Iglesias is a cardiologist and fellow of the American College of Cardiology; he is the current academic director of Trinidad Mitre Hospital (Buenos Aires). He has served as the president of the Argentinean Cardiology Society and as the president of the Argentinean Cardiology Foundation. Since 2010, he has been a validating expert for Practicum Script cases.
How long have you been a member of Practicum Script’s Committee of Experts?
Since 2010. I have been working with this educational project for six years.
What motivates you to continue being an active member of this committee?
There are a lot of reasons, but first and foremost among many, I find it particularly motivating because it is different—it’s a permanent challenge, and other educational experiences just don’t provide that, and that’s the main factor that has kept me so motivated for this project.
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What can you tell us about your experience as a validating expert for Practicum Script cases?
I believe that it has been very important, basically because it is real life. In the encyclopedic education we have received, where information is so ephemeral, but that refers to all information, it seems to me that transferring it to clinical cases stimulates the development of clinical reasoning. I think this is the most important point that I have learned: how my clinical reasoning ability has grown.
What do you think are the benefits of our learning model for specialists and residents?
We practice medicine in society. Interestingly, when you consult a book, what you are really studying is “healthy” patients, whereas in real life, what you are dealing with is sick patients; in other words, they have other problems apart from the disease we are studying—kidney problems, lung problems, neurologic problems… and that’s what makes the program so interesting, so stimulating, and so educational… like real life. And often, as I said before, our encyclopedic learning doesn’t make us see the disease, but Practicum Script really presents a mixture of complicated problems, like in the real world we deal with every day.
That’s why it’s useful for cardiology residents and for specialists, because sometimes our reading doesn’t really help us to see or think of patients in their totality; this is one of the most important benefits of this approach to learning.
How do you feel when you make decisions in controversial situations in which you might not coincide with other members of the Committee of Experts?
These are real patients. It makes me feel like I feel when I’m on the ward. We discuss the case, and we all have our own viewpoints of the problem and have to reach a consensus on what is best for the patient. That’s what real life is like. It’s true that we are not always prepared for dissent, we are not prepared for discordance. But I think that as we mature, we come to appreciate that it is interesting to consider other points of view. So I feel like I do when I’m on rounds and someone else thinks differently than I do. I think that this is useful because it helps us to grow intellectually and in our principles. I think that this is also part of reaching maturity.
Do you think that this experience has been useful for you in your professional and academic life?
Yes, without a doubt. In the committee, I am reaffirming what was for me this intellectual development—it is so motivating to see different cases, different problems. I think it has been very useful, so tied in to what I do every day, and many cases have been applicable to my usual practice with patients.
Do you remember one case in particular that you found especially complicated to validate?
Actually, there are several. I remember one, not very long ago, with multiple coronary aneurysms. Look, I have been a cardiologist for more than thirty years, and I have seen a lot of unusual cases. This case got me wondering and nervous. Because I had never seen anything like these multiple aneurysms. After I had evaluated the case, I was motivated to go out and read, discuss, and analyze this condition that was so different. I mention this particular case probably because it was very recent. You always remember the last one, but there have been several that have opened my mind.
Is there anything you’d like to add?
First, that everyone that has worked on these cases has worked conscientiously. These cases are really well thought out. I have always felt the need to congratulate the authors, and I still feel that, because they have put a lot of effort into make these cases true to life. Really, all of the cases have been first class. I have never come across anything that deserved major criticism, and if I have had minor complaints in any case, I have brought them up and they have been fixed. I congratulate the whole system, because I think that this way of looking at medicine is very useful and so different from what we have gotten used to through the years.
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