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Home hemodialysis education during postdoctoral training: Challenges and innovations
Joel D Glickman1, Rebecca Kurnik Seshasai1
1Renal Electrolyte and Hypertension Division, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Seminars in Dialysis
|January 17, 2018
Summary
Nephrology fellowship training in home hemodialysis (HHD) is often inadequate, leading to underutilization. Enhancing HHD education with experienced faculty and practical training is crucial for developing competent home dialysis nephrologists.
Area of Science:
- Nephrology
- Medical Education
- Renal Replacement Therapy
Background:
- Underutilization of home hemodialysis (HHD) in the US may stem from inadequate fellowship training.
- Many nephrology fellowship graduates do not feel competent in HHD, indicating training gaps.
Purpose of the Study:
- To identify essential components for effective HHD fellowship training.
- To propose improvements for HHD education to increase physician competency and modality utilization.
Main Methods:
- Review of current HHD fellowship training practices.
- Analysis of key educational elements including faculty mentorship, curriculum structure, and practical exposure.
- Emphasis on hands-on experience, including patient transitions and direct interaction with HHD nurses.
Main Results:
- Effective HHD training requires dedicated faculty with HHD expertise.
- A comprehensive curriculum should include lectures, 6-12 months of outpatient exposure, and at least three patient transitions.
- Fellows benefit from learning HHD nursing roles, patient selection criteria, and barrier identification.
Conclusions:
- Current HHD fellowship training requires enhancement to ensure physician competence.
- Structured training with practical experience and faculty mentorship is vital for promoting HHD adoption.
- Improved training can foster academic careers in home dialysis nephrology.
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