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We will always deal with uncertainty in our clinical practice, and decisions may not always be correct

DR. VÍCTOR EDUARDO VALLEJO GARCIA

Resident of Cardiology at the University Assistance Complex of Salamanca

Dr. Víctor Eduardo Vallejo is Honduran by birth, has a Medical degree from the University of Navarra (Spain), and has been nominated to a Medical Graduation Outstanding Award. Currently, he is a third-year resident of Cardiology at the University Assistance Complex of Salamanca (Spain), with a special interest in the field of Hemodynamics and Cardiac Imaging. He also holds a master's degree in Cardiovascular Critical Care from the CEU Cardenal Herrera University and another postgraduate degree in Thromboembolic Diseases from the University of Alcalá. His research is focused on Cardiotoxicity and Cardiac Imaging, and he is currently working on his doctoral thesis.

Have you found these 30 cases of Practicum Script useful in your field of work as a resident?

I think that the Practicum Script cases are very useful since they are similar to those cases that we see daily in our practice, hospital, or during calls. They allow us to review comprehensive and updated topics in Cardiology, emphasizing diagnostic and therapeutic methods, and detecting areas for improvement in our professional training, while still having fun. The opportunity to ask questions to experts and discuss with colleagues is also a plus.

Debate and controversy are the basis of our approach. How do you deal with dilemmatic situations?

When I face a situation that is complicated or requires discussion, I like to listen to all available opinions and compare them with what I have studied and experienced until reaching a decision. I think discussions are very healthy and necessary for professional training and also in life. As scientists, we should not believe in something "just because" or do things the way they have always been done. We must consider hypotheses, compare them, study, discuss, and learn from our colleagues. Sometimes you learn more from a good discussion or from listening to experts than from articles in high-impact journals.

Uncertainty is inherent to human nature. Is it difficult to let go the format of single correct answer so much in demand during medical school and residency?

I remember that one of my senior residents always told me that uncertainty is something we will always deal with in our clinical practice and the decisions we make (even those following the ESC guidelines) may not always be correct. I sometimes still have a hard time accepting that we don't always have the right answer for our patients' health problems. We have a lot to study and learn throughout life.

The theory of meaningful learning is based on the fact that students already have knowledge and emphasizes the importance of building conceptual networks. Do you consider Practicum Script effective in this task?

Practicum Script is effective in this task since it presupposes a broad Cardiology knowledge base and presents situations with patients in which we have to gather very different concepts and skills to reach a solution. In the same case, we need to have knowledge of clinical, imaging, hemodynamics, and functional tests and know how to use them for that particular patient. I think this is very important since it allows us to integrate what we learned and use it for concrete solutions, which is what we have to do with our patients, sometimes with very little time during an emergency.

You are a young professional. Why do you think a curriculum that does not contemplate seeing patients until the final stage is still maintained? What does controlled simulation bring to these real patients?

I think you are referring to the medical curriculum. In this case, I think there are notable differences between various Spanish universities. It is very important to see patients or resolve cases in controlled simulations. In my case, since the third [year] of medical school, I’ve been seeing patients at different rotations organized by the University of Navarra and as an intern in Cardiology for three years. This is different in other universities, and the knowledge that is acquired is eminently theoretical until you see the first patients in your first emergency call, which is a strong contrast. Controlled simulation allows you to learn and make mistakes in an environment that is not harmful to the patient. You can see your strengths and weaknesses, detect areas of improvement, analyze how you respond to stressful situations, and (the best thing), you can do all this without any consequence to the patient. If airplane pilots can use controlled simulations, why can't we?

We live in a globalized world. What is the value of programs of continuous professional development?

These programs can be a great help for continuous training of different professionals, especially in developing countries. Practicum Script has comprehensive and updated topics in Cardiology, with practical application to the patients that we see daily. The fact that we are able to participate in these programs from anywhere in the world allows us to always stay up-to-date with clinical practice guidelines and with the experience of colleagues in healthcare settings different from ours.

 

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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