Table 1.
Adaptations to Existing Objectives and Rotations.
| Curriculum structure | Previous methods | New methods—peak periods |
|---|---|---|
| Clinical rotations | ||
| • Consults | Team-based rotation with multiple learners and focus on both bedside and classroom teaching | Resident and medical student allocation variable; more fellow autonomy and staff-to-fellow teaching. Widespread efforts to minimize potential exposures. |
| • Hemodialysis | Rounding on daytime shifts with bloodwork review and prescription adjustment. | Where possible, one designated nephrologist to round in unit. Learning supplemented with online sessions. |
| • Peritoneal dialysis | In-person assessments and PD clinics. | Transition to telehealth-based clinic delivery and patient assessment on as-needed basis. |
| • Transplant | Donor and recipient assessments, management of short- and long-term complications for admitted in-patients as well as routine clinics. | Solid organ transplant on hold during peak period. Online sessions; further development of virtual curriculum if ongoing limited exposure to core concepts. |
| • Procedures | Procedural rotation and longitudinal opportunities for HD line and PD catheter insertion and removals. | Rotation on hold. Procedural exposure as able with appropriate PPE. |
| • Pathology | Laboratory-based rotation viewing cases alongside renal pathologist. | Rotation on hold. Supplemented with virtual slide bank, teleconferenced biopsy rounds, and online resources. |
| • CKD and longitudinal clinics | In-person clinics. | Primarily telehealth clinics. |
| Scholarly activities | ||
| • Conferences | Travel to major academic meetings | Transitioning to virtual platforms |
| • Research projects | Learning the research process and completing a project. | Virtual meetings; encourage online collaboration with other sites |
| • Journal club | Held in person | Virtual journal club |
| Teaching | ||
| • Academic half day | Afternoon small group session | Shorter lunchtime talks over Zoom |
| Evaluation and feedback | ||
| • Competence by design | EPAs | Continue; supplement with virtual cases if unable to directly observe skills |
| Wellness | ||
| • Resident-led events | Group gatherings for social events | Virtual session sponsored by Resident Doctors of BC with reimbursement |
| New objectives | ||
| • Virtual health | Learning to adapt to online platforms for delivery of care and trainee education | |
| • COVID-19 specific | Participation in committees to better understand provincial and local structures | |
Note. CKD = chronic kidney disease; PD = peritoneal dialysis; HD = hemodialysis; PPE = personal protective equipment; EPAs = entrustable professional activities.