Medical student attitudes toward kidney physiology and nephrology: a qualitative study

Abstract

Interest in nephrology among trainees is waning in the USA. Early perceptions and attitudes to subject matter can be linked to the quality of pre-clinical curricula. We wanted to explore these attitudes in the setting of modern curriculum redesign. We utilized Q methodology to understand first-year medical student attitudes after an innovative kidney physiology curriculum redesign that focuses on blending multiple learning methods. First-year medical students were invited to take a Q sort survey at the conclusion of a kidney physiology course. Students prioritized statements related to their understanding of kidney physiology, learning preferences, preferred course characteristics, perceived clinical relevance of kidney physiology, and interest in nephrology as a career. Factor analysis was performed to identify different student viewpoints. At the conclusion of our modified course, all students (n = 108) were invited to take the survey and 44 (41%) Q sorts were returned. Two dominant viewpoints were defined according to interest in nephrology. The Potentials are students who understand kidney physiology, perceive kidney physiology as clinically relevant, attend class sessions, utilize videos, and are willing to shadow a nephrologist. The Uninterested are students who are less satisfied with their kidney physiology knowledge, prefer to study alone with a textbook, avoid lectures, and are not interested in learning about nephrology. In an updated renal physiology course, students that use multiple learning methods also have favorable attitudes toward learning kidney physiology. Thus, modern curriculum changes that accommodate a variety of learning styles may promote positive attitudes toward nephrology.

Keywords:

• Renal physiology
• medical student
• nephrology
• attitudes
• medical education

Acknowledgements

The authors wish to thank Dr. Charles W. Hargett III, MD, the Duke School of Medicine, and the Division of Nephrology at Duke University Medical Center.

Disclosure statement

The authors have no conflicts of interest to declare. The results presented in this paper have not been published previously in whole or part.

Funding

J.K.R. was supported by the Duke Training Grant in Nephrology (T32DK007731). M.A.S. is funded by Career Development Award IK2BX002240 from the Department of Veterans Affairs, Office of Research and Development, Biomedical Laboratory Research and Development Service.

Ethical approval

The Duke Institutional Review Board deemed this survey exempt from review (Project 00049444).