculty with diverse interests and areas of expertise. Our experience with this elective in comparison to a traditional inpatient-based elective suggests that the combined elective format is perceived favorably by medical residents and provides them with a better educational experience, more representative exposure to nephrology, positive mentoring experiences, and the potential for greater interest in pursuing nephrology as a career. Our findings offer the possibility that interventions at the level of medical resident education might be a means to help promote interest in careers in nephrology.
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Affiliation(s)
- Kenar D Jhaveri
- Division of Kidney Diseases and Hypertension, Department of Medicine, North Shore University Hospital and Long Island Jewish Medical Center, Hofstra North Shore-LlJ School of Medicine, Great Neck, NY 11021, USA.
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