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Abstract

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Purpose of Program:

Since its inception in 2005, the Kidney Research Scientist Core Education and National Training Platform (KRESCENT) core curriculum has undergone regular review and evolution to ensure it continues to meet trainee needs within their current research milieus. In 2021, the KRESCENT 2.0 Health Research Training Program (HRTP) was funded through the pilot Canadian Institutes of Health Research (CIHR) HRTP program. This program report describes the formal evaluation and redesign process of the KRESCENT curriculum subsequently undertaken by a small pan-Canadian team over a period of two years, leading to the establishment of the current KRESCENT 2.0 curriculum.

Sources of information:

KRESCENT archived curriculum-related documents, including de-identified trainee reviews, reports and meeting minutes; equity, diversity, and inclusion (EDI) documents, including consultancy agreements, accountability reviews, proposals and contracts, and other related files. Other resources included websites, journal articles and the Raising Interdisciplinary Scientist Excellence Learning Management System (RISE-LMS) online training platform.

Methods:

Meeting minutes, consultancy, and curriculum-related documents were reviewed. Clarification of the process was provided through interviews with the senior KRESCENT consultant Dr Adeera Levin, past KRESCENT director Dr R. Todd Alexander, curriculum chair Dr Sunny Hartwig, members of the Patient Community Advisory Network (PCAN), and KRESCENT program manager Ms Julie Wysocki via in-person and virtual meetings as well as email correspondence.

Key Findings:

The KRESCENT 2.0 curriculum represents a three-year process of evaluation, consultation, and redesign led by the KRESCENT executive team. Administrative, logistical, and strategic support was provided by the Kidney Foundation of Canada (KFoC). Vital insights and guidance in the curriculum reshaping process were provided by a dedicated pan-Canadian working group of 10 scientists and educators spanning multiple disciplines and jurisdictions. Curricular elements to be introduced, retained, discarded, or revitalized were identified by clear consensus in each instance. Key recommendations from EDI consultants Mr Ike Okofur and Ms Nadia McLaren led to the development of a summer undergraduate studentship program to support Black and Indigenous scholars interested in nephrology research. Consultation with existing KRESCENT patient partners led to the formalization of their contributions through the establishment of PCAN. The PCAN team was appointed a role in administering the KRESCENT 2.0 core curriculum to reinforce the importance of understanding and leveraging the lived experience of patients and their caregivers in all aspects of kidney health research.

Limitations:

KRESCENT is an established three-year kidney training program for a small cohort of trainees. The biannual intensive small group workshop has been the core training milieu of the KRESCENT curriculum since program inception. Multiple training priorities in the core curriculum include pedagogical lectures in nephrology, professional skill development, non-academic career paths, cultural competency, sex and gender in research, community-building, honouring the lived experience, mentorship, wellness, knowledge translation, and interdisciplinary collaboration. This program report may therefore not generalize to new training programs, those with large group cohorts, or those with different priority areas.

Implications:

This program report may provide valuable guidance for other HRTPs seeking to establish or revitalize a training curriculum in a small group training milieu.

Keywords

Kidney Research Scientist Core Education National Training Program (KRESCENT)research capacity-building core curriculum Patient Community Advisory Network (PCAN)equity diversity and inclusion (EDI) principles

Introduction

The mission of the KRESCENT. Program is to build kidney research capacity in Canada. KRESCENT supports career development of outstanding young Canadian kidney researchers at the doctoral (PhD) and post-doctoral fellowship (PDF) levels, as well as in the new investigator (NI) period of a trainee’s first faculty appointment.^1-3 The vision of KRESCENT is daring boldly to reinvent the future of kidney health research training . To this end, KRESCENT seeks to provide essential professional skills training and learning opportunities that are not available in any other form or location through a unique three-year kidney-focused national core curriculum. Trainees are immersed in an intensive small group learning environment at biannual workshops that include a variety of small group exercises as well as didactic lectures and professional development sessions led by Canadian senior scientists. The core curriculum is designed to be complementary to core course work/degree programs in research design methodology and other core content areas that are available at a trainee’s home institution. The curriculum is also designed to complement local development of the trainee’s specific research project(s), either independently (in the case of NI awardees), or in conjunction with the local research supervisor (in the case of undergraduate, PhD or post-doctoral fellow awardees) at a trainee’s home institution.

The KRESCENT core curriculum is delivered through three educational formats:

In-person formal core lecture series, delivered at twice-yearly workshops (Spring and Fall).

Asynchronous web-based exercises (eg, sex and gender in health research, cultural competency training).

Individual and group assignments throughout the year (eg, grant proposals, manuscript submissions, transdisciplinary narrative reviews, Canadian Journal of Kidney Health and Disease [CJKHD] manuscript peer review) with in-person workshop integration (eg, oral presentations, mock grant review panel, and journal club).

Curriculum components are intended to:

Cultivate a collaborative, patient-centered and translational national community of kidney researchers to ensure knowledge translation from fundamental discovery to improved outcomes of Canadians living with kidney disease.

Cultivate equity, diversity, and inclusion (EDI), cultural competency and cultural humility, mental well-being and work-life balance, and a greater appreciation of the patient voice and lived experience.

Provide mentorship, professional skills training, and career coaching

Together, the aims, content and delivery format of the KRESCENT core curriculum are intended to foster a culture of scholarship, collaboration, and culturally-aware, inclusive leadership.

2017-2018 KRESCENT Curriculum Revamp

For the past 20 years, feedback from trainees, invited speakers and other workshop participants has been collected biannually, after each workshop (de-identified and collected by a third party not involved in running the program). Feedback has dynamically driven curricular evolution since program inception. This has been a crucial safeguard, ensuring KRESCENT best serves trainee needs within a rapidly evolving research climate and larger dynamic cultural milieu. Periodic formal curriculum evaluations have also been performed. The first formal review conducted from 2017 to 2018 was led by the incoming director and curriculum chair. Ms Lis Fowler, Kidney Foundation of Canada (KFoC) national director at the time, and Ms Chantal Boucher, KFoC administrative assistant, both provided indispensable strategic and logistical support.

As an initial step of the review, the curriculum chair conducted phone interviews with current and past trainees who responded to the invitation to provide feedback on the core curriculum. During interviews, 60 current and former KRESCENT trainees (out of a total of 65 awardees) shared their personal experiences while in KRESCENT as well as the perceived value of KRESCENT training in their professional lives. Interviewees discussed (i) what curricular elements had been helpful or unhelpful and why and (ii) what additional curricular elements would have been helpful and why. KRESCENT graduates who had continued in academia also discussed elements of their training experience in KRESCENT that in hindsight had been particularly helpful for them in navigating their early career path. Vital insights arising from this interview process led to the 2018 KRESCENT Mission and Values statements (Table 1), and a corresponding major reshaping of the curriculum. In addition to retiring some curriculum exercises and updating others, major changes were made to the curriculum to prioritize trainee mental health and well-being, patient-oriented research (POR), leveraging lived experience, and advancing cultural competence.

Table 1.

2018 KRESCENT Mission and Value Statements.

Mission	To encourage and support early career kidney research scientists and trainees in multiple disciplines, who will reinvent the future of kidney health research in Canada. We will do so by facilitating collaboration between and across disciplines, fostering the next generation of leaders, and by honoring both equity and diversity.
Values	1. People: It is from and through people that hypotheses are generated, tested and refuted or upheld. At the core of our values is the respect for others, including the diversity of Canadians and our Indigenous peoples.
	2. Integrity: Conclusions drawn from scientific research inform clinical decision-making, public policy and individual life choices. It is therefore paramount that the methodology employed, means of collecting data and dissemination of data occurs with the highest integrity. This includes ensuring all work performed, including negative studies is deposited in the scientific literature.
	3. Collaboration: We appreciate that we all have something to contribute to research into kidney health and disease. We all appreciate that we are not experts in all areas of kidney health and disease. We therefore acknowledge and embrace the opportunity to collaborate with other experts in and across our field of research.
	4. Community: Kidney science does not occur in a vacuum. Central to this are the societies and organizations, which raise funds for and communicate the knowledge generated by ourselves the researchers. For this community to function optimally everyone must contribute their part. This includes a commitment to quality peer review (both grants and papers), the dissemination of information to scientific, lay and clinical audiences and the participation of members in meetings of the societies.
	5. Excellence: We are committed to life-long learning and innovation. Our work aims to contribute the highest quality experiments thereby promoting kidney health through excellence in research.

2022-2024 Curriculum Review

In 2021, the Canadian Institutes of Health Research (CIHR) launched its pilot Health Research Training Platform (HRTP) program. Under the leadership of then KRESCENT director, Dr R. Alexander, the KRESCENT 2.0 HRTP application was awarded a six-year grant to ensure continuation of this capacity building program in Canada.⁴ Following the notification of this award in 2022, KRESCENT initiated a second formal evaluation and redesign of the core curriculum, resulting in the KRESCENT 2.0 core curriculum. Led by the KRESCENT curriculum chair, director and senior consultant, a small pan-Canadian working group representing multiple disciplines and jurisdictions in the kidney research community was assembled. In tandem, KRESCENT hired equity consultants Mr Ike Okafor and Ms Nadia MacLaren, of Bridge to Corporate Social Responsibility (B-CSR) Consultancy, representing Black, Indigenous, and People of Colour (BIPOC) communities. B-CSR performed an environmental scan of the entire KRESCENT program from application process to curriculum, and in their report provided concrete recommendations to increase the number of Black and Indigenous kidney researchers in Canada (Supplemental File 1). Also in 2022, KRESCENT organized a patient partner summit. At this meeting, existing patient partnership within the KRESCENT curriculum was formalized through establishment of the Patient Community Advisory Network (PCAN) with five founding members: Ms Nancy Verdin, Ms Tania Woodlock, Ms Anne MacPhee, Ms Mary Beaucage, and Dr Sunny Hartwig (chair). The newly formed PCAN team was tasked with providing curriculum recommendations to prioritize POR, including suggestions for new didactic sessions on POR, and incorporation of POR into training exercises.

In summary, formal curriculum recommendations for updating the KRESCENT 1.0 curriculum into KRESCENT 2.0 came from the curriculum working group, B-CSR consultation and PCAN over a two-year period between 2022 and 2023 (Table 2). A KRESCENT leadership retreat was held in 2023 to discuss recommendations and to finalize the curriculum. Although it is founded upon the original KRESCENT curriculum (ie, KRESCENT 1.0) and faithful to its mission and values,^2,3 the new KRESCENT 2.0 core curriculum described in this program report, rolled out over a span of two years (2024-2025), nevertheless incorporates significant changes in curriculum format and delivery.¹

Table 2.

Comparison of KRESCENT 1.0 and 2.0 Program Elements.

Note. CIHR = Canadian Institutes of Health Research; CJKHD = Canadian Journal of Kidney Health and Disease; NI = new investigator; PDF = post-doctoral fellow; POR = patient-oriented research; RISE-LMS = Raising Interdisciplinary Scientist Excellence Learning Management System; TDR = transdisciplinary research challenge.

Sources of Information and Methods

KRESCENT archived curriculum documents spanning 20 years (including de-identified trainee reviews, reports, meeting minutes, and workshop programs), working group documents (including meeting minutes, break out group summaries, and recommendations), and EDI documents (including consultancy agreements, accountability reviews, proposals, and contracts) were reviewed for this program report. Other resources included websites, journal articles and the RISE-LMS online training platform. Both during and after the review of all curriculum-related documents, clarification of the curriculum evaluation and revamp process was provided through interviews with the curriculum chair, members of PCAN, and the KFoC program manager, via in-person and virtual meetings as well as email correspondence.

Key Findings

Curriculum Revamp Workflow

Priority areas to be addressed in the remodeled KRESCENT 2.0 curriculum that were previously identified during the HRTP application process⁴ included:

Recruitment of Black and Indigenous kidney researchers.

Greater incorporation of POR across CIHR themes.

Increased training on incorporating sex and gender into research.

Exposure to novel techniques that can be used to understand kidney health and disease (eg, machine learning, omics, pragmatic randomized control trials, and n-of-1 trials).

Increased attention to trainee mental health.

Industry partnerships and mentorship in non-academic career paths.

Updating workshop exercises.

Many of these priority areas were straightforward to address through increased emphasis of existing curricular elements in the workshops themselves (items three to six). In the sections below, we highlight additions to the curriculum to create new opportunities for Black and Indigenous kidney researchers, greater patient involvement in the curriculum, enhancing mental health and wellness, as well as changes to workshop exercises deemed “make-work” projects by the revamp committee (summarized in Table 3).

Table 3.

Priority Areas and Actionable Items for the KRESCENT 2.0 Curriculum.

Priority area	General description	Actionable item(s)
1. Recruitment of Black and Indigenous scholars	Increased support for research that supports the kidney health and care of Black and Indigenous communitiesIncreased recruitment of Black and Indigenous kidney researchers	Establish a targeted KRESCENT fellowship to support a trainee doing research supporting kidney health and care in Black and Indigenous communities in CanadaLaunch a summer studentship program to support kidney research opportunities for Black and Indigenous students
2. Greater incorporation of POR across the CIHR themes	Integrate patient partners into research programsDeeper integration of the lived experience voice into the curriculumCreate a patient/mentor program for traineesEstablish novel relationships with hospitals and volunteers	Establishment of the KRESCENT PCAN teamIncreasing participation of PCAN beyond patient stories at workshops toward practical mentorship in improved lay communication (mentorship in writing lay abstracts led by PCAN, and willingness to provide one-on-one mentorship for interested trainees)PCAN members participate in the TDR exercise with trainees and share co-authorship on the resulting manuscript
3. Increased training on sex and gender in health research	Enhanced training in sex and gender within curriculumAddressing gender equityGoing beyond traditional sex and gender; incorporation of non-binaryOpportunities to link with interest groups and content experts	Additional mandatory online modules for sex and gender trainingIn-person didactic lectures on sex and gender training incorporated into KRESCENT core curriculumEstablishing a dedicated KRESCENT fellowship seat for sex and gender kidney researchHighlighting online training modules available on the RISE-LMS platformFor example, women in transplantation
4. Exposure to novel techniques	Incorporate didactic training in novel techniques into the curriculumInvolve experts in unique novel techniques to participate in workshops and online modules^a Add elective component into curriculum for specialized techniquesProvide funding for trainees to travel and learn new techniques	In-person didactic lectures with a focus on cutting-edge techniques in kidney researchAll invited speakers are tasked with highlighting innovations in their field as part of their lectureHighlighting online training modules available on the RISE-LMS platform
5. Increased attention to trainee mental health	Increased emphasis on trainee well-being	Greater investment of health and wellness modules in KRESCENT workshops (eg nature as medicine, forest bathing, mindfulness, group outings to art galleries, and didactic lectures)Invited speakers tasked with sharing ways they have navigated overall well-being during their careerHighlighting online training modules available on the RISE-LMS platform and other resources (eg KidneyLink)
6. Industry partnerships and mentorship in non-academic career paths	Greater exposure to non-academic career pathways	Guidance on alternate career pathways incorporated into KRESCENT curriculumHelping trainees connect with mentors within industryConnect with KRESCENT alumni who chose a non-academic pathway

Note. CIHR = Canadian Institutes of Health Research; KRESCENT = Kidney Research Scientist Core Education and National Training; NPA = nominated principal applicant; PA = principal applicant; PCAN = patient council advisory network; POR = patient-oriented research; RISE-LMS = Raising Interdisciplinary Scientist Excellence Learning Management System; TDR = transdisciplinary research challenge.

Prioritization of inviting Canadian content experts (vs international speakers) to participate in KRESCENT workshops provides important networking opportunities for trainees with senior Canadian researchers in a small group setting.

Creation of Opportunities for Black and Indigenous Kidney Researchers

A targeted initiative of KRESCENT 2.0 was to increase Black and Indigenous representation in kidney research by supporting training for Black and Indigenous scholars. In addition, KRESCENT seeks to increase support for research on racialized groups disproportionately affected by kidney disease.^5-11

Recognizing that disparities in access to academic exposure and research experience affect Black and Indigenous students long before post-doctoral training, KRESCENT retained EDI consultants Mr Ike Okafor and Ms Nadia McLaren, who represent these communities, to rigorously scrutinize the existing KRESCENT curriculum and advise how to support students identifying as Black or Indigenous who are interested in pursuing kidney research. Recommendations from their report fell into three main categories: (1) communication, nomenclature, and language/terminology (eg, applications and trainee feedback surveys); (2) policies (including trainee selection criteria, mentorship models, research supervisory, and trainee expectations); and (3) cultural humility and relationship building (Table 4). A Black Health Equity expert, Ms Lydia-Joi Marshall, was subsequently retained as an ongoing consultant for KRESCENT to ensure continued operational safety of the program for Black scholars. Responsibilities of the Black Health Equity expert are highlighted in Table 5. In-person anti-Black racism training was formally introduced to the KRESCENT 2.0 core curriculum in 2024 as a result.

Table 4.

EDI Consultancy Recommendations.

Surveys
Suggestion	Rationale
Adjust question regarding raceRemove the term “visible minority”	Visible minority is an outdated term
Add question on self-identifying race
Add question on socioeconomic status and country of birth	To ensure equality and fairness in the recruitment processTo statistically monitor the demographics of KRESCENT applicants
Trainee selection process
Suggestion	Rationale
Incorporate Black and Indigenous community members into the selection process. Include Elders, knowledge keepers, professors, and educators. Compensate fairly	To encourage equity in the selection process to provide an EDI lens in decision-making.
	To involve communities most affected by kidney disease, yet least represented in medical establishments to the health care systemMembers of Black and Indigenous communities can adequately view and value experiences of candidates which may otherwise go unrecognized
KRESCENT website
Suggestion	Rationale
Add multiple statements about EDI on KRESCENT website including EDI principles in the program, and the aim to increase the number of Black and Indigenous community scholars in kidney research	To demonstrate willingness to include Black and Indigenous communities in kidney science and researchTo revolutionize EDI principles into health care for a greater degree of health and wellness for underserved populations
Cultural safety
Suggestion	Rationale
Support for applicants Childminding offeringsFlexibility for BIPOC community holidays and responsibilitiesCommunity engagement Building and strengthening pathways between KRESCENT members and Indigenous communitiesCreation of a network and resource list of health-focused Indigenous and Black organizationsCreation of a network for Indigenous Elders and knowledge keepersEstablish an Indigenous councilElder engagement Incorporate Elders as staff in the KFoC underKRESCENTTrain staff on Elder protocolsHire Indigenous Elders through relationships and connections	Offers support to trainees who are parents of young childrenTo encourage community strengthening and celebrationsPromote security and validation for members of Black and Indigenous communitiesTo encourage further participation from Indigenous communities: “one of our own” peopleTo strengthen Indigenous community healthcare supportTo move beyond cultural competency into cultural fluencyTo discourage formal job postings; relational hire more significant and important for Black and Indigenous communities
Mentorship
Suggestion	Rationale
Recruit Indigenous and Black mentors	Mentors provide a layer of protection and sense of belonging to the traineesBlack and Indigenous mentors will bring a unique lens through which to appreciate lived experiences
New awards
Suggestion	Rationale
A new award for Black and Indigenous trainees with a drive for innovationBlack and Indigenous trainees must still be eligible for applying for other awards within the KRESCENT program	With a high prevalence of KD in Black and Indigenous communities, researchers representing underserved communities can help drive innovation and change within the healthcare system
Policies
Suggestion	Rationale
Incorporate a statement of commitment regarding truth and reconciliationCompose the statement under the guidance of Indigenous Elders and community leadersIncorporate an anti-Black racism statement	To ensure progress toward peace and reconciliation with Indigenous peoplesIndigenous reconciliation and anti-Black racism are crucial components to the KRESCENT programTo reduce racial disparities in health researchTo acknowledge and contest against systemic racism against Blacks embedded in society to treat all with respect and dignity

Note. EDI = equity, diversity, and inclusion; KD = kidney disease; KFoC = Kidney Foundation of Canada; KRESCENT = Kidney Research Scientist Core Education and National Training program.

Table 5.

Roles and Responsibilities of Black Health Equity Champion.

Description	Purpose
Engage potential Black and Indigenous applicants in an equitable manner with a Black mentor outside of the KRESCENT program	To provide Black and Indigenous applicants the opportunity to connect with a Black (female) mentor for the program
Support current trainees and mentors through workshops and discussions regarding cultural safety and inclusion	To ensure KRESCENT mentors provide an inclusive and safe environment for incoming Black and Indigenous scholars
Create educational resources on anti-Black racism in kidney care in the core curriculum (eg, create Black Health Awareness module)	To prevent racial bias within program documentation; to educate potential mentors on challenges Black and Indigenous communities experience in health care settings
Build relationships with Black KRESCENT trainees and summer students	To facilitate thriving and provide community support and safety for Black students with their mentors and peers
Ongoing program support and resource recommendations	To ensure program documentation and curriculum elements are presented in a fair, equitable, and open manner to Black and Indigenous communities

Summer Studentship Program

A major outcome of anti-racism consultancy was the creation of the KRESCENT Summer Studentship award for outstanding undergraduate students or medical students who identify as Black or Indigenous (Supplemental File 2). The program is incentivized through a competitive student salary ($750/week for up to 16 weeks) to complete a summer student research position in an approved Canadian kidney research laboratory (Table 6). KRESCENT also provides stipend support to supervisors who are selected by the program. Barriers preventing students from applying were identified via consultation with the EDI champion and anti-racism consultants. These barriers were reduced within the application process. Research projects are carried out in-lab over a period of 12 to 16 weeks in Canada under the supervision of a kidney researcher who has undergone anti-Black racism training.

Table 6.

KRESCENT Summer Studentship.

Description	Purpose
Black and Indigenous undergraduate students engage in research in a culturally safe and supported environment	To promote Black and Indigenous scholars in undergraduate degrees to explore kidney researchTo increase and support Black and Indigenous representation in kidney research
Supervisors are required by KRESCENT to complete cultural safety and sensitivity trainingNetworking opportunities with other summer students during the summerMentorship meetings with KRESCENT curriculum chair and Black equity consultant during the summer	Ensure a culturally safe environment for traineesCommunity-building and networkingTrack research progress and address any trainee concerns
Laboratory research projects are conducted for 12 to 16 weeks at a competitive summer salary of $750/week	Goal of producing a unit of research that contributes to a publication or presentation
Students present their research project at the fall KRESCENT workshop and receive feedback from KRESCENT curriculum chair	Cultivate oral and written scientific communication skills, exposure to in the academic milieu
Students submit abstracts to the annual meeting of the Canadian Society of Nephrology	Cultivate oral and written scientific communication skills, exposure to in the academic milieu

Opportunities for networking with fellow students in the program are provided via a moderated online platform (discussed below). In addition to the local supervisor, mentorship is provided by the KRESCENT curriculum chair and the equity consultant. Ongoing communication between the KRESCENT chair, equity consultant, trainees, and supervisors throughout the summer ensures a culturally safe environment for trainees, as well as tracking of research progress. Key research findings are presented at the following fall KRESCENT workshop, allowing for formalized experience-building exercises. To provide further opportunities for networking and exposure to the academic milieu, trainees are encouraged to submit abstracts to the Canadian Society of Nephrology (CSN) annual meeting. Since its inception in 2024, three Black medical students and three fourth-year Black undergraduate students have participated in the summer studentship to date, and three trainees have presented posters at the CSN annual meeting. No person identifying as Indigenous has yet applied.

Feedback from trainees has been singularly positive. KRESCENT is currently seeking to increase the number of mentors to better support outstanding scholars from racialized communities in accessing kidney research opportunities across Canada. The foremost metric of success of the summer studentship is defined by trainee satisfaction with their research experience, rather than an expression of intent to pursue further kidney research opportunities.

Increased Emphasis on Patient-Oriented Research

Over the past decade, patient engagement in research has emerged as a vital strategy to improve the quality, relevance, and impact of health research, leading to improved kidney care and outcomes.¹² Notwithstanding, for many researchers, there remains limited understanding of how to meaningfully engage with patients in the research milieu. In 2016, the Canadian kidney research community established a national POR network to overcome barriers to patient engagement, Canadians Seeking Solutions and innovations to overcome chronic kidney disease (Can-SOLVE CKD), which puts patients at the center of kidney health research.¹³

Building on this foundation, the first POR modules were introduced to KRESCENT in 2017. Patient partners were invited to share their lived experience stories at workshops, thereby embedding lived experience as an essential dimension of scientific development. Over the past eight years, KRESCENT has continued to expand patient partnership in kidney research, pioneering the inclusion of patient partners as co-educators, leaders, and mentors in kidney research training. This evolution reflects reciprocal learning: trainees gain early exposure to patient-centered perspectives, cultivate their oral and written communications for diverse audiences, and increase their confidence in engaging patients in research. In tandem, patient partners develop mentorship skills and confidence in shaping research directions.

In 2022, formal integration of patient partners as mentors and leaders was achieved through the creation of PCAN, a team comprised patients, caregivers, and organ donors. Patient Community Advisory Network members attend biannual workshops and educate trainees on the lived experience of kidney disease. They provide hands-on mentorship for trainees in lay abstract writing for grant applications and manuscripts. PCAN members are compensated hourly and receive an annual honorarium. All conference travel expenses are covered. PCAN mentorship has raised the overall quality and relevance of KRESCENT, positioning trainees for maximum success by increasing the likelihood that their research will result in meaningful change for patients.

Mental Health and Wellness

The COVID-19 pandemic had a disastrous and sustained effect on mental health and wellness, globally. Health care professionals in particular were severely impacted by increased workplace demands, and stress associated with increased health risks to their own lives and of their families during this time.¹⁴ In response to trainee feedback, mental health and wellness sessions were formalized into the KRESCENT curriculum in 2020, to help trainees cultivate well-being best practices. Didactic and interactive workshop modules included mindfulness, breath work, nature as medicine, and forest bathing (Table 3). Once in-person workshops resumed in late 2022, group outings were formalized into the KRESCENT 2.0 curriculum, including excursions to art galleries and other places of cultural interest at the completion of each workshop.

Raising Interdisciplinary Scientist Excellence Learning Management System Platform

The online virtual training hub Raising Interdisciplinary Scientist Excellence Learning Management System (RISE-LMS) platform was launched in 2022. RISE-LMS represents more than 2 years of collaboration between multiple HRTPs, spearheaded by Dr Susan Samuel, director of the Empowering Next-Generation Researchers in Perinatal and Child Health (ENRICH) HRTP, and administered through the SickKids Hospital Research Institute. Raising Interdisciplinary Scientist Excellence Learning Management System is a centralized, open-source training platform repository for the sharing of learning tools between HRTPs, allowing trainees across multiple health research disciplines to access to a plethora of common learning resources (eg, Indigenous cultural safety training, sex, and gender certificate training module). As part of the CIHR HRTP program mandate, all individual funded training bodies, to varying degrees, contribute to the RISE-LMS platform. Trainees from any HRTP can log into RISE and access these common training modules on their own time (asynchronous learning).

RISE-LMS also provides infrastructure support for curriculum delivery for multiple HRTPs. The KRESCENT program manager was instrumental in transitioning KRESCENT 2.0 curriculum administration to RISE-LMS over a period of two years. KRESCENT trainees now access mandatory modules asynchronously on RISE-LMS, such as San’yas Indigenous cultural safety and First Nations principles of Ownership, Control, Assess, and Possession (OCAP^®) certificate training modules. San’yas training is an introductory course for health care professionals seeking to enhance their knowledge, awareness, and skills when working with Indigenous people. This module explores the history of colonization and specific ways individuals can combat anti-Indigenous racism in the health care system; OCAP^® training provides guidance for clinicians and researchers seeking to utilize patient data from First Nations communities. Upon completion, certificates for these and other assignments are uploaded onto the server, enabling curriculum deliverables to be tracked. RISE-LMS also serves as a user-friendly centralized submission portal for trainee curriculum vitae (CVs), CIHR individual development plans (IDPs), progress reports, travel reimbursements, and other program-specific documents. With the steady increase in the number and complexity of CIHR requirements for continued funding of KRESCENT 2.0, RISE-LMS infrastructure support has been operationally essential for program administration and delivery.

Reimagining Existing Training Elements: Transdisciplinary Research Challenge and Mock Manuscript Exercises

The transdisciplinary research challenge (TDR) is designed to help first-year KRESCENT trainees collaborate with each other and to learn to approach research from an interdisciplinary mindset. In small groups of four to six, trainees work with members of PCAN to write a narrative review on a major issue in kidney disease and health (eg, hemodialysis and nephrotic syndrome) that includes at least three of the four CIHR themes: (1) biomedical research, (2) clinical research, (3) health services research, and (4) social, cultural, environmental, and population health research (https://cihr-irsc.gc.ca/e/53146.html).¹⁵ The review articles are intended to inform research strategies, develop priority areas of interest, and provide innovative, transdisciplinary solutions for the problem at hand. KRESCENT mentors provide internal peer review of the manuscript prior to submission to CJKHD. TDR manuscripts are supported through the publication process with a publication waiver. Trainees therefore produce a publication as a tangible outcome metric and CV line item as part of this exercise. To date, trainees have published 13 TDR articles in CJKHD.

The curriculum revamp process identified several issues with the existing TDR format. Because the TDR topic was predetermined by the annual theme for each workshop, an unequal share of the workload typically fell on 1 trainee whose area of expertise coincided with the annual workshop theme. This generally made the TDR a costly “make-work” project for 1 trainee, and an easy publication for the rest of the trainees involved in the exercise. Another related concern was that the publication conferred greater value to trainees whose content expertise aligned with the topic area. Other issues with the TDR related to time-management and varying work ethics amongst group members. The KRESCENT 2.0 TDR has since been modified to address trainee concerns. Increased guidance is provided throughout the exercise timelines, with monthly check-ins by the curriculum chair to the team, to ensure equitable workload distribution and timely deadline adherence. Importantly, trainees are now free to choose any topic in nephrology. Based on trainee feedback (2023-2024), this change has led to a fairer workload distribution amongst participating trainees, and has increased the perceived value of the TDR exercise (Table 3).

Historically, trainees have submitted a manuscript for mock peer review. This mock manuscript exercise from the original KRESCENT curriculum was intended to provide mentorship in manuscript writing and valuable peer review feedback. A key logistical issue with this exercise related to timing: trainees were at different stages of their research at the time of the mock manuscript submission deadline. Consequently, the quality of submissions varied tremendously, limiting the benefit of peer review for most manuscripts. There was strong consensus in the curriculum committee to eliminate this exercise and instead replace it with a journal club exercise. Specific comments relating to the mock manuscript exercise are summarized in Table 3.

Discussion

This report documents updates to the KRESCENT core curriculum, based on initiatives introduced in the KRESCENT 2.0 HRTP grant,⁴ and priority areas identified by a pan-Canadian curriculum revamp committee (Figure 1). Priority areas enhanced in KRESCENT 2.0 include:

creating opportunities for Black and Indigenous kidney researchers,

greater incorporation of POR across CIHR pillars,

increased training in sex/gender,

exposure to novel techniques that can be used to understand kidney health and disease (eg, machine learning, omics, pragmatic randomized control trials, and n-of-1 trials),

increased prioritization of mental health,

industry partnerships and mentorship in non-academic career paths, and

modifying the TDR and eliminating the manuscript exercise (summarized in Table 3).

Updates to the KRESCENT curriculum reflect these priority areas. New opportunities have been created to support training of outstanding Black and Indigenous students in kidney research through the Summer Studentship Program, now in its second year. PCAN has been established, providing mentorship in multiple trainee exercises at workshops. Invited speakers are now tasked with discussing how they have incorporated POR and sex and gender into their own research programs and are invited to provide didactic teaching on cutting-edge techniques or breakthroughs in their fields. Fireside chats center around work-life balance, navigating the common perils and pitfalls of academic life, and opportunities outside of the conventional academic career path. Dedicated workshop time has been allocated for wellness exercises, including nature therapy, rock climbing, ice skating, mindfulness practices, and other informal community-building excursions. In addition, experts in mental health have been invited to provide practical guidance on stress management and conflict resolution in the workplace.

Figure 1.

Overview of the KRESCENT core curriculum revamp process.

Limitations

KRESCENT is limited to the English language, with limited availability of French-speaking mentors. Our training program is also located within Canada, which may not be transferrable to similar mentorship-based training platforms in other countries.

Supplemental Material

sj-pdf-1-cjk-10.1177_20543581251411222 – Supplemental material for Revamping the KRESCENT Core Curriculum: The KRESCENT 2.0 Program Report

Supplemental material, sj-pdf-1-cjk-10.1177_20543581251411222 for Revamping the KRESCENT Core Curriculum: The KRESCENT 2.0 Program Report by Tarrah Wood, Veronica Kaye, Leanne Stalker, R. Todd Alexander, Adeera Levin and Sunny Hartwig in Canadian Journal of Kidney Health and Disease

Supplemental Material

sj-pdf-2-cjk-10.1177_20543581251411222 – Supplemental material for Revamping the KRESCENT Core Curriculum: The KRESCENT 2.0 Program Report

Supplemental material, sj-pdf-2-cjk-10.1177_20543581251411222 for Revamping the KRESCENT Core Curriculum: The KRESCENT 2.0 Program Report by Tarrah Wood, Veronica Kaye, Leanne Stalker, R. Todd Alexander, Adeera Levin and Sunny Hartwig in Canadian Journal of Kidney Health and Disease

Footnotes

Acknowledgements

The authors wish to thank Mr Ike Okafor and Ms Nadia McLaren, Bridge to Corporate Social Responsibility (B-CSR) specialists, for their assistance in reviewing the program to ensure equity. They also wish to thank Ms Lydia-Joi Marshall for her efforts in providing cultural support to black scholars for their summer studentship.

List of Abbreviations

BIPOC, Black, Indigenous, and People of Colour; EDI, equity, diversity, and inclusion; CIHR, Canadian Institutes of Health Research; CSN, Canadian Society of Nephrology; ECR, early career researcher; KD, kidney disease; KFoC, Kidney Foundation of Canada; KRESCENT, Kidney Research Scientist Core Education and National Training Curriculum; NI, new investigator; NPA, nominated principal applicant; PA, principal applicant; PCAN, Patient Community Advisory Network; POR, patient-oriented research; RISE-LMS, Raising Interdisciplinary Scientist Excellence Learning Management System; TDR, transdisciplinary research.

ORCID iDs

R. Todd Alexander

Sunny Hartwig

Ethics Approval and Consent to Participate

Not applicable.

Consent for Publication

Not applicable.

Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

Declaration of Conflicting Interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Supplemental Material

Supplemental material for this article is available online.

References

Todd Alexander

Hartwig

Burns

, et al. KRESCENT;2005–2025 – 20 years! Editorial. Can J Kidney Health Dis. 2025;12:356409.

Burns

Wolfs

Bélanger

, et al. The KRESCENT Program: an initiative to match supply and demand for kidney research in Canada. 2010;33:E356-E367.

Burns

Levin

Fowler

, et al. The KRESCENT program (2005-2015): an evaluation of the state of kidney research training in Canada. Can J Kidney Health Dis. 2017;4:693354.

Kaye

Wood

Klein

, et al. The KRESCENT 2.0 health research training platform application process: program report. Can J Kidney Health Dis. 2025;12:364309.

El-Dassouki

Wong

Toews

, et al. Barriers to accessing kidney transplantation among populations marginalized by race and ethnicity in Canada: a scoping review Part 1—Indigenous communities in Canada. Can J Kidney Health Dis. 2021;8:1996835.

Eneanya

Boulware

Tsai

, et al. Health inequities and the inappropriate use of race in nephrology. Nat Rev Nephrol. 2022;18(2):84-94.

Gill

Kaur

. Life on the line: prioritizing equity in kidney transplantation for populations marginalized by race and ethnicity. Can J Kidney Health Dis. 2025;12:331076.

Komenda

Lavallee

Ferguson

, et al. The prevalence of CKD in rural Canadian Indigenous peoples: results from the First Nations community based screening to Improve Kidney Health and Prevent Dialysis (FINISHED) Screen, Triage, and Treat Program. Am J Kidney Dis. 2016;68(4):582-590.

Promislow

Hemmelgarn

Rigatto

, et al. Young aboriginals are less likely to receive a renal transplant: a Canadian national study. 2013;14:11.

10.

Tonelli

Hemmelgarn

Kim

, et al. Association between residence location and likelihood of kidney transplantation in Aboriginal patients treated with dialysis in Canada. Kidney Int. 2006;70(5):924-930.

11.

Yeates

Cass

Sequist

, et al. Indigenous people in Australia, Canada, New Zealand and the United States are less likely to receive renal transplantation. Kidney Int. 2009;76(6):659-664.

12.

Scoles-Robertson

Jaure

. Patient involvement in nephrology research. Nat Rev Nephrol. 2025;21:718-719. doi:10.1038/s41581-025-00987-6.

13.

Levin

Adams

Barrett

, et al. Canadians seeking solutions and innovations to overcome chronic kidney disease (Can-SOLVE CKD): form and function. Can J Kidney Health Dis. 2018;5:7749530.

14.

Smallwood

Willis

. Mental health among healthcare workers during the COVID-19 pandemic. Respirology. 2021;26(11):1016-1017.

15.

Canadian Institutes of Health Research. What is health research? 2023. https://cihr-irsc.gc.ca/e/53146.html. Accessed July 10, 2024.

Supplementary Material

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