Background: Although 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 toward urine microscopy among internal medicine residents and to implement virtual urine microscopy teaching sessions., Methods: A voluntary, anonymous, online survey was sent to all of the categorical internal medicine residents ( n =131) training at the Icahn School of Medicine at Mount Sinai (ISMMS). The survey included 13 questions to assess attitudes toward, 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 that incorporated real-time urine sediment analysis with nephrology fellows and attending nephrologists., Results: The survey response rate was 45% (59 of 131). Forty-seven percent (28 of 59) of respondents reported performing urine microscopy at least once during their training, and 75% (44 of 59) of respondents did not feel comfortable performing urine microscopy. The majority of residents (92%; 54 of 59) reported they felt urine microscopy was very helpful or somewhat helpful in the evaluation of patients with AKI. Overall, 41% 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, although 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 effect of these sessions on learning of urine microscopy., Podcast: This article contains a podcast at https://www.asn-online.org/media/podcast/K360/2021_01_28_KID0006282020.mp3., Competing Interests: S.S. Farouk reports other interests/relationships with American Journal of Kidney Diseases (editorial board), Clinical Transplantation (editorial board), and Journal of Nephrology (editorial board). M.A. Sparks reports honoraria from Elsevier-Nephrology Secrets and scientific advisor of or membership with the American Board of Internal Medicine (nephrology board), NephJC (board of directors), American Society of Nephrology (media and communications committee), American Journal of Kidney Diseases (editorial board), Kidney360 (editorial board), Kidney Medicine (editorial board), American Heart Association (Kidney & Cardiovascular Disease Membership and Communications Committee and Kidney & Cardiovascular Disease Scientific and Clinical Education Lifelong Learning Committee), and the National Kidney Foundation North Carolina (medical advisory board). All remaining authors have nothing to disclose., (Copyright © 2021 by the American Society of Nephrology.)