ABSTRACT #36

IMPLEMENTATION OF A MOBILE-OPTIMIZED, SIMULATION-BASED NEPHROLOGY TEACHING TOOL FOR UNDERGRADUATE MEDICAL EDUCATION & ASSESSMENT OF KNOWLEDGE RETENTION

Margaret DeOliveira, Tonia Kim, David C. Thomas, Matt A. Sparks, Samira S. Farouk

PURPOSE AND GOALS: Perceived high complexity of nephrology and teaching quality have been identified as contributing factors to potential nephrology applicants choosing specialties other than nephrology. To simplify nephrology concepts and improve teaching, we implemented a mobile-optimized, simulation-based teaching tool for undergraduate medical education. We hypothesized that implementation of this tool would increase knowledge retention and impact attitudes towards nephrology.

METHODS: NephSIM is a free, open access, medical education teaching tool that uses interactive cases with iterative feedback to teach nephrology. NephSIM was implemented into a 2nd year medical school nephrology course using a pre-post test design with nonequivalent parallel groups. 2nd year medical students (MS2) were taught in small group sessions with standard cases in 2021(Control, n = 135) and then with NephSIM cases (n = 139) in 2022.

EVALUATION PLAN: A survey was administered via email to MS3 during their clinical rotations that included 5 nephrology cases, and questions addressing attitudes towards nephrology and future career plans. Knowledge acquisition was assessed by comparing MS2 nephrology course final grades.

SUMMARY OF RESULTS: Mean final course scores for the MS2 nephrology course were 91% (SD 5%, Control) and 90% (SD 4%, NephSIM). The survey response rate for the control and NephSIM groups were 16% (28/135) and 15% (21/139), respectively. Correct responses to nephrology cases were compared using Fisher’s exact test: Case 1: 88% (Control) vs 65% (NephSIM) (p = 0.08); Case 2: 88% vs 95% (p = 0.13); Case 3: 56% vs 68% (p = 1); Case 4: 62% vs 76% (p = 0.75 ); Case 5: 17% vs 26% (p = 1). At the time of survey completion, 71% (Control) and 76% (NephSIM) of respondents had completed their internal medicine clerkship.

29% (Control) vs 10% (NephSIM) expressed interest in internal medicine (IM), 25% vs 14% in surgery, and 19% vs 9.5% were unsure. 89% of control group respondents found nephrology somewhat/very difficult compared with 100% in the NephSIM group (p = 0.25). 7% (2/28) of control respondents reported they were “somewhat interested” in a nephrology career compared to 14% (3/21) in the NephSIM group (p = 0.64). No respondent in either group answered that they were “very interested” in nephrology career. 54% of control group respondents reported no interest in a future nephrology elective compared with 52% in the NephSIM group (p = 1).

REFLECTIVE CRITIQUE: Though this study is limited by selection bias and small sample size, implementation of a mobile- optimized simulation-based nephrology teaching tool may be associated with increased knowledge retention. The majority of students found nephrology pathophysiology somewhat/very difficult. No respondent in either group expressed a strong interest in a nephrology career, though the majority of this cohort also did not express interest in IM.