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Kidney Week

Abstract: TH-PO006

Impact of a Simulation Dialysis Access Ultrasound Tutorial for Nephrology Fellows

Session Information

  • Educational Research
    November 03, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
    Abstract Time: 10:00 AM - 12:00 PM

Category: Educational Research

  • 900 Educational Research


  • Hawkins, Alexander Scott, University of Washington, Seattle, Washington, United States
  • Sanghavi, Sarah F., University of Washington, Seattle, Washington, United States
  • Wong, Ryan, University of Washington, Seattle, Washington, United States

Bedside ultrasound imaging has grown in importance across a variety of specialties, but few Nephrology programs have any formal ultrasound teaching. We developed a tutorial for dialysis access ultrasound assessment using a simulation model, and evaluated the tutorial with a knowledge assessment and a survey on clinical ultrasound use.


We randomly assigned three first year Nephrology fellows to receive a hands-on ultrasound tutorial along with a didactic lecture about dialysis access, with two fellows receiving the didactic only. The tutorial presented several cases with simulation fistulas which could be physically examined with a mock ultrasound probe. Participants were prompted to measure a variety of parameters in evaluating the fistula and calculate blood flow. Cases included outflow stenosis, evaluation of fistula maturity, and pseudoaneurysm. The tutorial was led by a second year fellow. Six months later we sent a knowledge assessment (validated by several Nephrology faculty members), and a survey, which included qualitative measures of each fellow's practical experience with ultrasound, and confidence with vascular access issues.


The survey had a 100% response rate. Fellows who completed the tutorial scored an average of 6 of 7 points on the knowledge assessment, while those who did not scored an average of 3.5/7 points. The tutorial group rated their conceptual exposure to dialysis access ultrasound at 43.3/100 points (100 being highest exposure), compared with 29.5 points in the non-tutorial group. When asked about confidence in speaking with Radiology or Vascular Surgery about dialysis access issues on a 5-point scale, the tutorial group had an average response of 3 (Neutral), versus 2 (Slightly less confident) in the other group. In both groups, clinical use of ultrasound for dialysis access issues was low, with lack of time on rounds and lack of experience with ultrasound being selected as the main barriers.


Our hands-on simluation improved knowledge and confidence in assessing dialysis access issues among first year Nephrology fellows when compared with a didactic lecture alone. Barriers to clinical use of ultrasound for dialysis access issues include lack of time and experience. Though limited by small sample size, these results encourage further study and formal implementation into the curriculum.