Skip to main content

Advertisement

SpringerLink
Log in

Engaging medical students and residents in nephrology education: an updated scoping review

  • Review
  • Published:
Journal of Nephrology Aims and scope Submit manuscript

Abstract

Background

There is global recognition that interest in nephrology among pediatric and adult trainees is waning, while the burden of kidney disease continues to wax. There is a growing need to engage trainees in nephrology education. The objective of this study was to systematically review the literature on nephrology education for medical students and residents published in the last six years, collate the findings, and extract major themes in order to better define the gaps in this field.

Methods

A systematic literature search was conducted on four major academic search engines including MEDLINE (OvidSP), ERIC, EMBASE and Web of Science until October 22, 2020, retrieving a total of 2,694 studies. Forty studies published after September 2014 met the inclusion and exclusion criteria. These studies were analyzed based on study focus, type of study design, and outcomes.

Results

The studies fell into three main areas of focus: (a) factors that influence interest in nephrology careers (b) current gaps in nephrology knowledge and (c) innovative educational strategies. Barriers to engaging learners in nephrology include a lack of exposure, lack of mentorship, and perceived complexity of nephrology. Baseline awareness is deficient in the management of chronic kidney disease and acute kidney injury. Applying active learning strategies may reduce the perceived barriers to understanding nephrology.

Conclusion

The importance of engaging the future nephrology workforce is well-recognized. Nephrologist educators should focus their efforts in studying curriculum interventions and their impact not only on learner satisfaction, but also future behavior, career choices, and patient outcomes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Sharif MU, Elsayed ME, Stack AG (2016) The global nephrology workforce: emerging threats and potential solutions! Clin Kidney J 9:11–22. https://doi.org/10.1093/ckj/sfv111

    Article  PubMed  Google Scholar 

  2. Weinstein AR, Reidy K, Norwood VF et al (2010) Factors influencing pediatric nephrology trainee entry into the workforce. Clin J Am Soc Nephrol 5:1770–1774. https://doi.org/10.2215/CJN.07071009

    Article  PubMed  PubMed Central  Google Scholar 

  3. Nakhoul GN, Mehdi A, Taliercio JJ et al (2019) Residents’ perception of the nephrology specialty. Kidney Int Rep 5:94–99. https://doi.org/10.1016/j.ekir.2019.08.013

    Article  PubMed  PubMed Central  Google Scholar 

  4. Roberts JK, Sparks MA, Lehrich RW (2016) Medical student attitudes toward kidney physiology and nephrology: a qualitative study. Ren Fail 38:1683–1693. https://doi.org/10.1080/0886022X.2016.1230459

    Article  PubMed  Google Scholar 

  5. Jhaveri KD, Sparks MA, Shah HH et al (2013) Why not nephrology? A survey of US internal medicine subspecialty fellows. Am J Kidney Dis 61:540–546. https://doi.org/10.1053/j.ajkd.2012.10.025

    Article  PubMed  PubMed Central  Google Scholar 

  6. Williams SE (2018) Nephrophobia: teaching renal medicine to the undergraduate student. J Nephrol 31:793–794. https://doi.org/10.1007/s40620-018-0528-9

    Article  PubMed  Google Scholar 

  7. Jozefowicz RF (1994) Neurophobia: the fear of neurology among medical students. Arch Neurol 51:328–329. https://doi.org/10.1001/archneur.1994.00540160018003

    Article  CAS  PubMed  Google Scholar 

  8. Tonelli M, Wiebe N, Manns BJ et al (2018) Comparison of the complexity of patients seen by different medical subspecialists in a universal health care system. JAMA Netw open 1:e184852. https://doi.org/10.1001/jamanetworkopen.2018.4852

    Article  PubMed  PubMed Central  Google Scholar 

  9. Kalloo SD, Mathew RO, Asif A (2016) Is nephrology specialty at risk? Kidney Int 90:31–33. https://doi.org/10.1016/j.kint.2016.01.032

    Article  PubMed  Google Scholar 

  10. Rangaswami J, Mathew RO, McCullough PA (2018) Resuscitation for the specialty of nephrology: is cardionephrology the answer? Kidney Int 93:25–26. https://doi.org/10.1016/j.kint.2017.10.002

    Article  PubMed  Google Scholar 

  11. Maursetter LJ, Stern LD, Sozio SM et al (2016) Enhancing nephrology career interest through the ASN kidney TREKS program. J Am Soc Nephrol 27:1604–1607. https://doi.org/10.1681/ASN.2015101086

    Article  PubMed  PubMed Central  Google Scholar 

  12. Bayliss GP, Cobb J, Decker B et al (2019) Kidney mentoring and assessment program for students: a guide for engaging medical students in nephrology. Clin Kidney J 12:761–766. https://doi.org/10.1093/ckj/sfz108

    Article  PubMed  PubMed Central  Google Scholar 

  13. Shah S (2019) Mentorship in the digital age: nephrology social media collective internship. Clin J Am Soc Nephrol 14:294–296. https://doi.org/10.2215/CJN.09970818

    Article  PubMed  PubMed Central  Google Scholar 

  14. Colbert GB, Topf J, Jhaveri KD et al (2018) The social media revolution in nephrology education. Kidney Int Rep 3:519–529. https://doi.org/10.1016/j.ekir.2018.02.003

    Article  PubMed  PubMed Central  Google Scholar 

  15. Kochhar KP (2007) Teaching physiology by poetry—an ode to nephros [3]. Indian J Physiol Pharmacol 51:421–422

    Google Scholar 

  16. Jhaveri KD, Perazella MA (2016) Nephrologists as educators: clarifying roles, seizing opportunities. Clin J Am Soc Nephrol 11:176–189. https://doi.org/10.2215/CJN.12151214

    Article  PubMed  Google Scholar 

  17. Bayefsky SD, Shah HH, Jhaveri KD (2016) Nephrology education for medical students: a narrative review. Ren Fail 38:1151–1159. https://doi.org/10.1080/0886022X.2016.1185352

    Article  PubMed  Google Scholar 

  18. Dixon A (2020) Medical student interest in pediatric nephrology: can an enjoyable lecture increase interest? Am J Kidney Dis 75:562. https://doi.org/10.1053/j.ajkd.2020.02.094

    Article  Google Scholar 

  19. Elbaba M (2016) Using simulation to enhance the training in pediatric nephrology. Pediatr Nephrol 31:1907. https://doi.org/10.1007/s00467-016-3467-5

    Article  Google Scholar 

  20. Reid Burks A, Nicklas D, Owens J et al (2016) Urinary tract infections: pediatric primary care curriculum podcast. MedEd Portal J Teach Learn Resour 12:10434. https://doi.org/10.15766/mep_2374-8265.10434

    Article  Google Scholar 

  21. Corporation HM, College WCM (2017) Acute pediatric nephrology simulation. Pediatr Nephrol 32:1656. https://doi.org/10.1007/s00467-017-3753-x

    Article  Google Scholar 

  22. Karangizi AHK, Chanouzas D, Mahdi A, Foggensteiner L (2019) How can we make renal medicine careers more appealing to UK trainees? Clin Kidney J 12:756–759. https://doi.org/10.1093/ckj/sfz002

    Article  PubMed  PubMed Central  Google Scholar 

  23. Barat A, Goldacre MJ, Lambert TW (2018) Career choices for nephrology and factors influencing them: surveys of UK medical graduates. J R Soc Med Open 9:1–10. https://doi.org/10.1177/2054270418793024

    Article  Google Scholar 

  24. Alebiosu CO, Oyebisi O, Adeyera O (2020) Sat-472 factors associated with choosing nephrology as a subspecialty by internal medicine residents in Nigeria. Kidney Int Rep 5:S197. https://doi.org/10.1016/j.ekir.2020.02.503

    Article  Google Scholar 

  25. Sozio SM, Pivert KA, Shah HH et al (2019) Increasing medical student interest in nephrology. Am J Nephrol 50:4–10. https://doi.org/10.1159/000501058

    Article  PubMed  Google Scholar 

  26. Shah HH, Adams ND, Mattana J et al (2015) Nephrology elective experience during medical residency: a national survey of US nephrology fellowship training program directors. Ren Fail 37:999–1006. https://doi.org/10.3109/0886022X.2015.1055693

    Article  PubMed  Google Scholar 

  27. Nair D, Pivert KA, Baudy A, Thakar CV (2019) Perceptions of nephrology among medical students and internal medicine residents: a national survey among institutions with nephrology exposure. BMC Nephrol 20:146. https://doi.org/10.1186/s12882-019-1289-y

    Article  PubMed  PubMed Central  Google Scholar 

  28. Beckwith H, Kingsbury M, Horsburgh J et al (2018) Why do people choose nephrology? Identifying positive motivators to aid recruitment and retention. Clin Kidney J 11:599–604. https://doi.org/10.1093/ckj/sfy076

    Article  PubMed  PubMed Central  Google Scholar 

  29. Daniels MN, Maynard S, Porter I et al (2017) Career interest and perceptions of nephrology: a repeated cross-sectional survey of internal medicine residents. PLoS One 12:e0172167. https://doi.org/10.1371/journal.pone.0172167

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Roberts JK, Hargett CW, Nagler A et al (2015) Exploring student preferences with a Q-sort: the development of an individualized renal physiology curriculum. Adv Physiol Educ 39:149–157. https://doi.org/10.1152/advan.00028.2015

    Article  PubMed  PubMed Central  Google Scholar 

  31. Roberts JK, Chudgar SM, Engle D et al (2018) Digital chalk-talk videos improve knowledge and satisfaction in renal physiology. Adv Physiol Educ 42:146–151. https://doi.org/10.1152/advan.00131.2017

    Article  PubMed  Google Scholar 

  32. Faye M, Keita N, Ba B et al (2020) SAT-487 knowledge and practical attitudes of students at the end of the medical study cycle on screening for chronic kidney disease. Kidney Int Rep 5:S203–S204. https://doi.org/10.1016/j.ekir.2020.02.519

    Article  Google Scholar 

  33. Akbar SR, Iqbal HI, Ahmed U (2015) The need to emphasize nephrology knowledge in residents-in-training. N Am J Med Sci 7:524–528. https://doi.org/10.4103/1947-2714.170621

    Article  PubMed  PubMed Central  Google Scholar 

  34. Saad CY, Fogel J (2018) Awareness and knowledge among internal medicine resident trainees for dose adjustment of analgesics and neuropsychotropic medications in CKD. South Med J 111:155–162. https://doi.org/10.14423/SMJ.0000000000000781

    Article  CAS  PubMed  Google Scholar 

  35. Mills H, White W, Crisp R et al (2015) Developing a simulation-based training programme in renal emergency medicine for medical trainees. Nephrol Dial Trans. https://doi.org/10.1093/ndt/gfv190.24

    Article  Google Scholar 

  36. Sims N, Dietiker K, Feig D et al (2014) A novel teaching mechanism in nephrology of the dangers of hypocalcemia in chronic renal failure. J Investig Med 62:533–534. https://afmr.org/files/Southern/2014/Southern_Regional_Meeting_Abstracts.pdf

  37. Zakaria F, Wan Zukiman WZHH (2020) SAT-482 “U-R-ine” town board game: learning AKI the fun way!!! Kidney Int Rep 5:S201. https://doi.org/10.1016/j.ekir.2020.02.513

    Article  Google Scholar 

  38. Renaud C, Siddiqui S, Jiexun W et al (2019) Faculty use of active learning in postgraduate nephrology education: a mixed-methods study. Kidney Med 1:115–123. https://doi.org/10.1016/j.xkme.2019.04.006

    Article  PubMed  PubMed Central  Google Scholar 

  39. Dehghan A, Amini M, Sagheb MM et al (2017) Early clinical exposure program in learning renal physiology. J Adv Med Educ Prof 5:172–176

    PubMed  PubMed Central  Google Scholar 

  40. LeClair RJ, Binks AP (2019) Integrating acid-base and metabolic lab panels across systems in an M1 classroom activity. MedEd PORTAL J Teach Learn Resour 15:10793. https://doi.org/10.15766/mep_2374-8265.10793

    Article  Google Scholar 

  41. Da J, Ran Y, Pi M et al (2018) Application of mini-clinical evaluation exercise for assessing the integrated-based learning during physical diagnostic course. Biochem Mol Biol Educ 46:417–423. https://doi.org/10.1002/bmb.21137

    Article  CAS  PubMed  Google Scholar 

  42. Giffen ZC, Carvalho H (2015) Development of a manipulative for nephron physiology education. Adv Physiol Educ 39:39–41. https://doi.org/10.1152/advan.00087.2013

    Article  PubMed  Google Scholar 

  43. Robinson PG, Newman D, Reitz CL et al (2018) A large drawing of a nephron for teaching medical students renal physiology, histology, and pharmacology. Adv Physiol Educ 42:192–199. https://doi.org/10.1152/advan.00022.2017

    Article  PubMed  Google Scholar 

  44. Bhaskar A, Oommen V (2018) A simple model for demonstrating the factors affecting glomerular filtration rate. Adv Physiol Educ 42:380–382. https://doi.org/10.1152/advan.00195.2017

    Article  PubMed  Google Scholar 

  45. Gomez AC, Warburton KM, Miller RK et al (2017) An interactive ambulatory nephrology curriculum for internal medicine interns: design, implementation, and participant feedback. Am J Kidney Dis 70:415–421. https://doi.org/10.1053/j.ajkd.2017.03.022

    Article  PubMed  PubMed Central  Google Scholar 

  46. Bijol V, Byrne-Dugan CJ, Hoenig MP et al (2015) Medical student web-based formative assessment tool for renal pathology. Med Educ Online 20:26765. https://doi.org/10.3402/meo.v20.26765

    Article  PubMed  Google Scholar 

  47. Lawless ME, Mehri S, Henriksen J et al (2014) Modular education system improves pathology education in renal and genitourinary systems. Lab Investig 94:148A. https://doi.org/10.1038/labinvest.2014.20

    Article  Google Scholar 

  48. Wall D (2010) Evaluation: improving practice, influencing policy. In: Swanwick T (ed) Understanding medical education: evidence, theory and practice. Wiley-Blackwell Publishing Ltd, West Sussex, pp 336–351

    Chapter  Google Scholar 

  49. Cook DA, West CP (2013) Perspective: reconsidering the focus on “outcomes research” in medical education: a cautionary note. Acad Med 88:162–167. https://doi.org/10.1097/ACM.0b013e31827c3d78

    Article  PubMed  Google Scholar 

  50. Hoenig MP (2015) Share your passion for nephrology: ten tips to invigorate attending rounds and precepting sessions. Am J Kidney Dis 66:28–32. https://doi.org/10.1053/j.ajkd.2015.03.027

    Article  PubMed  Google Scholar 

  51. Raff AC (2020) Great nephrologists begin with great teachers: update on the nephrology curriculum. Curr Opin Nephrol Hypertens. https://doi.org/10.1097/MNH.0000000000000676

    Article  Google Scholar 

  52. Melamed ML, Campbell KN, Nickolas TL (2017) Resizing nephrology training programs a call to action. Clin J Am Soc Nephrol 12:1718–1720. https://doi.org/10.2215/CJN.04740517

    Article  PubMed  PubMed Central  Google Scholar 

  53. Bramstedt KA, Prang M, Dave S et al (2014) Telemedicine as an ethics teaching tool for medical students within the nephrology curriculum. Prog Trans 24:294–297. https://doi.org/10.7182/pit2014289

    Article  Google Scholar 

  54. Pargeter K, Bhatt U (2014) Medical student assessment of technology utilization in nephrology education during preclinical years. Am J Kidney Dis 63:A88. https://doi.org/10.1053/j.ajkd.2014.01.296

    Article  Google Scholar 

  55. Tena-Santana G, Gutierrez-Morales I, Navarro-Gilabert A et al (2014) A simulated practical scenario to teach students the pathophysiological manifestations of a renal insufficiency. Acta Physiol 212:21. https://doi.org/10.1111/apha.12387

    Article  CAS  Google Scholar 

  56. Gonzales F III, Post M, Lee L (2015) Effective medical education resource design and integrative learning: a lesson in autosomal recessive polycystic kidney disease. FASEB J 29:691–2

    Google Scholar 

  57. Blakemore N, Bhandari S (2016) Increasing knowledge of acute kidney injury (AKI). Nephrol Dial Trans. https://doi.org/10.1093/ndt/gfw187.45

    Article  Google Scholar 

  58. Phon E, Toru H, Nov T et al (2019) SAT-341 outcome of training courses to cambodian students and doctors in renal replacement therapy, nephrology, nutrition, diabetes, and clinical engineer supported by Japanese dialysis related societies. Kidney Int Rep 4:S151. https://doi.org/10.1016/j.ekir.2019.05.389

    Article  Google Scholar 

  59. Solez K, Osaldor S (2020) SAT-481 nephrology immersion: a successful natural experiment. Kidney Int Rep 5:S201. https://doi.org/10.1016/j.ekir.2020.02.512

    Article  Google Scholar 

Download references

Acknowledgements

We thank Dr. Savithiri Ratnapalan, Professor, Department of Pediatrics and Dalla Lana School of Public Health, University of Toronto for her help with reviewing the protocol and critically reviewing the initial version of this manuscript.

Funding

No funding was received to assist with the preparation of this manuscript.

Author information

Authors and Affiliations

  1. Division of Nephrology, Department of Pediatrics, McMaster University, Hamilton, ON, Canada

    Charushree Prasad & Rahul Chanchlani

  2. MLIS, Librarian, McMaster University, Hamilton, ON, Canada

    Stephanie Sanger

  3. Division of Nephrology, Department of Pediatrics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada

    Amrit Kirpalani

  4. Division of Nephrology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada

    Damien Noone

Authors
  1. Charushree Prasad
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Stephanie Sanger
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Rahul Chanchlani
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Amrit Kirpalani
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Damien Noone
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

CP had the idea for the article, CP, RC, AK and DN conceptualized the study and methodology. CP and SS performed the systematic literature search and data analysis. CP and DN drafted the original manuscript and RC, AK, and SS critically revised the work.

Corresponding author

Correspondence to Charushree Prasad.

Ethics declarations

Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Compliance with Ethical Standards

The authors have no relevant financial or non-financial interests to disclose. Ethics approval was not required for this scoping review.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 20 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Prasad, C., Sanger, S., Chanchlani, R. et al. Engaging medical students and residents in nephrology education: an updated scoping review. J Nephrol 35, 3–32 (2022). https://doi.org/10.1007/s40620-021-01135-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40620-021-01135-6

Keywords

Search

Navigation