RESUMEN
Background: Teaching clinical reasoning is a challenge in medical education. Aim: To design a clinical reasoning assessment instrument. Material and Methods: Structured interviews were carried out to six physicians with at least five years experience. The Grounded Theory method was used to determine the relevant categories of the clinical reasoning process and the modified Delphi expert judgment method to validate the categories, the definition of observable behaviors and the format of the instrument. Results: The relevant reasoning categories were the reason for consultation, medical history, physical examination, additional tests, diagnosis, therapeutic options and reasoning reassessment capacity. Expert judgment assessed at a level of "strongly agree" and "agree" the sufficiency, clarity and pertinence of all categories, related observable behaviors and instrument format. The internal Kappa consistency yielded an index of 0.92. Conclusions: The resulting instrument was constructed with the following axes derived from the main categories and subcategories: reason for consultation, history, physical examination, additional tests, diagnosis, therapeutic options and reassessment capacity.
Asunto(s)
Humanos , Educación Médica , Toma de Decisiones Clínicas , Técnica Delphi , Investigación CualitativaRESUMEN
The use of educational videos is a valuable tool in preclinical dental training, as long as the pedagogical objectives match the appropriate learning stage. Accordingly, this teaching innovation suggests the realization of three types of didactic videos inserted in a specially designed pedagogical methodology for the preclinical cycle. After half a semester of use, quantitative results yielded a positive perception in relation to the promotion of evaluation criteria and conflictual tone development. On the other hand, perception of negotiation promotion and reaching consensus was divided into positive and negative. Both the analysis of frequency access to online videos and category formation clearly highlight the importance students give to demonstrative videos as well as the teachers role when using them. By way of conclusion, it can be said that students considered educational videos, especially the demonstrative type, as a useful tool for developing conflictual tone and evaluation criteria, being always complementary to the role that the teacher who guides their preclinical training plays.
El uso del video didáctico es una herramienta valiosa en la formación preclínica del odontólogo, siempre y cuando logre hacer coincidir los objetivos pedagógicos con la etapa de aprendizaje adecuada. En esta línea, esta innovación docente plantea la realización de tres tipos de video didácticos insertados en una metodología docente especialmente diseñada, en el ciclo de preclínica. Luego de un semestre de utilización los resultados cuantitativos arrojaron una percepción positiva en relación al fomento del desarrollo del criterio de evaluación y tono conflictual, mientras que la percepción del fomento de la negociación y toma de acuerdo estuvo dividida en positivas y negativas. Tanto el análisis de frecuencia de acceso a los videos en línea como el levantamiento de categorías dejan de manifiesto la importancia que le dan los estudiantes a los videos demostrativos como también al rol docente durante su utilización. A modo de conclusión se puede decir que los estudiantes consideraron al video didáctico, especialmente los de tipo demostrativo, como una herramienta útil para el desarrollo del tono conflictual y criterio evaluador, siendo siempre complementaria al rol docente que guía su formación preclínica.