Impact of a Longitudinal Virtual Education Series on Home Dialysis Education: A Mixed-Methods Evaluation.

KEY POINTS: Participation in the American Society of Nephrology Longitudinal Virtual Home Dialysis Program was associated with improved comfort levels in managing home dialysis. Nephrology fellowship training in home dialysis is sporadic and lacks structure. The HDU and ASN-HDU provides a structured curriculum that addresses many, but not all, gaps in home dialysis training during fellowship.

BACKGROUND

Home dialysis has clinical and economic benefits, yet it remains underutilized in the United States. One barrier is a lack of experience among fellows due to inadequate training. To enhance fellow training, the American Society of Nephrology launched the Home Dialysis Virtual Longitudinal Education Program (ASN-HDU) with Home Dialysis University (HDU) in 2023.

METHODS

We evaluated the ASN-HDU longitudinal program using mixed-methods. We sampled participants (P) from two groups: (1) fellows who attended both HDU and the American Society of Nephrology virtual program and (2) fellows who only attended HDU. We sent a post-HDU survey and 8-month follow-up survey to assess quantitative changes in comfort in home dialysis. We interviewed participants from both groups and used a constant comparative method to identify qualitative themes related to home dialysis training.

RESULTS

After attending HDU, 52 participants reported median comfort levels of 7–8 of 10 for peritoneal dialysis topics and 4–5 of 10 for home hemodialysis topics. In the follow-up survey, only participants of ASN-HDU demonstrated significant improvement in comfort level for all home dialysis topics by 1–2 of 10 (except volume overload management on peritoneal dialysis). Two main themes emerged from 10 qualitative interviews: (1) home dialysis training is sporadic and lacks structure, with subthemes describing challenges with receiving hands-on training, lack of systematic training, and a need for fellows to create their own training pathways, and (2) HDU and ASN-HDU are structured curricula that fill many educational gaps, but not all, with subthemes describing the value of these programs, examples of how fellows apply knowledge gained in clinical practice, and gaps that these curricula cannot directly address.

CONCLUSIONS

Participation in ASN-HDU was associated with improved fellow comfort levels in home dialysis. Both HDU and ASN-HDU help address several gaps in home dialysis training in fellowship programs, but trainees may benefit from additional hands-on clinical experience.