The need for individualizing teaching and assurance of knowledge transmission to patients training for home dialysis

Abstract

Patients have varied learning styles and this has implications for home haemodialysis (HHD). Assessment tools directed toward understanding these styles remains understudied. As a consequence, this may lead to substandard retention rates or adverse events in HHD programs. As part of a continuous quality improvement initiative we have aimed to improve our understanding of patient learning styles and consequently tailor home dialysis training to individuals. To objectively determine knowledge translation and comprehension, irrespective of learning styles, we have introduced an objective structured clinical examination (OSCE). This assessment tool allows for further refinement of educational priorities by highlighting both deficiencies and strengths.Thereafter, an exit OSCE ensures patients attain an acceptable standard to complete home haemodialysis independently. We hope this tool will help shape future training criteria for HHD programs and consequently reduce adverse event rates. K E Y W O R D S home dialysis training, individualized education, patient OSCE SUMMARY AT A GLANCE • Patients have individualized learning styles and home dialysis training should be personalized.• Home modalities improve clinical endpoints and are more cost effective than incenter treatment.

Adaptation of home nocturnal hemodialysis for a patient with epidermolysis bullosa: A call to personalized care!

“…Our case further involved an innovative approach to create solutions for barriers which may be perceived as absolute contraindications. 8 In summary, we are reporting a successful transition of a patient with EB and ESKD to home nocturnal hemodialysis. Our case illustrated several principles in integrated thinking, nosogogy and the importance of training assurance.…”

“…Equally important, the role of the teacher/nurse is to help promote changes in behavior in order to accommodate the illness and identify the potential obstacles. Our case further involved an innovative approach to create solutions for barriers which may be perceived as absolute contraindications 8 …”

The Feasibility of Implementing Patient-Centered Objective Structured Clinical Examination during Home Hemodialysis Training

“…The background and rationale were described previously. 3 In brief, each OSCE contains a practical component, where the patient is graded on their ability to complete a typical hemodialysis treatment using a Fresenius 2008 H machine and simulated scenarios. Domains (including machine setup, dialysate preparation, vascular access, and troubleshooting) were tested.…”

“…2 As such, determination of patients' competency in performing home hemodialysis is critical. In the medical education literature, 3 formative standardized examinations have improved self-confidence and competence in learners. We hypothesize that implementing Objective Structured Clinical Examination (OSCE) will augment home hemodialysis training by enhancing patient competence and improving patient and provider confidence.…”