Kidney Week

Abstract: SA-PO915

Assessing Teaching Practices in Percutaneous Kidney Biopsy among Pediatric Nephrology Training Programs

Session Information

• Educational Research
  November 04, 2017 | Location: Hall H, Morial Convention Center
  Abstract Time: 10:00 AM - 10:00 AM

Category: Nephrology Education

• 1301 Educational Research

Authors

• Tuchman, Shamir, Children's National Medical Center, Washington, District of Columbia, United States

Shamir Tuchman,

• Mahan, John D., Nationwide Children's Hospital, Columbus, Ohio, United States

John D. Mahan,

Background

Standardized approaches for teaching kidney biopsies in pediatric nephrology fellowship training have not been established. To date, there has not been a comprehensive assessment of kidney biopsy teaching practices among pediatric nephrology training programs. The purpose of this study was to determine common practice patterns for teaching kidney biopsies for pediatric nephrology trainees.

Methods

An online survey was piloted and administered to training program directors (TPD’s) at 40 ACGME accredited pediatric nephrology training programs in the United States.

Results

28 (70%) of TPD’s completed the survey. Trainees performed the majority of all kidney biopsies at 73% of the institutions with the majority (63%) of kidney biopsies performed by 1^st year trainees. A supervising attending nephrologist was uniformly in attendance in the procedure area. Less than 50% of programs used didactic instruction or simulations in teaching obtaining consent and performing kidney biopsies. “Observation” was uniformly employed (100%) as the primary teaching modality for these purposes. All institutions used ultrasound localization for kidney biopsies. In 22% of the institutions, the trainee performing the biopsy was responsible for ultrasound guidance of the biopsy needle. 86% of the programs that have the nephrologist performing simultaneous ultrasound provided formal instruction in ultrasonography to their trainees. There was a broad range in the number of kidney biopsies performed by each trainee through training ranging from 10 to 150 biopsies with 10-80% of these performed in renal allografts. Among TPD’s, the minimum number of kidney biopsies felt to be sufficient to attain competency for independent practice was 10 with the majority (57%) of TPD’s feeling that 20-40 biopsies were necessary for a trainee to achieve competence. 92% of training programs provide teaching in the interpretation of kidney biopsies using a combination of didactic instruction (73%), renal pathology conferences (93%), and formal rotations with pathology within or outside their institutions (63%).

Conclusion

Despite a lack of formalized guidance or national standards, pediatric nephrology training programs employ common practices in teaching pediatric nephrology trainees to competently perform kidney biopsies in children and adolescents.