ArticleCanadian journal of kidney health and disease2026
Addition of a Home Hemodialysis Counseling Scenario to an Existing Formative Objective Structured Clinical Examination (OSCE) for Nephrology Fellows: A Research Letter.
Article in Canadian journal of kidney health and disease, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Home hemodialysis (HHD) prevalence is low in the United States; thus, nephrology fellows may have limited HHD clinical experience and be hesitant to counsel suitable patients. We describe a formative HHD counseling simulation scenario, part of a previously described nephrology-specific formative Objective Structured Clinical Examination (OSCE) that assesses fellow counseling skills using validated assessment instruments. Methods: During a 20-minute simulation, fellow performance was assessed by a standardized patient using the Essential Elements of Communication-Global Rating Scale 2005 (EEC-GRS) and by faculty using an HHD-specific Mini-Clinical Evaluation Exercise (Mini-CEX). Overall, EEC-GRS and Mini-CEX scores were the primary outcome measures. After the simulation, fellows were surveyed anonymously regarding satisfaction with the scenario and HHD clinical experience/education. Program directors reported HHD curriculum components. Fellow performance was analyzed by training year. Results: Four programs (19 fellows: 10 first-year, nine second-year) participated. All had an HHD curriculum. Three offered HHD training courses but no HHD clinic. One had a longitudinal HHD clinic (two first-year and two second-year fellows) but did not offer a training course. There were no significant differences in overall EEC-GRS or Mini-CEX scores between first- and second-year fellows. No fellow had an unsatisfactory overall score. On the post-OSCE survey (37% response rate), six of seven (86%) responding fellows agreed/strongly agreed that the simulation increased their "comfort in discussing HHD with a patient." Conclusion: This educational, formative HHD counseling scenario, part of a previously described OSCE, is a low-risk opportunity for fellows to practice patient communication skills and appears to increase fellow comfort in discussing HHD.
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