A Survey-Based Evaluation of Self-Perceived Competency after Nephrology Fellowship Training

Berns, Jeffrey S.

doi:10.2215/cjn.08461109

Cited by 133 publications

(143 citation statements)

References 8 publications

Supporting

Mentioning

137

Contrasting

Unclassified

Order By: Relevance

“…There have been substantial changes both in the demographics of trainees entering nephrology and the overall structure of training programs (in part due to changes in work hours mandated by the Accreditation Council for Graduate Medical Education). A recent paper examining the experience of trainees who graduated between 2005 and 2009, which primarily examined procedural and clinical competence, has provided important information about nephrology education as well (18). The primary focus of this study was to determine the factors that lead to a career in academic nephrology, and potential future directions for study include comparisons of training experiences and career trajectories of recent trainees with those of earlier graduates.…”

Section: Discussionmentioning

confidence: 99%

Factors in Career Choice among US Nephrologists

McMahon

Thomas

Tucker

et al. 2012

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

SummaryBackground and objectives There is a projected shortage of kidney specialists, and retention of trainees in nephrology is important. Determining factors that result in choosing a nephrology career could inform future strategies to attract nephrology fellows. Results Of the 3399 members, 913 (23%) returned the survey. Mean age was 51.1610.5 years, and 46.1% were academic nephrologists. In addition, 38.4% of respondents graduated between 2000 and 2009. Interest in nephrology began early in training, with the intellectual aspects of nephrology, early mentoring, and participation in nephrology electives named as the most common reasons in choosing nephrology. Academic nephrologists were more likely to have participated in research in medical school, have a master's degree or PhD, and successfully obtained research funding during training. Academic debt was higher among nonacademic nephrologists. Research opportunities and intellectual stimulation were the main factors for academic nephrologists when choosing their first postfellowship positions, whereas geographic location and work-life balance were foremost for nonacademic nephrologists.Conclusions These findings highlight the importance of exposing medical students and residents to nephrology early in their careers through involvement in research, electives, and positive mentoring. Further work is needed to develop and implement effective strategies, including increasing early exposure to nephrology in preclinical and clinical years, as well as encouraging participation in research, in order to attract future nephrology trainees.

show abstract

Section: Discussionmentioning

confidence: 99%

Factors in Career Choice among US Nephrologists

McMahon

Thomas

Tucker

et al. 2012

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

show abstract

“…Moreover, the exposure or lack thereof to a particular dialysis modality during fellowship training may influence future practice patterns (38,39). In the United States, 30% of new nephrologists felt competent with acute PD compared with 90% of new nephrologists felt competent with acute HD (41). The recent reports suggesting acceptable outcomes with PD may stimulate nephrologists from Western countries to re-examine, and potentially broaden, their approach to treating patients with AKI and make appropriate changes in the curriculum of training programs.…”

Section: Discussionmentioning

confidence: 99%

Use of Peritoneal Dialysis in AKI

Chionh

Soni

Finkelstein

et al. 2013

Clinical Journal of the American Society of Nephrology

163

117

View full text Add to dashboard Cite

SummaryBackground and objectives The role of peritoneal dialysis in the management of AKI is not well defined, although it remains frequently used, especially in low-resource settings. A systematic review was performed to describe outcomes in AKI treated with peritoneal dialysis and compare peritoneal dialysis with extracorporeal blood purification, such as continuous or intermittent hemodialysis.Design, setting, participants, & measurements MEDLINE, CINAHL, and Central Register of Controlled Trials were searched in July of 2012. Eligible studies selected were observational cohort or randomized adult population studies on peritoneal dialysis in the setting of AKI. The primary outcome of interest was all-cause mortality. Summary estimates of odds ratio were obtained using a random effects model. ResultsOf 982 citations, 24 studies (n=1556 patients) were identified. The overall methodological quality was low. Thirteen studies described patients (n=597) treated with peritoneal dialysis only; pooled mortality was 39.3%. In 11 studies (7 cohort studies and 4 randomized trials), patients received peritoneal dialysis (n=392, pooled mortality=58.0%) or extracorporeal blood purification (n=567, pooled mortality=56.1%). In the cohort studies, there was no difference in mortality between peritoneal dialysis and extracorporeal blood purification (odds ratio, 0.96; 95% confidence interval, 0.53 to 1.71). In four randomized trials, there was also no difference in mortality (odds ratio, 1.50; 95% confidence interval, 0.46 to 4.86); however, heterogeneity was significant (I 2 =73%, P=0.03).Conclusions There is currently no evidence to suggest significant differences in mortality between peritoneal dialysis and extracorporeal blood purification in AKI. There is a need for good-quality evidence in this important area.

show abstract

“…62 A recent U.S. study concluded that nephrology training programs are perceived of as doing an excellent job, but signifi cant gaps in training were identifi ed in some areas, among them home-and selfcare HD and PD. 63 We can conclude that modality choice is a complex process that is infl uenced by many medical, psychological, organizational, and logistic factors, and also by fi nancial incentives. The key issue is that patients be treated accordingly to their physical, social, and psychological needs.…”

Section: Factors Infl Uencing Modality Choicementioning

confidence: 95%

Home dialysis: A Dutch perspective

Boeschoten

Michels

2011

Dialysis & Transplantation

View full text Add to dashboard Cite

For patients with end‐stage renal disease who are not (yet) eligible for renal transplantation, treatment with dialy‐sis is mandatory for survival. Home dialysis modalities (home hemodialysis or peritoneal dialysis) offer patients more ﬂexibility compared with in‐center treatment and have been advocated as the ﬁrst choice in clinically stable patients. However, despite encouraging developments in dialysis systems that make the procedure easier, in many countries the proportion of patients using home dialysis, especially peritoneal dialysis, is decreasing. In Europe this decrease is most pronounced in the Netherlands and the United Kingdom. This evolution cannot be motivated by an inferiority of home dialysis modalities compared with in‐center treatment, as all these modalities have been shown to generate similar results. Other, often non‐medical, factors (such as reimbursement, social and logistic issues, and the experience of physicians and nurses with home dialysis) seem to be responsible for this development.

show abstract

A Survey-Based Evaluation of Self-Perceived Competency after Nephrology Fellowship Training

Cited by 133 publications

References 8 publications

Factors in Career Choice among US Nephrologists

Factors in Career Choice among US Nephrologists

Use of Peritoneal Dialysis in AKI

Home dialysis: A Dutch perspective

Contact Info

Product

Resources

About