Division of Nephrology, University Health Network, Toronto, Ontario, Canada.
Satellite Healthcare, San Jose, California, USA.
Nephrology (Carlton). 2021 Jul;26(7):569-577. doi: 10.1111/nep.13867. Epub 2021 Mar 11.
Home dialysis therapies are flexible kidney replacement strategies with documented clinical benefits. While the incidence of end-stage kidney disease continues to increase globally, the use of home dialysis remains low in most developed countries. Multiple barriers to providing home dialysis have been noted in the published literature. Among known challenges, gaps in clinician knowledge are potentially addressable with a focused education strategy. Recent national surveys in the United States and Australia have highlighted the need for enhanced home dialysis knowledge especially among nephrologists who have recently completed training. Traditional in-person continuing professional educational programmes have had modest success in promoting home dialysis and are limited by scale and the present global COVID-19 pandemic. We hypothesize that the use of a 'Hub and Spoke' model of virtual home dialysis mentorship for nephrologists based on project ECHO would support home dialysis growth. We review the home dialysis literature, known educational gaps and plausible educational interventions to address current limitations in physician education.
家庭透析疗法是一种灵活的肾脏替代策略，具有经过证实的临床获益。尽管全球范围内终末期肾病的发病率持续上升，但在大多数发达国家，家庭透析的使用率仍然较低。已在已发表的文献中注意到提供家庭透析的多种障碍。在已知的挑战中，临床医生知识方面的差距可以通过有针对性的教育策略来解决。最近在美国和澳大利亚进行的全国性调查强调了加强家庭透析知识的必要性，尤其是在最近完成培训的肾病学家中。传统的面对面继续专业教育计划在促进家庭透析方面取得了一定的成功，但受到规模和当前全球 COVID-19 大流行的限制。我们假设，基于 ECHO 项目的肾病学家虚拟家庭透析指导的“中心辐射”模式将支持家庭透析的发展。我们回顾了家庭透析文献、已知的教育差距以及合理的教育干预措施，以解决当前医生教育方面的局限性。
