Aprenentatge basat en problemes en l'ensenyament de la semiologia mèdica

Experiència d'aplicació de la metodologia de l'aprenentatge basat en problemes (ABP) en l'ensenyament de la semiologia mèdica en alumnes de segon de medicin

¿Evaluamos correctamente la competencia en comunicación clínica?

Comunicarse con el paciente en la práctica clínica hace referencia a la forma en que el médico y el paciente se relacionan mediante el lenguaje verbal y no verbal con el objeto de alcanzar una comprensión compartida de problemas y soluciones. El gran reto es determinar cómo evaluar el grado de adquisición de competencias en comunicación clínica. Los autores del presente trabajo proponen una evaluación sumativa de las competencias en comunicación clínica basado en la combinación de diferentes métodos. Se destaca la importancia de la evaluación formativa mediante feed-back. Se plantea la necesidad de desarrollar y validar escalas de evaluación en comunicación clínica en el ámbito de pre-grad

¿Evaluamos correctamente la competencia en comunicación clínica?

Comunicarse con el paciente en la práctica clínica hace referencia a la forma en que el médico y el paciente se relacionan mediante el lenguaje verbal y no verbal con el objeto de alcanzar una comprensión compartida de problemas y soluciones. El gran reto es determinar cómo evaluar el grado de adquisición de competencias en comunicación clínica. Los autores del presente trabajo proponen una evaluación sumativa de las competencias en comunicación clínica basado en la combinación de diferentes métodos. Se destaca la importancia de la evaluación formativa mediante feed-back. Se plantea la necesidad de desarrollar y validar escalas de evaluación en comunicación clínica en el ámbito de pre-grad

Learning Clinical Communication

Problem statement: Clinician-patient communication is a basic skill that medical students should learn as part of their training process. Communication skills curriculums aim to develop effective communication with patients, carers, and colleagues by working on both verbal and non-verbal skills. These include being able to take a history and share information, and particularly explaining procedures and discussing treatment options and their effects. Students taking the Communication, interview and clinical history module are asked to follow a simulated-patient clinical interview, which is recorded and then self and tutor- assessed using standardized questionnaires. Purpose of study: The aim of this study is to conduct a pilot test to compare questionnaire results for self and tutor-assessed video-recorded clinical interviews. Methods: The results of students’ self-assessment questionnaires within the Communication, interview and clinical history module (second year of the medical degree) were compared with those of their tutors. The questionnaire used was a shortened version of the 17-itemCICCA-D (Conectar-Identificar-Comprender-Acordar-Ayudar – Connect-Identify-Understand-Agree- Help) instrument (score of 2, 1 or 0 for each item), based on patient-centred interviews. The assessments were carried out independently from one another, with no previous training, after watching the clinical interview video recording. Results: A total of 47 student and tutor assessments were carried out. Differences in the global average scores were statistically significant (p-value < 0.05). The students’ mean self-assessment score was 13 (SD = 5), while the tutors’ was 15 (SD = 5). A weak direct and statistically significant correlation was observed in the global questionnaire score between both self and tutor assessment (n = 47): with an ICC of 0.41 (confidence interval [CI] 95%, (0.09 – 0.66). Conclusions: Pilot test results show that tutors consider students having better communication skills than students themselves. Lack of previous training in the use of the questionnaire could be relevant. Further research is needed to confirm these preliminary result

Characterisation of four novel fibrillin-1 (FBN1) mutations in Marfan syndrome.

Forty-four percent of the fibrillin-1 gene (FBN1) from 19 unrelated families with Marfan syndrome was screened for putative mutations by single strand conformational polymorphism (SSCP) analysis. Four novel mutations were identified and characterised in five people, three with classical Marfan syndrome (two from one family, and one from an unrelated family), one with a more severe phenotype, and one with neonatal Marfan syndrome. The base substitutions G2113A, G2132A, T3163G, and G3458A result in amino acid substitutions A705T, C711Y, C1055G, and C1152Y, respectively. C711Y, C1055G, and C1152Y lead to replacement of a cysteine by another amino acid; the latter two occur within epidermal growth factor-like motifs in exon 25 and 27, respectively. The A705T mutation occurs at exon 16 adjacent to the GT splice site. The A705T and C711Y mutations, at exon 16 and 17, respectively, are the first documented in the second transforming growth factor-beta 1 binding protein-like motif of FBN1