Exploration of clinical teaching mode for arteriovenous fistula based on competence-based medical education_West China Medical Journal

Authors：

CAO Zhengjiang ,  YU Shaobin , FU Ping

Department of Nephrology and Institute of Kidney Diseases, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

YU Shaobin, Email: yushaobinhx@wchscu.edu.cn

Keywords：

Arteriovenous fistula; clinical teaching; competence-based medical education

DOI：

10.7507/1002-0179.202606065

Video：

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Arteriovenous fistula (AVF) requires high proficiency in delicate vascular procedures. The traditional “mentor-prentice” teaching model faces limitations such as inconsistent teaching standards and a lack of objective evaluation indicators, making it difficult to meet the current training needs of vascular access physicians. Therefore, the vascular access team in the Department of Nephrology of West China Hospital, Sichuan University, has proposed a clinical teaching mode for AVF based on competence-based medical education. The aim is to comprehensively enhance the clinical abilities of trainees by constructing AVF surgical training models and integrating diversified teaching methods and assessment evaluation systems. This article introduces the aforementioned mode, aiming to provide a reference for medical institutions at all levels to conduct high-quality AVF teaching.

Citation： CAO Zhengjiang, YU Shaobin, FU Ping. Exploration of clinical teaching mode for arteriovenous fistula based on competence-based medical education. West China Medical Journal, 2026, 41(7): 1146-1149. doi: 10.7507/1002-0179.202606065 Copy

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14.	望云, 周秀秀, 施曉雷, 等. 基于費曼學習法在放射科住院醫師規范化培訓 CT 三維圖像后處理教學模式的探索[J]. 影像研究與醫學應用, 2026, 10(8): 185-187.
15.	易東曄, 姜曉兵, 趙沃華, 等. 費曼學習法在神經外科腰椎穿刺術實踐教學中的應用[J]. 中國臨床神經外科雜志, 2025, 30(12): 755-758.
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21.	Lok CE, Huber TS, Lee T, et al. KDOQI clinical practice guideline for vascular access: 2019 update[J]. Am J Kidney Dis, 2020, 75(Suppl 2): S1-S164.
22.	Tricard T, Pan J, Song Q, et al. Validation of the Objective Structured assessment of Technical Skill (OSATS) in China[J]. J Surg Educ, 2025, 82(1): 103304.
23.	Hopmans CJ, den Hoed PT, van der Laan L, et al. Assessment of surgery residents’ operative skills in the operating theater using a modified Objective Structured Assessment of Technical Skills (OSATS): a prospective multicenter study[J]. Surgery, 2014, 156(5): 1078-1088.
24.	Bari V. Direct observation of procedural skills in radiology[J]. AJR Am J Roentgenol, 2010, 195(1): W14-W18.
25.	Siau K, Crossley J, Dunckley P, et al. Direct observation of procedural skills (DOPS) assessment in diagnostic gastroscopy: nationwide evidence of validity and competency development during training[J]. Surg Endosc, 2020, 34(1): 105-114.

1. Lok CE, Huber TS, Orchanian-Cheff A, et al. Arteriovenous access for hemodialysis: a review[J]. JAMA, 2024, 331(15): 1307-1317.
2. Ugarte R, Curry J, de Virgilio C, et al. Association of surgeon volume and operative factors with early thrombosis of arteriovenous fistulas for hemodialysis[J]. J Vasc Surg, 2025, 81(6): 1479-1484.
3. Mo H, Ahn S, Han A, et al. Outcome after early thrombotic occlusion of arteriovenous fistulas[J]. J Vasc Access, 2023, 24(6): 1268-1274.
4. Kearney GP, Gardiner N, Carr D, et al. See one, do one, teach one: other professionals don’t accept this so why should the medical profession?[J]. BMJ, 2025, 389: r432.
5. Hsiao CT, Chou FC, Hsieh CC, et al. Developing a competency-based learning and assessment system for residency training: analysis study of user requirements and acceptance[J]. J Med Internet Res, 2020, 22(4): e15655.
6. 彭睿涵, 劉霞, 王貫, 等. 醫學生勝任力評價研究的范圍綜述[J]. 中國循證醫學雜志, 2026, 26(1): 119-124.
7. Coleman T, Dasgupta A, Carsten CG 3rd. Preparing a dialysis patient[J]. Semin Vasc Surg[J], 2024, 37(4): 364-368.
8. Suominen V, Heikkinen M, Keski-Nisula L, et al. Preoperative physical examination for primary vascular access--reliability in determining vessel quality. Acta Chir Belg[J], 2006, 106(5): 554-559.
9. Corvino F, D’Antuono F, Giurazza F, et al. Complications of tunneled central venous catheter placement: a narrative review of risks, prevention, and management strategies[J]. Front Radiol, 2025, 5: 1684246.
10. Chlorogiannis DD, Bousi SE, Zachiotis M, et al. Pre-operative ultrasound mapping before arteriovenous fistula formation: an updated systematic review and meta-analysis[J]. J Nephrol, 2024, 37(2): 281-292.
11. 中國醫院協會血液凈化中心分會血管通路工作組. 中國血液透析用血管通路專家共識(第 2 版)[J]. 中國血液凈化, 2019, 18(6): 365-381.
12. Cavero-Redondo I, Saz-Lara A, Bizzozero-Peroni B, et al. Accuracy of the 6-minute walk test for assessing functional capacity in patients with heart failure with preserved ejection fraction and other chronic cardiac pathologies: results of the ExIC-FEp trial and a meta-analysis[J]. Sports Med Open, 2024, 10(1): 74.
13. 吳鴻泉, 吳正規, 周永, 等. 費曼學習法在耳鼻咽喉頭頸外科進修醫師培養中應用的探討[J]. 右江民族醫學院學報, 2022, 44(3): 459-462.
14. 望云, 周秀秀, 施曉雷, 等. 基于費曼學習法在放射科住院醫師規范化培訓 CT 三維圖像后處理教學模式的探索[J]. 影像研究與醫學應用, 2026, 10(8): 185-187.
15. 易東曄, 姜曉兵, 趙沃華, 等. 費曼學習法在神經外科腰椎穿刺術實踐教學中的應用[J]. 中國臨床神經外科雜志, 2025, 30(12): 755-758.
16. Ge WL, Zhu XY, Lin JB, et al. Critical thinking and clinical skills by problem-based learning educational methods: an umbrella systematic review[J]. BMC Med Educ, 2025, 25(1): 455.
17. Thistlethwaite JE, Davies D, Ekeocha S, et al. The effectiveness of case-based learning in health professional education. A BEME systematic review: BEME guide No. 23[J]. Med Teach, 2012, 34(6): e421-e444.
18. Wu F, Wang T, Yin D, et al. Application of case-based learning in psychology teaching: a meta-analysis[J]. BMC Med Educ, 2023, 23(1): 609.
19. Donkin R, Yule H, Fyfe T. Online case-based learning in medical education: a scoping review[J]. BMC Med Educ, 2023, 23(1): 564.
20. 中華醫學會腎臟病學分會專家組. 透析通路中國指南(2024 年版)[J]. 中華腎臟病雜志, 2024, 40(12): 990-1070.
21. Lok CE, Huber TS, Lee T, et al. KDOQI clinical practice guideline for vascular access: 2019 update[J]. Am J Kidney Dis, 2020, 75(Suppl 2): S1-S164.
22. Tricard T, Pan J, Song Q, et al. Validation of the Objective Structured assessment of Technical Skill (OSATS) in China[J]. J Surg Educ, 2025, 82(1): 103304.
23. Hopmans CJ, den Hoed PT, van der Laan L, et al. Assessment of surgery residents’ operative skills in the operating theater using a modified Objective Structured Assessment of Technical Skills (OSATS): a prospective multicenter study[J]. Surgery, 2014, 156(5): 1078-1088.
24. Bari V. Direct observation of procedural skills in radiology[J]. AJR Am J Roentgenol, 2010, 195(1): W14-W18.
25. Siau K, Crossley J, Dunckley P, et al. Direct observation of procedural skills (DOPS) assessment in diagnostic gastroscopy: nationwide evidence of validity and competency development during training[J]. Surg Endosc, 2020, 34(1): 105-114.

West China Medical Journal

Exploration of clinical teaching mode for arteriovenous fistula based on competence-based medical education

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