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Once you graduate, you only rarely become in contact again with multiple authorities in Cardiology

DR. CÉSAR GEOVANNY PALOMEQUE MONTALVO

Cardiologist in charge of his own clinic in Río Grande, Tierra del Fuego (Argentina)

“I am a clinical cardiologist from Ecuador, and I live and work in the city of Río Grande, a province in Tierra del Fuego, Argentina. In regards to my professional practice, I share a cardiology center with a partner, where we perform ambulatory care." This is a brief self-description by Dr. César Geovanny Palomeque Montalvo. He is 40 years old and talks about experience as the ability to capture "subtle details that allow us to analyze new cases in a more agile way." That is what Practicum Script is: experience acquired through simulation.

Madrid - October 16, 2018. What benefits does Practicum Script offer for continuous training of specialists like you?
The Practicum Script course represents a very useful tool since once you graduate, you will only rarely be in direct contact again with multiple authorities in cardiology or able to compare your opinions with those of others with respect to the cases presented.

Is more simulation equal to greater confidence in the decision-making process before the patient?
The simulated cases allow us to analyze the actions to be taken from a theoretical point of view, while constantly exercising our critical judgment.

To what extent would medical error rates reduce with clinical reasoning training and an expansion of differential diagnoses?
Constant mental training with simulated cases allows us to keep our clinical reasoning abilities fresh, reducing considerably potential errors.

You concluded the course with a coincidental rate of 83% in hypotheses and 91% in scenarios. Is questioning a healthy habit?
During the course, I felt a need to read again and refresh certain topics. Being able to contrast opinions is very helpful to gain different perspectives on the same subject.

How do you approach dilemmatic situations without categorical evidence?
When not enough evidence is available for decision making, it is certainly up to each person to decide what could be helpful for the patient, with as much suggestion as possible from other colleagues.

Is there such a thing as a clinical eye, or is it just accumulated experience?
The clinical eye is the skill developed through experience. With the volume of patients and cases that a person is exposed to during his professional life, he captures subtle details that grant him more agility to analyze new cases.

To what extent does medical judgment play a role in regards to patients who do not follow the clinical guidelines?
The guidelines are based on analyses of large studies carried out with groups of patients with specific characteristics. Therefore, they help in profiling criteria, but decision making is established with human patients and all their nuances.

You know that the cases are real. Do you observe a correspondence between your daily practice and the simulation exercise?
The vast majority of the cases presented, in one way or another, have similarities with patients seen in daily practice. Right now, I cannot remember a specific case that resembles any of the scenarios presented in the course.

How is your work environment and the type of patients that you see? How does PS fit into their care practice?
I am a clinical cardiologist, and I work in outpatient clinics. I live in an industrial city that has a young population and very cold weather most of the year, which is why most patients are sedentary, smokers, and dyslipidemic. The tool that I mostly have had to strengthen since moving here has been to keep myself updated with the primary and secondary prevention guidelines.

Prevention is the main pillar to control cardiovascular disease. Is the training to recognize patterns and clinical thinking skills equally essential?
Permanent training is our best tool to offer to our patients all the help that they expect and need.

 

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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