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Abstract: PO1370

Assessing Nephrology Competency in General Pediatrics

Session Information

Category: Educational Research

  • 800 Educational Research

Authors

  • Kirpalani, Amrit, Hospital for Sick Children, Toronto, Ontario, Canada
  • Jawa, Natasha, Hospital for Sick Children, Toronto, Ontario, Canada
  • Prasad, Charushree, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
  • Atkinson, Adelle R., Hospital for Sick Children, Toronto, Ontario, Canada
  • Feldman, Mark E., Hospital for Sick Children, Toronto, Ontario, Canada
  • Jeffers, Justin M., Johns Hopkins University, Baltimore, Maryland, United States
  • Noone, Damien Gerard, Hospital for Sick Children, Toronto, Ontario, Canada
Background

General pediatricians may be the first-line providers to care for children with kidney disease, however studies suggest they find nephrology to be a difficult subject. This study aimed to identify areas of lowest perceived competency and importance within nephrology for general pediatricians.

Methods

A web-based survey was distributed to general pediatricians through the Paediatricians of Ontario network, to all Pediatrics Residency Program Directors in Canada and to Pediatric Nephrologists in the Canadian Association of Paediatric Nephrologists.

Pediatricians were asked to rate nephrology objectives of training on a 5-point Likert scale for perceived competence and importance. Program Directors and Nephrologists were asked for perceived importance of each objective for general pediatricians. Scores were analyzed using Student’s t-test and mean scores were calculated. Knowledge Gap scores were calculated as the difference between perceived importance and competence scores.

Results

General Paediatricians. 60/350 (17%) responded to the survey. Domains scoring significantly below the mean in terms of competency (2.9/5) and importance (3.2/5), respectively, were kidney stones (2.5 and 2.6), AKI (2.5 and 2.4), CKD (1.9 and 2.1), Tubular disorders (1.8 and 2.0), and kidney transplant (1.6 and 1.7). Hypertension had the most significant knowledge gap score (0.8/5, 16%, p<0.05).

Program Directors. 9/17 (53%) responded to the survey.
Nephrologists. 20/80 (25%) responded to the survey

Program Directors and Nephrologists agreed that Stones, CKD, Tubular disorders, and Transplant were of lower importance. AKI was the domain with the largest discrepancy in perceived importance rated between nephrologists (4.2) and Program Directors (4.2) compared to general pediatricians (2.4) (1.8/5, 36%, p<0.05).

Conclusion

General pediatricians do not feel comfortable with AKI and do not find this topic important to their practice, contrary to Program Directors’ and Nephrologists’ opinions, and despite growing evidence in recent years of the under-recognition, poor follow-up, and significant long-term implications of AKI.

Hypertension is the area with the largest knowledge gap, which also raises concerns due to its rising prevalence in pediatrics.

Educational interventions are needed to address deficits in these crucial domains of renal health in general pediatrics.