Dr. Evelyn Vanina Re is a graduate from the Universidad de Rosario and a clinical cardiologist registered for the past two years in the province of Santa Fe, Argentina. She practices her specialty in both the public and private sectors. She is an on-call physician at the coronary unit of the Sanatorio Británico and Hospital Provincial de Santa Fe and is part of the medical team, also as an on-call physician, of the Centro Gallego de Buenos Aires. "Uncertainty, in her opinion, is what leads a professional to train more rigorously.”
Madrid, August 24, 2018. What has your experience with Practicum Script brought to you?
It has provided me with reasoning skills for real clinical cases and situations of dilemma that sometimes arise in daily practice. The reasoning of different differential diagnoses along with the wide range of therapeutic options that we have available today is a very useful tool to improve the quality of our care.
Do you think it is right to reject the single response format and not avoid controversy?
He who knows, doubts. The more you learn in your daily exercise, the greater the range of possibilities to suspect and rule out. Uncertainty is what leads a professional to train more rigorously.
What type of cases do you prefer?
In general, I like cases of ischemic heart disease, which is the most frequent pathology in the clinic and in the hospital, along with heart failure. On average, answering a complete case takes me about 20 minutes.
Practicum Script is conceived as an athenaeum or club of clinical thinkers...
The forum with colleagues is an interesting exchange space where we can open our perspective to many different ones. And that makes you grow as a professional; it is enriching to be able to listen to another opinion and understand that an approach can be made from different points of view.
Have you observed any change in your diagnostic approach since you started using the simulator?
Yes, this exercise makes us reason and propose different differential diagnoses or perform an internal brainstorm before taking any decision. And this will always improve our patients’ care.
Perhaps you are aware of a recent research from Stanford showing that more than 50% of the physicians suffer from burnout. Can the implementation of clinical reasoning reduce stress rates?
Yes, our main strength – and the one we can use to defend our position in different clinical scenarios – is knowledge. Knowledge provides us security, and a professional who works with conviction is surely a less stressed professional.
We know that in the US, medical error is the third cause of death. Are you aware of the figures in your country? To what extent can training with tools such as PS be helpful?
I am not aware of the percentage of deaths caused by medical malpractice in our country, but it is certainly high. The world needs physicians of high quality, both professionally and humanely, and I believe this platform enriches us in both ways.
How would you define the type of patients that you see?
I practice my specialty in different sectors, both public and private. Consequently, I see some patients with high socioeconomic status and others with fewer resources and more humble. To our good fortune, I can say that in my country, access to health care is free and universal. Likewise, we have professionals of excellent quality in different areas and patients who use public hospitals and have access to sophisticated diagnostic techniques and costly treatments paid by the state, which integrates and offers equal opportunities to these patients. This is only seen in a few countries worldwide, and we are proud that it is so.
Our hospitals are "teaching hospitals," in which professionals train from the start on real patients and with prestigious teaching professionals who provide the tools to allow future physicians to function autonomously in their practices. However, I believe that the training of a health care professional lasts a lifetime. Therefore, training tools such as Practicum Script strengthen us in all possible aspects.
What differences do you observe between health care practice in the public compared with the private sector?
As I mentioned earlier, patients’ access to care, both in clinics and hospitals, is the same in our country. The difference may lie in medical supplies, which are sometimes scarcer in the public sector.
Your generation has grown up in a globalized environment. What do you think about Practicum Script’s international vocation?
PS is an international platform that I love, since one can talk with a colleague in another country, with probably different practice experiences. We can become aware of different opinions depending on each one’s reality. PS is a reasoning platform that is unique and very useful for all of us professionals who have the fine opportunity of using it and finding a completely different and very valuable way of training. Thank you for allowing me to be part of it.
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