Medical education has changed substantially over the last decade. Traditional modes of acquiring medical information, including textbooks and journal articles, have evolved into a more inclusive learning experience. Social media, such as blogs, Twitter, and user-produced videos, created by anyone with the desire to share are now at the forefront of medical education. One of the first nephrology blogs was Renal Fellow Network (RFN) (1), a forum where trainees can share posts that are open to the community to read and comment on. On its 10-year anniversary, the American Society of Nephrology (ASN) has created a partnership with RFN to continue its legacy and forge new opportunities. In this article, we review the goals and structure of RFN, consider how RFN can continue to positively influence nephrology education, and discuss the new ASN partnership.
RFN has served as a virtual meeting place for nephrology fellows from around the world for the last decade. In 2008, the late Nathan (Nate) Hellman aptly named his blog “Renal Fellow Network” while a nephrology fellow. RFN became a popular destination for many trainees in nephrology and inspired others to develop online resources for medical education (2,3). Nephrology online resources, now termed free online medical education (FOAMed), have multiplied and matured since 2008 (4). Nephrology has emerged as a leader in FOAMed (4), and RFN is recognized as part of the movement that ushered nephrology into the age of social media (4,5). Nephrology FOAMed has continued to increase in both number and diversity of content modality. Content includes online games, like NephMadness; journal-based blogs, such as the American Journal of Kidney Diseases blog; discussions on Twitter; and live patient discussions, such as the Glomerular Disease Trial and Study Consortium (4).
The goal of RFN was clear from the inaugural post—it “intended to provide a forum to discuss interesting nephrology cases, scientific papers, and other topics germane to nephrologists.” Trainees may select a topic of their choice on the basis of their experiences or interests, draft a post, and then submit to a faculty advisor for review. After revisions are completed, the faculty advisors again review and publish the post. This peer review process helps to ensure a high-quality and accurate post, and also prevents the posting of inappropriate or inaccurate material. Finally, the post is shared on social media platforms and emailed to RFN subscribers. The inclusion of contributions from medical students, PhD students, postdoctorates, and residents in addition to fellows provides early exposure to nephrology-related topics and the RFN community, which may foster interest in the field (6,7). In addition, faculty advisors serve as mentors and role models for trainees, allowing for another layer of exposure to nephrology.
The individual blog posts cover a wide variety of topics, including journal articles, deidentified patient reports, brief topic reviews, and high-yield teaching points for the nephrology board examination. Figure 1 shows the diversity of posts, including AKI/glomerular disease (13%), transplantation (11%), CKD (15%), dialysis (11%), electrolytes and acid/base disorders (14%), and biomedical research (8%). As of July 2018, a total of 161 individuals posted 1474 posts on RFN. Although these contributors are primarily based in the United States, posts from abroad are welcome. RFN also serves as a forum for dissemination of relevant information for trainees, including upcoming conferences, funding opportunities, courses, and deadlines.
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Figure 1.: Renal Fellow Network contributors and diversity of post content from April 2008 to May 2018.
An important goal for trainee RFN contributors is to provide a unique opportunity to learn and practice writing skills that are important for academic success. Training curricula in medical school, residency, and fellowship do not traditionally address online medical writing. Active participation in the writing process with experienced faculty advisors can help trainees write in a more succinct, engaging manner and introduce them to the peer review process. After the post has been published, comments from the online community serve as a second pass informal peer review.
For subscribers and readers, the goal of RFN is the global presentation of nephrology material in an easily digestible, bite-sized manner (8). In a survey of 271 United States nephrology fellows, 34% of respondents reported visiting RFN within the last 3 months (9). Although selection bias may be inherent from an electronically distributed survey, most nephrology fellows preferred online educational material compared with other options (10). Blogs like RFN effectively and efficiently share information that fellows can use to not only learn but also, connect to the international nephrology community (11). With over 7700 followers and 3400 likes, the RFN Twitter and Facebook accounts can rapidly spread posts internationally and invite rich commentary that further contributes to the educational experience. As an outward-facing website, RFN has the potential to share enthusiasm and novelty in nephrology in an easily digestible format to those whose interest is just being piqued, and thus, it has the potential to increase interest in nephrology.
After its initiation, RFN quickly became a popular site, with 25,000 monthly unique visitors by 2011 and 50,000 by 2018 (2). RFN formed a partnership with the National Kidney Foundation in 2010 to provide structure and credibility to the site. In the initial years, RFN was led by two nephrology fellows who solicited contributors from across the world. In the last several years, several faculty advisors have continued to manage the site due to the high turnover of fellows (after graduation), whereas content is still primarily from trainees. In the last 3 years, interns participating in the Nephrology Social Media Collective internship have posted to RFN as an integral part of their curriculum (2).
The new partnership with the ASN comes at an important time for RFN. Because the numbers of posts per year and posts per contributor have decreased over time, we hope that the RFN–ASN collaboration will accelerate the growth and increase the reach of RFN. In addition to social media followers and RFN subscribers, the large ASN membership will significantly increase the RFN community. The ASN partnership will also help raise the RFN profile. We foresee this collaboration leading to more interest in posting content, because this activity will have more validity after it is included on one’s curriculum vitae (12). To increase involvement of nephrology fellows, we will solicit two nephrology or postdoctoral fellows to serve as coeditors of RFN for a 2-year term with faculty advisors. They will serve as interns on the ASN Media and Communications Committee to offer perspectives on effective ways to engage with trainees and recruit contributors to provide a steady stream of content. As editors, nephrology fellows will learn skills critical for academic success including leadership, organization, and writing skills.
Patient deidentified learning points from the closed ASN Communities forum discussion may serve as inspiration for posts with implicit permissions. The ASN Communities Weekly Rewind synopsis of high-yield topics will be added to RFN as well. The collaboration will also involve rebranding and updating of the current RFN website. Although we anticipate multitude of positives that come from this partnership with the ASN, we also recognize the potential unintended consequence of too much editorial oversight leading to restricted viewpoints.
In conclusion, RFN has grown over the past 10 years from a personal blog to a rich source of easily accessible information for current and future nephrology trainees around the world. The RFN–ASN collaboration marks the beginning of an exciting new chapter for the website that will allow for RFN to continue to have a positive effect in nephrology education.
Disclosures
S.F. and M.A.S. have no financial conflicts to disclose. S.F. is the inaugural Renal Fellow Network (RFN) editor and the American Society of Nephrology (ASN) Media and Communication Committee Intern. M.A.S. is a member of the ASN Media and Communications Committee and a past editor and a current faculty advisor for the RFN.
Acknowledgments
We thank all of the past contributors to Renal Fellow Network (RFN) and the past editors Conall O’ Seaghdha, Graham Abra, and Gearoid McMahon. We also thank the current faculty advisors Paul Phelan, Gearoid McMahon, Andrew Malone, Kelly Hyndman, Anna Burgner, Jennie Lin, and Pravir Baxi. We especially thank the late Nate Hellman, founder of RFN. We are immensely grateful for the early collaboration and support from the National Kidney Foundation.
The content of this article does not reflect the views or opinions of the American Society of Nephrology (ASN) or the Clinical Journal of the American Society of Nephrology (CJASN). Responsibility for the information and views expressed therein lies entirely with the author(s).
The views expressed in this article are those of the authors and do not necessarily represent the policy or position of the US Department of Veterans Affairs or the US Government.
Individuals interested in contributing to RFN should visit the website (www.renalfellow.org) for more information.
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