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Even though I am a Family Physician, I also treat infants, and the course has helped me with diagnostic decisions

DR. VERÓNICA P. MURILLO PERALTA

Family Physician at Centro San Marcos (Ecuador)

Dr. Verónica P. Murillo Peralta is a 36-year-old Family Physician with a degree in Health Management and Pediatric Emergency. She was born in the port city of Guayaquil, in Ecuador, and currently works at Centro San Marcos in a deprived area of the province of Santa Elena. For more than 15 years, she has been associated with the "noble specialty of Pediatrics," as she describes her care practice, and subject to an unstable climate and a poor population. Mothers (in the area) have an average of nine children, and the environmental demands are high. "The Practicum Script course of Pediatrics has been challenging, but I have certainly learned a lot," she says.

Madrid, November 8, 2018. Even though you took the Pediatrics course, you are a Family Physician. To what extent has this immersion been useful for you?

To enter the world of Pediatrics having a medical specialty in Community Health focused on Primary Care is not easy. It entails a number of expectations regarding clinical diagnoses in children, as opposed to adults. It requires a lot of diligence and meticulousness when giving a diagnosis because not everything that is written in books occurs on a daily basis. The Practicum platform has helped me enormously in terms of discerning a diagnosis clearly to hit the target and project evidence and treatments accordingly. Even though I am a Family Physician, I also treat infants, and the course has helped me with diagnostic decisions. I have learned a lot about this noble specialty.

Could you mention a concrete example in which you have applied what you have learned with this simulation tool?

The area where I work is still a rural one. It lacks the whole range of specialties, and Family Physicians are in charge of seeing all the pathologies that affect the community. That is why Family Physicians must constantly be up to date: to provide a comprehensive and adapted service with quality and warmth. The simulator is focused on differential diagnoses and, thanks to becoming able to recognize certain clues, I have accurately diagnosed diseases like lymphoblastic leukemia, thrombocytopenic purpura, neonatal hypothyroidism, and pediatric tuberculosis, among other pathologies; this has allowed me to refer the patients to successful treatments.

Would you recommend the experience to other specialists in Family Medicine who, in their care practice, also manage pediatric patients?

I would certainly recommend Practicum Script. The simulator trains us to make better decisions in terms of clinical diagnosis and treatment. In my professional field, with the patients that I see on a daily basis, it has led me to think better and transfer what I learned with the simulator to my daily practice. The clinical cases are perfectly interwoven with real ones, and that makes Practicum a very relevant tool to help us stay up to date and recall clinical scenarios and ways to approach (them).

How is your work environment and what type of patients do you see? Could you assess the use of Practicum Script in terms of this context?

I am a specialist in family health, and I work at the private medical center San Marcos. The area in which I have lived and worked for 18 years is a rural region with a highly variable climate and a population of medium to low socioeconomic level. The poor education (of the population) leads to families with mothers with 6 to 12 children, while fathers are dedicated to fishing. These conditions increase overpopulation, overcrowding, and malnutrition. What happens is that children are the most vulnerable part of the population pyramid. Respiratory and digestive pathologies, parasitoses, and malnutrition converge.

We promote health every day, carrying out educational talks, quarterly vitamin and deworming campaigns, dental checkups, prophylactic measures, fluoride applications, evaluation of elderly individuals with catastrophic illnesses, and many others. This is how we manage the 365 days of the year: working with and for the community. In these and other tasks, Practicum Script is a learning network that is reliable and close to real issues.

Hurry, fatigue, and lack of knowledge are among the most common causes of medical errors, but what about flaws in the reasoning process?

Most doctors err in thinking that the little or much they know about medicine should suffice, when in reality, knowledge should be applied with a self-assessment of competencies and a search for alternatives for medical updates that help us improve clinical reasoning and decrease errors in decision making.

In a globalized and digitalized world, it is often said that “it is not about asking what one knows, but about what one does with that knowledge.”

Clinical reasoning skills are shaped with experience gathered along years and from being in direct contact with the patient by performing a thorough history taking. One thing is to know, and another is to apply that knowledge. Being somewhat self-taught, reading daily, experimenting with simulated cases, and staying up to date on medical issues makes us more precise with regard to decision making. Specifically, Practicum Script is a platform that has helped me distinguish better how to diagnose clinically (different) pathologies and to obtain better results in the treatments that I recommend.

 

Testimonies

For me, the program is very interesting, since it allows me to sharpen my interrogation and direct it more towards a specific pathology and to have more knowledge of laboratory and cabinet exams. I think it is very important that we keep our medical sagacity throughout our practice and that in the few minutes it takes to answer any of the cases that Practicum Script presents, you acquire more knowledge.

Dr. Miguel Olivares Alcocer

Pediatrician in Guanajuato (Mexico)

I would like to express my gratitude to the Practicum Institute of Health Sciences Research for the opportunity given to Latin American physicians  to access and take different courses of our specialty for the benefit of our dear patients, in my case in Mexico. It has encouraged me to improve myself and keep abreast of the advances in Pediatrics and put into practice the knowledge acquired in the hospital where I work. Thanks friends and congratulations to this valuable team of Practicum Script Education.

Dr. Heriberto Fuentes García

Pediatrician in Sonora (Mexico)

I am grateful for this study tool that, through Nestlé and with this method, allows us to review different issues with cases that confront us in decision-making and serve us in the daily consultation.

Dr. Josué Refugio de León Padilla

Pediatrician in Jalisco (Mexico)

It is an excellent educational support platform for the pediatrician, offers very specific clinical challenges with alternatives for diagnosis and differential diagnoses, with the support of experts, a bibliography and a forum to share opinions. It's easy to navigate and it's fun, a tool that's worth using and making the most of it.

Dr. Guillermo Yanowsky-Reyes

Surgery Pediatrician in Guadalajara (Mexico)
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