Integrating Point of Care Ultrasound into Nephrology Fellowship Training: Insights from a Pilot Program.

Ann Young,William Beaubien-Souligny,Alireza Zahirieh,Ron Wald,Claire Kennedy,Alberto Goffi,Daniel Blum,Benoit Imbeault

doi:10.24908/pocus.v7ikidney.14987

Abstract

In nephrology, point-of-care ultrasound (POCUS) has multiple applications including the rapid evaluation of acute kidney injury, enhancing the initial evaluation of chronic kidney disease, direct evaluation of vascular access, and improved fluid balance management in acute and chronic settings [1, 2]. Recently, the role of POCUS has been formally acknowledged by the American College of Physicians and curricula specific to nephrology have been proposed [3, 4]. However, the integration of a novel clinical skill into a field comes with its unique set of challenges. Above all, most nephrologists in leadership roles within fellowship training programs lack POCUS experience, which represent a significant barrier for adequate exposure and teaching. Although educational curriculum centered on nephrology have been proposed, the optimal model to ensure adequate POCUS exposure considering the scarcity of expertise among educators is not known.

Highlights

In nephrology, point of care ultrasound (POCUS) has multiple applications including the rapid evaluation of acute kidney injury, enhancing the initial evaluation of chronic kidney disease, direct evaluation of vascular access, and improved fluid balance management in acute and chronic settings [1, 2]
The focus was limited to renal POCUS with the aim of enabling the operator to detect hydronephrosis and to evaluate chronic kidney disease by measuring longitudinal kidney length
We proposed to fellows undergoing their clinical rotations the goal of autonomously performing three or more renal POCUS assessments per week for the following four month period, aiming for a total of 50 studies

Summary

Introduction

Point of care ultrasound (POCUS) has multiple applications including the rapid evaluation of acute kidney injury, enhancing the initial evaluation of chronic kidney disease, direct evaluation of vascular access, and improved fluid balance management in acute and chronic settings [1, 2]. In 2018, we aimed to develop a pilot POCUS program for nephrology fellows at the University of Toronto. The objective was to provide adequate POCUS exposure without a dedicated POCUS rotation. These included access to dedicated POCUS devices and the presence of one supervisor per site able to provide ad hoc assistance if needed.

Objectives

Results

Conclusion