Family Physician Training and the Development of the Clinical Aptitude

José Alberto García Mangas; Leonardo Viniegra Velázquez

2004, Number 4

<< Back Next >>

Rev Med Inst Mex Seguro Soc 2004; 42 (4)

Family Physician Training and the Development of the Clinical Aptitude

García MJA, Viniegra VL

Full text

How to cite this article

Language: Spanish
References: 15
Page: 309-318
PDF size: 143.72 Kb.

ABSTRACT

Objective: to evaluate the development —over time— of the clinical aptitude of family medicine residents through a longitudinal design comparing the same group of students in two situations; at the beginning of the first year (July, 1999) and at the end of the third year (January 2002). Material and methods: the population was studied by means of a census of first-year family medicine residents (1999) and evaluation at the end of the third year (2002). To evaluate clinical aptitude, 12 real clinical cases of frequent health problems in the practice of the family physician were used; the instrument was validated in a previous study. Results: in global analysis when comparing mean obtained by residents according to academic degree, we could observe that clinical aptitude is very similar. When applying t test, means showed statistically significant differences, p ‹ 0.001. In global comparison by cases, no significant difference was found. In global analysis of indicators, no significant statistical difference was found. Most residents showed a superficial aptitude (68.8 79.6 %), 29.2 versus 14.1 % a very superficial aptitude, and 2.0 versus 6.3 %, an intermediate aptitude. Conclusions: when comparing means of the same group at the beginning (1999) and at the end (2002) of the educational process 145.7 versus 161.4, advancement of approximately 10 % of 412 in favor of the third year is considered clearly inadequate from clinical perspective and education. The experience expressed in the years of practice during residency seems to influence very little the development of the clinical aptitude, even though significant statistical differences exist.

REFERENCES
1. Freire P. Pedagogía del oprimido. México: Siglo XXI; 1970. p. 70-96.
2. Hernández RG. Paradigmas de la psicología educativa. México: Instituto Latinoamericano de la Comunica-ción Educativa; 1991. p. 73-90.
3. De-Vega M. Introducción a la psicología cognitiva. Madrid, España: Alianza; 1998. p. 493-510.
4. Viniegra VL. Hacia otra concepción del currículo. México: Instituto Mexicano del Seguro Social; 1999. p. 13-23.
5. Lifshitz A. Tendencias de la educación médica. Gac Med Mex 1997;133:25-33.
6. Viniegra L. La crítica: aptitud olvidada por la educa-ción. México: Instituto Mexicano del Seguro Social; 2000. p. 1-26.
7. Viniegra L, Jiménez JL, Pérez-Padilla JR. El desafío de la evaluación de la competencia clínica. Rev Invest Clin 1991;43:87-98.
8. Carrillo FLMR. Iatrogenias. En: La responsabilidad profesional del médico. Porrúa; 1998. p. 9-34.
9. Donabedian A. La calidad de la atención médica. Definición y métodos de evaluación. México: Prensa Médica Mexicana; 1991. p. 3-37.
Viniegra VL, et al. Tendencias iatrogénicas como indicador de competencia clínica en cursos de especialización en medicina. Rev Invest Clin 1989; 41:185-190.
García MJA, Viniegra VL. Evaluación de la aptitud clínica en residentes de medicina familiar. Rev Med IMSS 2003;41(6):487-494.
Narro RJ. La educación médica en México. Univer-sidad de México. Revista de la Universidad Nacional Autónoma de México 1992;47:12-15.
Lifshitz A. Heurística y decisiones clínicas. Gac Med Mex 1999;134: 323-326
Bravo TR, Campos AC. Medicina basada en pruebas (Evindence-based Medicine). JANO 1997;53:71-72.
Viniegra VL. Materiales para una crítica de la educación. México: Instituto Mexicano del Seguro Social; 1999. p. 105-145.