An integrated pathology and ultrasonography-based simulation for training in performing kidney biopsy

Clin Nephrol. 2018 Mar;89(3):214-221. doi: 10.5414/CN109267.


Background: Medical practice trends and limitations in trainees' duty hours have diminished the interest and exposure of nephrology fellows to percutaneous kidney biopsy (PKB). We hypothesized that an integrated nephrology-pathology-led simulation may be an effective educational tool.

Materials and methods: A 4-hour PKB simulation workshop (KBSW), led by two ultrasonography (US)-trained nephrologists and two nephropathologists, consisted of 6 stations: 1) diagnostic kidney US with live patients, 2) kidney pathology with plasticine models of embedded torso cross-sections, 3) US-based PKB with mannequin (Blue Phantom™), 4) kidney pathology with dissected cadavers, 5) US-based PKB in lightly-embalmed cadavers, and 6) tissue retrieval adequacy examination by microscope. A 10-question survey assessing knowledge acquisition and procedural confidence gain was administered pre- and post-KBSW.

Results: 21 participants attended the KBSW and completed the surveys. The overall percentage of correct answers to knowledge questions increased from 55 to 83% (p = 0.016). The number of "extremely confident" answers increased from 0 - 5% to 19 - 28% in all 4 questions (p = 0.02 - 0.04), and the number of "not at all confident" answers significantly decreased from 14 - 62% to 0 - 5% in 3 out of 4 questions (p = 0.0001 - 0.03). Impact of the imparted training on subsequent practice pattern was not assessed.

Conclusion: A novel KBSW is an effective educational tool to acquire proficiency in PKB performance and could help regain interest among trainees in performing PKBs. .

MeSH terms

  • Biopsy
  • Cadaver
  • Clinical Competence*
  • Fellowships and Scholarships
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Kidney / diagnostic imaging*
  • Kidney / pathology*
  • Manikins
  • Nephrology / education*
  • Self Efficacy
  • Simulation Training*
  • Surveys and Questionnaires
  • Ultrasonography, Interventional