In the NEWS: NephSim as an educational tool

Nephrology education related published work is sparse. NephSim, a mobile optimized website tool with cases and interactive approach was developed in 2018. Over 24 cases have been presented and discussed in this tool. Case contents have been amazing. But what the creators of this tool now did is- validate it with a peer reviewed publication. Recently published in JGME, a med ed journal, Farouk et al showcase the NephSim tool and discuss the results of their outreach of this tool and a survey that showed high rate of satisfaction and usability.

Innovation in Nephrology education is extremely important. Case discussions leading to differential diagnosis and then pathology and diagnosis helps in creating and making a Nephrologist a better diagnostician. The NephSim project also showcases the use of website, social media platforms such as twitter and other ways to share information.

This tool can easily be replicated in other fields in internal medicine or medicine. The ease of using and doing the cases makes it very accessible and able to be transformed in all fields in medicine. The drawbacks- survey response was low but enough to make major conclusions. But like most med-ed studies, it touches the first tier of outcomes- medical knowledge (self-assessed) and not addressing other ways of medical knowledge. We hope to see using some of these tools used( perhaps in combo)- such as NephSim, Nephmadness, Whatsapp, blogs, NephJC. Etc—to change practice patterns, behaviors and ultimately effect patient outcomes.

An inspiring story of a medical student interested in Nephrology

A recent study in CJASN 2014 aimed to determine the association of body mass index (BMI) with access to kidney transplantation in men and women.  While the study highlighted some very important points, we should notice that the second author on the manuscript is a medical student. Her name is Elizabeth Hendren from University of British Columbia, MD Candidate, Class of 2015

           

ASN offers amedical student grant every year to few students that are interested in renalrelated projects. She was a recipient in 2013.

I had the opportunity to ask her a few questions.

“What was your role in the project that has the current manuscript in CJASN?

Elizabeth: “For this study I performed the background literature review, helped the statisticians with the data analysis and then presented the data at the American Transplant Congress in 2013 - providing feedback from that session into the final abstract.”

How did the ASN grant help you with this study and in general regarding research opportunities?

Elizabeth: “The ASN grant actually helped with two summer's worth of research.  I worked with  Howard Yan who was a 2012 recipient on a biopsy project and he was the one who let me know about the grant. I then applied in 2013 to work on an exciting survey idea for living donors and their willingness to enter the paired exchange.  I actually was a clinical trials coordinator for the same research group before medical school, but this project funding was my first foray into planning my own research project from the start.”

Are you interested in pursuing a career in Nephrology?

Elizabeth: “At this point I am planning on Internal medicine, and probably Nephrology.  I'm trying to keep my options open within Internal Medicine at this point. Nephrology excites me in particular because of the amazing mentorship.  In particular, I remember meeting Dr. Segev and Dr. Ratner at ATC 2013.  I had read countless papers by these two authors and to have them talk to me and talk about their research was so inspiring! I felt like I was talking to celebrities.

Locally, I've also had great mentorship through Drs. John and Jag Gill but also through allof our staff nephrologists and many of the residents.  I am so happy to go to our research office at the end of a long day and know I will always leave with more knowledge than when I entered.  Luckily, I also love the physiology, the biochemistry and immunology that build the fundamentals of Nephrology.”

Thanks Elizabeth for being so passionate about what you do and continue on this passion in whatever career path you take.

Kidney SMART: For medical students

ASN initiative to spark research interest in nephrology for medical students.  After completing one year course in medical school, students can attend a one week renal physiology course with great sessions.
And then they get to attend the ASN kidney week during their later part of medical school.
It mirrors from the fellows course at Mount Desert Island Biologic Labs.
Check out the official website at Kidney SMART

Want to be an attending physician on the ward - or not??

Can Nephrologists be medicine attendings or co-attendings on ward months for residents?

One of the reasons that residents don't get a good flavor of nephrology is because nephrologists have started to back off on serving as medicine attendings at many places and are only focused on subspecialty care consultation services.  Although, studies have shown that replacement of specialists with general-hospitalists in the last 15 years on the wards has had a positive impact on trainees medical education. A recent editorial by Wachter and Verghese in JAMA suggests that specialty attendings might not be ideal in the current health care settings to serve as medicine ward attendings. But they do emphasize that their presence is important. Hence, their exposure to residents can be via conferences or even " short bursts of co-attending."

What does co- attending mean? Do you manage the patient together? What is the second attending's role? Certain academic centers to have two attendings that round with the teams. Perhaps that might work. This might be one of the reasons why many residents don't get exposed to nephrology related education or other specialty related education. A ward "work" attending along with a subspecialty " teaching attending" might be another approach that might work as well.

I wonder how many practicing academic nephrologist do inpatient medicine ward months in 2012?
Would love to hear from many that do and what their experience is compared to 1980s or 1990s?

Check out the full viewpoint in JAMA Sept 2012 issue. 
Check out the podcast that goes along with this topic as well on the main JAMA website

Proteinuria: From a Medical Student's view

Using Concept Maps and trying to understand what the medical student already knew and then after reading and doing a renal elective, improved on her "concepts".

Proteinuria, A medical student prespective

View more presentations from Nephrology, NSLIJ