Abstract: SA-PO030
Nephrology Fellow Performance on a Formative Peritoneal Dialysis Objective Structured Clinical Examination
Session Information
- Educational Research
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Educational Research
- 800 Educational Research
Authors
- Yuan, Christina M., Walter Reed National Military Medical Center, Laurel, Maryland, United States
- Y'Barbo, Brian C., Brooke Army Medical Center, San Antonio, Texas, United States
- Braden, Gregory Lee, Kidney Care and Transplant Services of New England, Springfield, Massachusetts, United States
- Ching, Alice, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
- Cohen, Scott D., George Washington University School of Medicine, Washington, District of Columbia, United States
- Elfering, Sarah L., University of Minnesota School of Medicine, Minneapolis, Minnesota, United States
- Lit, Yiming, Stanford University/PAVA, Palo Alto, California, United States
- Malhotra, Varun, Nephrology Associates of Tidewater, LTD, Virginia Beach, Virginia, United States
- Maynard, Sharon E., Lehigh Valley Health Network, Emmaus, Pennsylvania, United States
- Raghavan, Rajeev, Baylor College of Medicine, Houston, Texas, United States
- Watson, Maura A., Walter Reed National Military Medical Center, Laurel, Maryland, United States
- Prince, Lisa K., Colorado Kidney Care, Denver, Colorado, United States
Group or Team Name
- Nephrology Education Research and Development Consortium (NERDC)
Background
Less than 10% of prevalent ESRD patients are treated with peritoneal dialysis (PD), and nephrology fellows may not have sufficient PD exposure to be comfortable with the procedure. We previously developed and initially validated a formative objective structured clinical examination (OSCE) assessing management of PD-associated peritonitis (based on the International Society for Peritoneal Dialysis practice guideline). We now report the preliminary results of fellow testing.
Methods
The OSCE test committee set the passing threshold at 16/22 points (Ebel’s method), with median relevance essential/important for all questions (content validity index 91%). Validators (16 board-certified practicing nephrologists) had a mean score of 19 (SD 2) points, with 94% passing. Cronbach’s alpha was 0.70. Score agreement between investigators was very good (Kappa =0.85). The OSCE is being prospectively administered by 19 U.S. nephrology fellowship programs. Fellows are anonymous, and have 1 hour to take the test (using local institutional order sets at the program director’s discretion).
Results
9 programs have submitted OSCE results. 48 fellows were tested (25 1styear and 23 2ndyear). Mean time to take the test was 34 (SD 8) minutes. Mean score was 17 (SD 3), with 71% passing. 19% correctly indicated the 3 diagnostic criteria for peritonitis (vs. 44% of validators); 72% recognized peritonitis-associated ultrafiltration failure (vs. 100% of validators); and 22% correctly prescribed a 21 day course of antibiotics for gram negative peritonitis (vs. 63% of validators). Some programs used the OSCE to introduced a didactic session on PD-associated peritonitis management.
Conclusion
The OSCE is an opportunity for program directors to assess local curriculum effectiveness, and for fellows to ascertain their familiarity with PD-associated peritonitis management practice guidelines.
The views expressed in this abstract are those of the authors and do not reflect the official policy of the Department of Army/Navy/Air Force, Department of Defense, or the US Government.