Effect of a Structured POCUS Workshop on Nephrologists’ Confidence and Skills: A Questionnaire-Based Study

 

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https://storage.unitedwebnetwork.com/files/1099/c2633599360019bcc12694ee4fbc6212.pdf
Effect of a Structured POCUS Workshop on Nephrologists’ Confidence and Skills: A Questionnaire-Based Study

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Fumiya
Kitano
Fumiya Kitano fumiya.kitano@marianna-u.ac.jp St. Marianna University School of Medicine Division of Nephrology and Hypertension, Department of Internal Medicine Kawasaki Japan *
Masafumi Sakai masafumi.sakai@marianna-u.ac.jp St. Marianna University School of Medicine Division of Nephrology and Hypertension, Department of Internal Medicine Kawasaki Japan - Yokohama General Hospital Department of Internal Medicine Yokohama Japan
Kana Shirai kana.ishikawa@marianna-u.ac.jp St. Marianna University School of Medicine Division of Nephrology and Hypertension, Department of Internal Medicine Kawasaki Japan -
Keisuke Yoshida k.yoshida0622@gmail.com Gyotoku General Hospital Department of Internal Medicine Chiba Japan -
Yugo Shibagaki yugoshibagaki@gmail.com St. Marianna University School of Medicine Division of Nephrology and Hypertension, Department of Internal Medicine Kawasaki Japan -
Masahiko Yazawa masahikoyazawa@gmail.com St. Marianna University School of Medicine Division of Nephrology and Hypertension, Department of Internal Medicine Kawasaki Japan - Yokohama General Hospital Department of Internal Medicine Yokohama Japan
 
 
 
 
 
 
 
 
 

Point-of-care ultrasound (POCUS) is an essential bedside tool in nephrology for rapid assessment of volume status, venous congestion, acute kidney injury (AKI), and vascular access. In Japan, however, nephrology-oriented POCUS training programs remain limited, and outcome evaluation methods are inconsistent. We previously reported that, within the workshop group (WS)—defined as an intensive, structured, domestic POCUS program including hands-on lectures held from April to June 2023—the rate of POCUS implementation for AKI increased significantly from pre- to post-workshop (Nephrology. 2025; doi:10.1111/nep.70060). In the present study, we assessed educational effects on nephrologists’ confidence scores (self-perceived technical skills, diagnostic confidence, and teaching ability) and compared those scores between WS and an on-the-job training–only group (OJT).

We enrolled 34 of 44 eligible nephrologists affiliated with St. Marianna University Hospital between April and June of 2023, 2024, or 2025 (WS n=19; OJT n=15). A questionnaire administered in August 2025 captured four confidence domains—(1) technical skills, (2) diagnostic assessment, (3) teaching ability, and (4) satisfaction—using a 5-point Likert scale (1 = no confidence at all; 5 = very confident). Two time points were assessed by retrospective recall: post-intervention (WS: immediately after the workshop; OJT: after a few months of initial on-the-job training following hospital assignment) and current (August 2025). Data are reported as mean ± standard deviation(SD). Between-group comparisons were performed using Student’s t-test, and within-group pre–post changes were assessed with a paired t-test.

Mean postgraduate year was 8.0 ± 3.0 in WS and 7.3 ± 3.5 in OJT. In WS, participants retrospectively rated confidence at two time points (post-workshop and August 2025). Across the four domains, post-intervention means ranged from 3.84 to 4.37 (SD 0.44–0.58), indicating high confidence. At the current assessment (approximately two years after WS), means were lower than post-intervention in all four domains (p≤0.02). In OJT, confidence was rated after a few months of initial on-the-job training and at August 2025. Across the four domains, mean scores after a few months of initial on-the-job training were 3.07–3.80 (SD 0.77–1.11), with no significant change between the two time points (p=0.17–0.36).

Because outcomes were based on retrospective self-assessment, the study is subject to recall bias and reflects perceived rather than observed performance. Even so, the intensive, structured, domestic POCUS program with hands-on lectures produced high immediate confidence, and all domains showed significant declines over approximately two years. Periodic refresher programs appear necessary to sustain POCUS implementation and clinician confidence.

Kewords