An online training and feedback module enhances the musculoskeletal examination performance of medical interns.

BACKGROUND: Pathologies of the locomotor system are frequent and can cause disability and impact the quality of life of the people affected. In recent years, online training and feedback have emerged as learning tools in many fields of medicine. OBJECTIVE: This study aims to evaluate medical interns' musculoskeletal examination performance after completing an online training and feedback module. METHODS: This study employed a quasi-experimental design. Medical interns were invited to complete a 4-week musculoskeletal physical examination training and feedback module via an e-learning platform. The course included written and audiovisual content pertaining to medical history, physical examination, and specific tests for the diagnosis of the most common knee, spine, shoulder, ankle, and foot conditions. Before and after completing the module, their ability to perform the physical examination was evaluated using an objective structured clinical examination (OSCE) with simulated patients that took place face-to-face. A control group of experts was assessed using the OSCE, and their performance was compared to that of the interns before and after the training. At the end of the module feedback on the OSCE was provided to participants through the platform asynchronously and two evaluation questions about the user experience were conducted at the end of the study. RESULTS: A total of 35 subjects were assessed using the OSCE, including 29 interns and 6 experts. At the beginning of the training module, the group of interns obtained an average score of 50.6 ± 15.1. At the end of the module, 18 interns retook the OSCE, and their performance increased significantly to an average of 76.6 ± 12.8 (p < 0.01). Prior to the training, the experts performed significantly better than the interns (71.2 vs. 50.6; p = 0.01). After the interns received the training and feedback, there were no significant differences between the two groups (71.2 vs. 76.6; p = 0.43). Two evaluation questions were conducted at the end of the study, revealing that 93% of the participants affirm that the training module will be useful in their clinical practice, and 100% of the participants would recommend the training module to a colleague. CONCLUSION: The online training and feedback module enhances the musculoskeletal examination performance of medical interns.

Resultados de la reparación quirúrgica del canal auriculo-ventricular completo / Repair of atrioventricular canal malformation

En Mayo de 1981 a Junio de 1989, se han reparado con circulación extracorpórea, 48 pacientes portadores de canal auriculo-ventricular completo sin otras lesiones mayores asociadas. La mortalidad hospitalaria es de un 8,3% y la global de un 20,8%. No se han presentado casos de bloqueo AV permanente y sólo en 1 caso se realizó reoperación para recambio valvular. En los últimos tres años (24 pacientes) se ha operado más precozmente (promedio de edad de 16,6 meses baja a 9,5 meses), lo que junto a una mejor comprensión de la patología y a avances en las técnicas quirúrgicas y en el cuidado postoperatorio, han permitido alcanzar una mortalidad hospitalaria de un 4,2%