Lessons Learned from the ASN Renal Educator Listserv and Survey

Abstract

SummaryNephrology ranks next to last in career choices among US medical school graduates. The American Society of Nephrology established a Workforce Committee to help address this issue. Surveys of US medical students indicate that experiences during kidney pathophysiology courses in the preclerkship years may impact their decision to consider a career in nephrology. In October of 2011, preclinical kidney physiology and pathophysiology course directors at US medical schools were surveyed about teaching methods, curricular content, resources, and institutional support for teaching to identify what worked well and what impairs their teaching efforts. A Listserv of these educators, the American Society of Nephrology Renal Educators Listserv, was used to electronically administer the survey. Course leaders from 62 of 114 (54.4%) surveyed medical schools responded. Most of these educators are nephrologists, but physiologists and other clinicians also lead courses; 60% of course directors noted that lectures are videotaped, resulting in decreased attendance. A range of resources is used: 68% use audience response systems, 16% use the simulation center, and none of the educators indicated use of social media (such as Twitter or Facebook); 50% of respondents receive no remuneration, and 68% receive no full-time equivalent for their efforts. Audience response systems, virtual microscopy, and flash animations were identified as valuable teaching tools. Course directors, during subsequent dialogue on the American Society of Nephrology Renal Educators Listserv, have cited incorporation of case scenarios and integration of clinical exposure during preclinical years as methods that inspired interest. Hopefully, adoption of such approaches will ultimately serve to stimulate interest in nephrology.

It Takes a Spark to Light a Fire

“…6,7 Unexpectedly, several clinical trials failed to confirm in clinical settings the encouraging preclinical findings, particularly in the prevention of acute ischemic injury. [8][9][10] In contrast to erythroid precursor cells, the expression of EpoR on nonerythroid cells is low and is unlikely to be sufficient for EpoR activation to occur.…”

“…Reasons for the declining interest in nephrology have been discussed in many excellent reviews. [4][5][6][7] These reasons include dissatisfaction with early nephrology experiences in medical school, limited clinical exposure to the breadth of patients with nephrologic disease, the increased educational role of hospitalists at the expense of nephrologists, lack of new therapeutics, the perception that the job market is soft, lifestyle issues, negative role modeling, complexity of the specialty, the Medicare ESRD program, and changes in nephrology reimbursement.…”

Nephrology education for medical students: a narrative review

“…[1][2][3][4][5][6] This concerning finding is magnified by the reality that an aging population and rising incidence of such chronic diseases as diabetes mellitus and hypertension continue to increase the demand for specialists, including nephrologists. Recent studies suggest that experiences in medical school -both positive and negative -can influence a medical trainee's decision to pursue nephrology.…”

“…Recent studies suggest that experiences in medical school -both positive and negative -can influence a medical trainee's decision to pursue nephrology. Limited medical student exposure to clinical nephrology, 7 confusing methods of teaching complex material, 7 a dearth of nephrology courses taught by nephrologists, 2 and the widespread view of nephrology as a highly specialized field focused on rare and severe diseases 8 may contribute to apathy toward a career in nephrology. Conversely, effective teaching and role models may explain the finding of a study 6 that over 20% of nephrology fellows first became interested in the field during medical school.…”

Nephrology elective experience during medical residency: a national survey of US nephrology fellowship training program directors

“…[1][2][3][4][5][6] Several factors can influence medical trainees' career choices, including intellectual interest in a particular field, the presence or lack of a significant procedural component, income potential, job opportunities, financial debts, family commitments, and geographical constraints, among others. [7][8][9][10][11][12] Exposure to various subspecialties during medical school or residency may be one such variable that can strongly influence career choices. 8,9 Although many factors may play a role in attracting medical students and residents into nephrology, one important factor may be how well nephrology is presented to trainees.…”