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It helps us to be self-critical and up-to-date, and to anticipate future actions

DR. PAOLA COURTADE

Clinical cardiologist at the Ventura Lloveras Hospital in San Juan (Argentina)

"I work as a clinical cardiologist at the Ventura Lloveras Hospital, a center in the suburbs of San Juan, and I am also employed at Cimac, a private clinic where I practice in the areas of sports, smoking cessation, and stress test." This is the professional profile of the Argentine physician Paola Courtade. She informs us that in addition to having done a postgraduate course in sports medicine and cardiovascular rehabilitation, she is the head of Semiology practices at the Catholic University of Cuyo. She also integrates several FAC committees and carries out cardiovascular prevention campaigns, which led her to win an award from the Medifé Foundation in 2013. That same year, together with FAC and its then-president, Dr. D'Ovidio, she authored a paper on ventricular myxoma in a young woman with recurrent stroke.

Madrid, February 8, 2018. Last year, you were a very active member of the campaign “Conocé tus números” (Know your numbers). What are the rates of hypertension in Argentina and surrounding regions? Which initiatives work in preventing this disorder?

The National Registry of Hypertension (RENATA2) has reported a prevalence of hypertension of 36.3% in Argentina. It also showed that 38.8% of the patients with hypertension were unaware of their disease and that only 24.2% were well controlled.

The campaign “Conocé tus números,” proposed by the Inter-American Heart Association, evaluated a random sample of 150 participants in a peripheral area of San Juan province and determined that 12% of the patients had uncontrolled hypertension (including some with a known diagnosis [of the disease] and others who were newly diagnosed). Also, 34% of this population was overweight and 4% had obesity.

With these results, we started working in prevention [of diseases] such as diabetes, promotion of physical exercise (with the “Sarmiento en Movimiento,” a campaign with more than 500 participants and a striking success), and nutrition, among others.

How can a tool like Practicum Script help you face this reality?

Practicum Script presents several clinical cases related to primary and secondary prevention [of] hypertension and its complications. In many cases, this tool reflects the reality of my daily clinical practice and is useful to expand my knowledge and improve my care of patients.

We often refer to the community of Practicum Script users as a club of clinical thinkers. What advantages do you notice in improving clinical reasoning and correcting cognitive failures?

In my opinion, by evaluating each clinical case and thinking about different diagnostic hypotheses or possible treatments, we broaden our observation of the case in particular. It also helps us to be self-critical and up-to-date, improve reasoning skills, rethink our responses, and anticipate future actions.

Given your teaching experience, what value do you give to the possibility of learning from error without any consequence? Do residents and specialists benefit equally from this virtual athenaeum? 

The controlled simulation offered by Practicum Script is very valuable. The tool includes real cases, some of which are common in daily practice. This supports our decisions and allows us to compare our criteria with those of the experts. In cases that are less common, we can recollect what we have learned. I believe that both residents and specialists benefit [from this tool] because it prioritizes different cases at different stages and according to each subspecialty. During residency, the training is more focused on urgent care. In my case, in particular, I see patients in my office and work with clinical cardiology, and the simulated cases keep me updated. 

In the 30 cases that you have worked on, you must have seen a direct connection between the simulation and your clinical practice… 

Many of the 30 simulation cases were similar to cases that I see in daily practice. To mention one of them, I would choose the one of an asymptomatic 45-year-old female athlete without cardiovascular risk factors who during a stress test done as part of a check-up presented an ST-segment depression during exercise. The differential diagnoses proposed for the test included coronary artery disease, muscular bridge, anomalous coronary origin, hypertrophic cardiomyopathy, and a false positive stress test. Since I usually perform stress tests in my practice and see athletes, this case caught my attention and broadened my vision and reasoning toward other diagnoses that I often not take into account. 

Would you recommend the course to a colleague? Which resource has been most useful? Would you change anything?
I have broadly recommended the course to my colleagues. The opportunity to reason about different hypotheses and the coincidence [of my hypotheses] with those of the experts have been very useful to me, along with the bibliography endorsing each positioning. I think it is very well done, and the only thing that I would have liked to see is the final conclusion: what the patient really had and how he was treated or actually progressed.

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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