Dr. Natalia Noemí Salcedo is a Cardiologist at the Private Center for Respiratory Medicine of Paraná (CPMR), in Argentina. She concluded the Second Practicum Script course in Cardiology, launched in June in collaboration with the Argentine Federation of Cardiology. Her results? Almost 60% of coincidental hypotheses and more than 85% of scenarios. Before joining the CPMR team, she worked at the Rubén Darío Medical Center and the Caseros Model Sanatorium, both in Buenos Aires. For Dr. Salcedo, the cases presented in the course are similar to those in her medical practice, and "most cases have differential diagnoses that are often not considered.”
Madrid, August 30, 2019. From the 30 cases that you worked on during the course, have you seen a direct connection between the simulation and your clinical practice? Tell us about the context of your health care practice.
Yes, there is a correlation since the cases presented [in the course] are common in medical practice. Most scenarios have differential diagnoses that are often not considered.
We often refer to the community of Practicum Script users as a club of clinical thinkers. What advantages do you see in improving clinical reasoning and correcting cognitive failures?
Exercises with differential diagnoses from a semiological perspective are essential. Complementary tests have to refute or confirm a suspected diagnosis and should not be used in the first place to “see what can be found.”
Traditional models of medical education reinforce the concept of infallibility, but learning from error is perhaps the most basic lesson of all. Is err without consequences useful in medical training?
Errors during training have a different burden than those occurring after graduation. A diagnostic error can be fatal, although sometimes you have time to correct it. I think that doctors should commit the least amount of errors possible and the only way to achieve this is with knowledge.
What is the value of a virtual athenaeum like Practicum Script as a continuous professional development tool?
It is very important.
Would you recommend the course to a colleague? Which resource has been most useful? Would you change anything? Do you have anything to add?
Yes, I would recommend it. What helped me the most was the possibility to succeed in some of the answers and the reason for that. I found the system confusing, and I ultimately did not know what the correct diagnosis was, which is also important. It would be good if it continued with all differential diagnoses and if it discriminated well those “subcases” arising from the main one.
Editorial Note: Practicum Script addresses clinical uncertainty and highlights this aspect.