Building Diagnostic Schemas Improves Resident Confidence in Managing AKI
- Educational Research
November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Educational Research
- 1000 Educational Research
- Jensen, Colton, University of Vermont, Burlington, Vermont, United States
- Agrawal, Varun, University of Vermont, Burlington, Vermont, United States
The complexity of nephrology has been identified as a major contributing factor as to why fewer resident physicians are pursuing it as a career. Improving resident comfort and knowledge about nephrology topics, particularly acute kidney injury (AKI), is imperative to decreasing resident perception of their difficulty. There is a paucity of data on effective teaching methods for AKI for resident physicians. Therefore, we designed and tested a workshop where interns build an AKI diagnostic schema to see if that improved their comfort with the topic.
The workshop took place during dedicated didactic time for interns at an academic hospital’s internal medicine residency. They received a pre-workshop survey that explored their perceived knowledge of AKI etiology, diagnosis, and management as well as their comfort level with explaining AKIs to patients and medical students. Interns were briefed on how to use diagnostic schemas and together constructed one for AKI (pre-renal, intrinsic, and post-renal causes). They then underwent didactics on pathophysiology, clinical manifestations, diagnostic work up, and management of AKI using this schema. Finally, the group used the schema to map out a general approach for a patient presenting with an AKI and answered practice questions. Finally, they took a post-workshop survey with the same questions as the pre-survey.
12 interns completed the pre-workshop survey and 15 completed the post-workshop survey. In the pre-survey, only 25% of the interns “agreed” or “strongly agreed” they felt comfortable working up and managing a patient with an AKI and only 16% had an organized approach compared to 80% of interns in the post-survey for both responses. 8% and 16% of interns felt comfortable explaining AKIs to patients and medical students, respectively, which improved to 73% and 57% after the workshop.
Internal medicine interns felt more confident diagnosing and managing AKI as well as discussing it with their patients and medical students after building and practicing with a diagnostic schema. Though this study was limited by study size and lack of control group, it serves as a first step in collecting data and exploring effective teaching methods for common nephrology topics, with the crucial goal to increase resident comfort level with kidney disorders and bolster interest in nephrology.