Clinical performance and skill retention after simulation-based education for nephrology fellows.

Area of Science:

• Medical Education
• Nephrology
• Surgical Skills Training

Background:

• Simulation-based education (SBE) effectively enhances temporary hemodialysis catheter (THDC) insertion skills in nephrology fellows.
• Further research is needed to assess skill transfer to clinical practice and long-term skill retention.

Purpose of the Study:

• To evaluate the transfer of THDC insertion skills from a simulated environment to actual patient care.
• To assess the retention of THDC insertion skills in nephrology fellows over a 1-year period after SBE.

Main Methods:

• A prospective observational cohort study involving 12 nephrology fellows from three academic centers.
• Fellows were assessed using a skills checklist immediately after SBE, at 6 months on actual patient THDC insertions, and at 1 year using the simulator.
• A minimum passing score (MPS) was established by an expert panel for simulator-trained fellows.

Main Results:

• Simulator-trained fellows demonstrated comparable performance on actual patient THDC insertions at 6 months post-intervention (86.2%) versus immediate posttest (93.5%).
• A statistically significant decline in simulated THDC insertion skills was observed at 1 year (73.4%) compared to the immediate posttest (93.5%).

Conclusions:

• Nephrology fellows trained with SBE maintain high performance in THDC insertion on actual patients up to 6 months.
• Significant skill decay occurs by 1 year, indicating a need for refresher or booster training interventions at approximately 6-month intervals.