Dr. Juan José García García is currently the chief of pediatrics at Hospital Sant Joan de Déu in Barcelona, one of the most important highly specialized children's hospitals in Europe. He is also the president of the Spanish Society of Hospital Pediatrics and an Associate Professor at the University of Barcelona.
Residents in pediatrics at Hospital Sant Joan de Déu are using the Practicum Script clinical reasoning training program, thanks to an academic agreement with the Practicum Foundation: What do you think this tool can contribute to their training?
One of the most useful aspects of the program is that it can show them (the residents) their strong points and especially their weak points. When they try to resolve a case and realize that there are a series of concepts that are not crystal clear to them, it can guide their learning because they can focus on the areas that they need to improve. Furthermore, since the cases are so true to life, I think that the program can help them learn to make better decisions.
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I think the most important difference is how closely the cases resemble true life—the cases are presented to students in the same way as in daily practice. In fact, first a clinical history is introduced, and then the student must make a decision. Depending on how the student has responded, diverse possibilities can be presented progressively. I think this is a clear differential aspect.
The simulator incorporates up to 300 different clinical situations based on real clinical histories without clear-cut solutions. To what extent do you think residents could benefit from dealing with cases in which there can be more than one valid solution for the same patient?
The truth is, it is a bit shocking for them at first. They are used to multiple choice type situations, where there is only one correct answer. In Practicum Script, however, when these cases are presented, they find themselves in situations that are much closer to real life, where absolute truths often just don’t exist, where there are different approaches to the same patient, and all of them can be valid. So I really think that this has a very positive effect on the student’s learning.
"It’s something much closer to real life, where absolute truths often just don’t exist "
Another thing that makes the Practicum Script program different is that it combines scientific evidence with expert opinion. What do you think about the feedback that participants receive?
I believe it is fundamental. Sadly, the evidence we have in medicine is limited—although it increases throughout the years, we are often swimming in murky waters where there is no absolute truth. For this reason, expert opinion is fundamental—first of all, because the experts know all the scientific evidence about a particular topic, and they also know when there is not enough solid evidence to support one viewpoint or another. That’s why they are able to give us a valid opinion about how to proceed based on their prior knowledge and experience. So this is an absolutely crucial point.
Apart from residents, would you recommend Practicum Script courses to other colleagues?
I think all physicians can benefit from these courses, no matter how long they have been practicing. The courses will help some physicians in a particular way and others in other ways. I think that the course can be very useful for more experienced physicians too, because daily practice does not end up making you an expert in everything, no matter how many years you have been in the field.
More information: Academic agreement between the Practicum Foundation and Hospital Sant Joan de Déu
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