SAT-481 NEPHROLOGY IMMERSION: A SUCCESSFUL NATURAL EXPERIMENT

Abstract

It all began in January 2009 when Medical Resident 1 expressed an interest in kidney medicine and began working on Nephrology research tasks with the last author as an undergraduate student. This all emerged unintentionally, not conceived of as an experiment until the first and second author began doing similar Nephrology research tasks in January 2018 and September 2019 as premed students and decided to test this immersion approach to learning kidney medicine and kidney pathology before medical school, after receiving the required privacy training. This method stands out from the usual stepwise acquisition of knowledge in classical medical education in medical school because it allows the student to be fully “immersed” into the world of nephrology without necessarily having adequate background in medicine in general. Just like other immersive education, nephrology immersion was established by the inclusion of premedical students in a renal pathology and nephrology lab. The students had the opportunity to work with pathologists and clinicians on a daily basis, gaining knowledge of the specialty by attending weekly nephrology/pathology rounds, regularly studying renal biopsies from the hospital, and completing online and in-person curricula meant for nephrology trainees (eg. the American Society of Nephrology Kidney Week Early Program ‘Fundamentals of Renal Pathology’). The students demonstrated understanding of kidney pathology and nephrology material in several ways: successful completion of standardized curricula, weekly preparation and presentation of kidney biopsy cases at pathology/nephrology rounds, and training new pathology fellows. A necessary component is that the students must suspend belief that they have truly mastered the subject until they are in medical school and learn the surrounding context of related subjects necessary to fully understand nephrology. However, if this sort of nephrology immersion education can succeed safely and comfortably because students are very likely to choose a career in Nephrology due to them being predisposed to the specialized knowledge of the field. Standardized curricula make it easy to assess the knowledge of such immersion students and they perform at a level comparable to current nephrology fellows, despite lacking full “medical” understanding of the subjects. Immersion is an effective education technique in many other areas of human endeavor, and represents an additional innovative approach to kidney education, which is something the American Society of Nephrology (ASN) is seeking in several of its programs.