Dialysis Curriculum
The clinical curriculum for dialysis is designed to help fellows become competent in caring for patients who require dialysis therapy. Fellows will have the opportunity to work in both inpatient and outpatient dialysis centers at the VA and University of Utah Hospitals and Huntsman Cancer Institute. Over the course of 24 months, fellows are expected to demonstrate progressive increase in competency. The educational objectives are divided into 4 dialysis rotations, each 6 months in length, as follows:
- Months 1-6 - Fellows function at least a the level of accurate reporting of the history, physical and other data, i.e., they correctly recall and state the relevant facts. Fellows begin to understand or comprehend this information, reviewing and reporting the relevant facts in an organized and efficient manner. Fellows begin to describe how to apply this information to make diagnostic and therapeutic decision.
- Months 7-12 - Fellows are able to accurately interpret the history, physical examination and data. The information is analyzed and an accurate differential diagnosis is formulated. Fellows are able to perform urinalysis accurately. Fellows continue in their abilities to design a diagnostic plan and therapeutic interventions.
- Months 13-18 - Fellows are able to correctly manage general nephrology patient care. This extends previous expectations to formulating a correct diagnostic plan, making the correct diagnosis. They should be beginning to critically analyze literature relevant to the care issues.
- Months 19-24 - Fellows are competent in all six core competencies. They function as selfeducators, reading and analyzing the literature, and adjusting their care based on this analysis. They also function as educators in a larger context, using their clinical experience and information they have obtained from the literature to teach their colleagues, staff and faculty.
Training Methods
- Handouts
- At the beginning of the Fellowship, fellows are given The Handbook of Dialysis (Daugirdas and Ing) and access to UpToDate.
- Didactic sessions
- Weekly didactic conference – Dialysis issues are covered in detail in the didactic conference held each Wednesday from 3:00-4:00 PM. Sessions are devoted to hemodialysis issues (including systemic disorders accompanying ESRD, dialysis access, dialyzers, technical aspects, kinetics, and complications), peritoneal dialysis (including indications, mechanics, adequacy, and complications), CRRT, and vascular access placement.
- Primer Course – Fellows have special sessions on CRRT and peritoneal dialysis alogn with management of acute and chronic complications.
- Conferences – Fellows attend the following conferences:
- Nephrology Clinical Conference - General nephrology, dialysis and transplant cases are discussed in the setting of case-based presentations, Landmark articles review, M&M, and journal club.
- Nephrology Research Conference – About seven conferences are devoted to dialysis yearly.
- Inpatient attending rounds
- Outpatient hemodialysis and peritoneal dialysis rounds
- Note that interdisciplinary interactions are a key part of these clinics.
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