Urine Microscopy for Internal Medicine Residents: A Needs Assessment & Implementation of Virtual Teaching Sessions

Background: Though urine microscopy is an important step in the initial evaluation of a patient with kidney disease, internal medicine residents have minimal exposure to this technique during their training. The goal of this study was to understand knowledge of and attitudes towards urine microscopy among internal medicine residents, and to implement virtual urine microscopy teaching sessions. Methods: A voluntary, anonymous, online survey was sent to all the categorical internal medicine residents training (n = 131) at the Icahn School of Medicine at Mount Sinai (ISMMS). The survey included thirteen questions to assess attitudes towards, experience with, and clinical interpretation of urine microscopy specimens. In response to the survey results, we implemented virtual urine microscopy teaching sessions using video conferencing software which incorporated real-time urine sediment analysis with nephrology fellows and attending nephrologists. Results: The survey response rate was 45% (59/131). Forty-seven percent (28/59) of respondents reported performing urine microscopy at least once during their training and 75% (44/59) of respondents did not feel comfortable performing urine microscopy. The majority of residents (92%, 54/59) reported they felt urine microscopy was very helpful or somewhat helpful in the evaluation of patients with AKI. Overall, 41% percent of responses to clinical interpretation questions were considered correct. Following survey completion, virtual urine microscopy sessions were held monthly and well received by the participants. Conclusions: Our study found that internal medicine residents perceive urine microscopy as a helpful diagnostic tool, though lack the skills to perform and interpret urine microscopy sediments. Virtual educational sessions using video conferencing software are a technically feasible approach to teaching urine microscopy to internal medicine residents. Future studies include a study of the impact of these sessions on learning of urine microscopy.