Abstract

OLVERA ACEVEDO, Arturo; URIBE RAVELL, Jorge Augusto; ANGELES GARAY, Ulises  and  CARRILLO GONZALEZ, Ana Laura. Clinical skills after structured rounds compared with routine daily rounds in resident physicians. Investigación educ. médica [online]. 2015, vol.4, n.14, pp.81-87. ISSN 2007-5057.

Introduction and objective: Clinical skill is defined as the degree of mastering the identification of situations of variable complexity by the physician, as well as discrimination and choosing among alternatives of interpretation, action or decision. The medical round is the main educational activity in the training of physicians. The objective was to demonstrate the superiority of structured medical rounds on the development of clinical skills in Internal Medicine resident physicians compared with routine daily rounds. Method: This study was performed with Internal Medicine resident physicians, who were divided into 2 groups. Structured and problematized medical rounds were carried out by the residents of an experimental group, and routine daily medical rounds were carried out by the control group. At the end of the intervention, a validated questionnaire with 7 indicators of clinical skill was completed. The scale of clinical skill was estimated by the Perez Padilla and Viniegra test. For the comparison of the mean score for indicators between the 2 study groups, the Shapiro-Wilk normality, Student t and the Mann-Whitney U tests were used. Results: As regards the indicators of clinical skill, the mean value for indication of diagnostic aids was 11±0.82 for the control group, and 12.3±0.96, p=.094; for the experimental group; form diagnostic integration was 12.3±1.71 and 14.3±0.96, p=.087; for therapeutic actions 11.3±1.71 and 13.3±1.26, p=.62; for indication of invasive procedures 9.5±0.58 (median 9.5), and 10±1.41 (median 9.5), p=.75; for identification of risk factors 11.5±1.29 and 11±1.4, p=.336; for iatrogenic omission 7.5±1.29 and 11.3±1.71, p=.032; and for iatrogenic committing of an error 8.5±0.58 (median 8.5) and 11.8±0.96 (median11.5), p=.019; respectively. Conclusions: The structured and problematized medical rounds have a more positive effect on the development of clinical skills in Internal Medicine resident physicians for the care of systemic lupus erythematosus (SLE).

Keywords : Medical rounds; Medical education; Clinical skill.

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