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While reasoning, I ask myself questions related to the differential diagnoses

DR. ESTEBAN RENGEL

Cardiologist at Magna Grupo Médico in Tucumán (Argentina)

Dr. Esteban Rengel has been a specialist in Cardiology for 11 years and sees patients at Magna Grupo Médico in Tucumán, where hemodynamics and non-invasive studies are available. In addition, he is an on-call physician at a coronary unit in an interior city in his province, offering therapy with thrombolysis and temporary pacemaker. Halfway between private and public care, he considers Practicum Script to "be a very valuable update tool for physicians dedicated to health care."

Madrid – August 22, 2018. What are the advantages of the Practicum Script course for your training and practice as a specialist?
In my particular case, the greatest advantage is that the model of learning through real clinical cases allows me to incorporate and reinforce knowledge acquired in the natural environment of my competence, i.e., my practice and the coronary unit.

Does the presentation of real clinical cases with some degree of uncertainty reinforce the safety of decision making before the patient?
Certainly. I am convinced that the way to learn and incorporate decisions in my clinical practice is through real cases. The cases presented cover the entire range of possible cardiological care, thus reinforcing cases that I see on a daily basis, and I learn from new situations that may arise.

What is the average time that you take to solve each clinical case? Can you mention a case that has been of special interest to you?
Each case takes me about half an hour. Of course, when the case is in my area of interest, it may take less time (ischemic heart disease, for example); arrhythmia is challenging for me and takes me longer because I read the entire accompanying bibliography.

Of all the assets that we offer during the course, which is the most interesting as a learning resource?
The consultation with the tutor and the forum with colleagues are the most useful tools for me, without any doubt.

Do you think that training in clinical reasoning improves patient care? Have you noticed any change in your way of reasoning about a diagnosis?
Yes. I consider that this reasoning training has improved my care for the patients because, while reasoning, I ask myself questions related to differential diagnoses, which I learned with this course.

What can be done to reduce medical error, which is currently the third cause of hospital death in the US? To what extent can training with tools such as PS be helpful?
Medical error is inherent in our daily practice. We are fallible beings. We can’t know everything, but in turn, because we are physicians, we are required to be in permanent training. This tool helps us in a vital way to train from where we are only through access to an online platform. 

Could you tell me about the specific context of your clinical practice and assess the use of PS within this context?
In my case, I have the whole spectrum of possible patients. On the one hand, being a physician in a coronary unit of a public hospital, I see patients of low social status for whom the coronary unit of the hospital is the only access to a cardiologist. My use of Practicum Script is very helpful during the admission of these patients and to provide the best possible care for them, while I adapt to the limitations of my environment.

On the other hand, in my private practice, I am still associated to my cardiology training center, which allows me to participate in the patient’s entire diagnostic and therapeutic process, putting into practice the knowledge that I learned with the simulator.

Finally, I must emphasize that for physicians with a specialty like mine, fully devoted to the health care task, it is difficult to receive training in person, which is why I greatly value the possibility of training with virtual courses like Practicum Script.

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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