title: Training in dialysis access - charting future success.
abstract: OBJECTIVE
  Medical education and training in dialysis access skills remains complex and inadequate as learners come from diverse backgrounds and from various specialties so that appropriate training is limited. As a result, a system of progressive education including live lectures, and hands on training has emerged, but there is controversy as to what constitutes the best educational model.
  
  
  METHODS
  Presently there is no recognized or structured training in vascular access during residency or fellowships. Here we present a model of dialysis access training for beginner to advanced surgeons.
  
  
  RESULTS
  A structured hands-on and didactic surgery training certification course consisting of a one week curriculum with 49 hours of ACCME credit hours has been in effect for one year. The learning impact and the performance outcome are high but with limited attendance capacity. Pre- and post- training test results attest to training effectiveness. To increase access, an off-site training curriculum has been initiated, entailing 1-2 days (8-15 credit hours) consisting of didactic lectures and surgical training. This teaching module has moderate learning impact for 50-100 attendees.Finally, a tiered, web-based training curriculum (10 ACCME credit hours) can accommodate an unlimited number of learners, but has a lower skills learning impact.
  
  
  CONCLUSIONS
  The future dialysis access training must also accommodate learners with diverse individual backgrounds, and different levels of professional (skill) development. To be effective and accessible, a variety of educational system, for example on site or web based is needed. Collaborative initiatives for global dialysis access training are currently underway.
authors.affiliation: Department of Surgery, Tulane University, New Orleans, Louisiana - USA.|Dialysis Access Institute, Orangeburg Regional Medical Center, Orangeburg, South Carolina - USA.
authors.forename: Ingemar
authors.initials: I
authors.lastname: Davidson
authors.affiliation: Palo Alto Medical Foundation, Mountain View, Palo Alto, California - USA.
authors.forename: Bart
authors.initials: B
authors.lastname: Dolmatch
authors.affiliation: Nephrology and Dialysis Unit, Ospedale San Carlo Borromeo, Milan - Italy.|Department of Clinical and Biomedical Sciences, University of Milan, Milan - Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Gallieni
authors.affiliation: Departments of Cardiac, Thoracic and Vascular Surgery, Yong Loo Lin School of Medicine, Singapore - Singapore.
authors.forename: Pei
authors.initials: P
authors.lastname: Ho
authors.affiliation: Vice President, Operations and Programming, AKH Inc., Northfield, Illinois - USA.
authors.forename: Kelly
authors.initials: K
authors.lastname: Kraines
authors.affiliation: Department of Surgery, University Putra Malaysia Kuala Lumpur, Kuala Lumpur - Malaysia.
authors.forename: Ngoh C
authors.initials: NC
authors.lastname: Liew
authors.affiliation: Vascular Surgery, Medanta Medicity Hospital, Medanta - India.
authors.forename: Rajiv
authors.initials: R
authors.lastname: Parakh
authors.affiliation: Dialysis Access Institute, Orangeburg Regional Medical Center, Orangeburg, South Carolina - USA.
authors.forename: John
authors.initials: J
authors.lastname: Ross
authors.affiliation: Department of Surgery, Tulane University, New Orleans, Louisiana - USA.
authors.forename: Douglas
authors.initials: D
authors.lastname: Slakey
mesh_terms: D001166:Arteriovenous Shunt, Surgical / Q000193:education*; D002568:Certification; D002983:Clinical Competence; D003479:Curriculum; D004503:Education, Medical, Graduate / Q000379:methods*; D005257:Fellowships and Scholarships; D006801:Humans; D007396:Internship and Residency; D007674:Kidney Diseases / Q000628:therapy*; D059032:Learning Curve; D017145:Models, Educational; D006435:Renal Dialysis; D013598:Systems Theory; D013997:Time Factors