Abstract: SA-PO0985
A Formalized Urine Microscopy Curriculum for Nephrology Trainees
Session Information
- Educational Research
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Educational Research
- 1000 Educational Research
Authors
- Lee, Jacqueline, Stanford Medicine, Stanford, California, United States
- Naing, Aung, Stanford Medicine, Stanford, California, United States
- Mohty, Ralph, The University of Arizona College of Medicine Phoenix, Phoenix, Arizona, United States
- Fatehi, Pedram, Stanford Medicine, Stanford, California, United States
- Lit, Yiming, Stanford Medicine, Stanford, California, United States
- Bahrainwala, Jehan Z., Stanford Medicine, Stanford, California, United States
Background
Urine microscopy is a foundational diagnostic tool in nephrology; however, there is no standardized training requirement in nephrology fellowship programs. This lack of formalization may contribute to variability in graduating fellow competence. We developed and implemented a structured urine microscopy curriculum to address this educational gap.
Methods
The curriculum is designed for first year fellows to complete in the first six months of fellowship, consisting of three asynchronous modules supplemented by supervised hands-on microscopy. Content includes: (1) specimen collection, preparation, and microscopy technique; (2) identification of cells and casts; and (3) recognition of other findings (e.g. crystals). Modules were developed from a combination of authoritative written source in collaboration with faculty leads, and delivered as voiced-over videos. Analysis using descriptive statistics were done on pre- and post-curriculum surveys using Likert scales assessing self-reported familiarity and diagnostic confidence.
Results
Thirteen participants completed the pre-intervention survey (6 fellows, 5 advanced practice providers, 1 resident, 1 other). Most participants (77%, n=10) reported no prior formal urine microscopy training. Despite this, 85% rated urine microscopy as somewhat or extremely important to practice.
Post-intervention data collection is ongoing, and current results represent a preliminary analysis (post-survey n=4 fellows). Following curriculum implementation, familiarity improved from 38.5% reporting being familiar or very familiar in the pre-survey to 75% reporting being familiar in the post-survey. Self-reported diagnostic confidence also improved across key domains. The proportion of trainees reporting being "somewhat likely" or "very likely" to identify cells (e.g. RBCs, WBCs, urothelial cells, etc) increased from 62% to 100%, casts from 62% to 100%, and crystals from 39% to 75%.
Conclusion
A substantial proportion of trainees lack formal training in urine microscopy despite recognizing its clinical importance. Implementation of a structured curriculum is feasible and associated with improved self-reported familiarity and diagnostic confidence. These findings support broader integration of standardized urine microscopy training within nephrology education.