Clinical competence in family medicine residents; an approach towards its evaluation. Multicenter design

Abstract

Introduction: In Mexico, this inquiry to the best of our knowledge represents the first multicenter work that studies the degree of development of clinical aptitude in four Family Medicine Units of the Health Sector. Therefore, the research question is : What is the degree of development of clinical aptitude in three health institutions? This study will provide knowledge that will allow undertaking researches in which educational strategies that propitiate the development of this aptitude are tested.

Objective: To determine the degree of development of clinical aptitude in family medicine residents from four academic sites.

Method: Prospective, cross-sectional, observational and multicenter design. The entire enrollment of the 2019-2020 academic year was studied with informed consent. An instrument was constructed that assessed the variable “clinical aptitude” by means of eight indicators and 182 items; conceptual, content and reliability validity was assessed by five family physicians with teaching and educational research experience.

Results: Of the four sites, the highest overall scores on the indicators were achieved by the R1 of the Family Medicine Unit # 20 of the Mexican Social Security Institute (UMF20 IMSS), R2 and R3 of the General Zone Hospital # 1 (HGZMF1 IMSS). UMF20 R1s achieved the highest scores on 3/8 indicators. The R2s and R3s of HGZMF1 achieved the highest scores on 2/8 indicators. Differences were estimated between R1s (n = 46), between R2s (n = 47) and between R3s (n = 40) of the four sites by indicator and no significant statistical differences were found in any case.

Conclusions: The degree of development of clinical aptitude can be considered medium level in the four academic sites. This can be partly explained by the fact that the instrument explored problematic clinical situations, which required the resident to reflect critically on his previous clinical experience.