AB1405 Real rheumatic patients: A practical training for general doctors

Abstract

Background Despite the recent advances in the treatment of rheumatic diseases, especially if early diagnosed, it is already known that they are poorly recognized and managed by physicians in general, especially in primary care setting. Continuing medical education has been an alternative used in the rheumatology training for doctors. Regarding the specificities of rheumatology physical examination, real patients seemed to be the best option to facilitate the teaching-learning process in this area. Objectives To assess the confidence of physicians to recognize the rheumatic diseases, after participation in a workshop using active teaching methodology with real patients. Methods A practical workshop was conducted after a one-day scientific meeting in Natal-Brazil, focused in update general practitioners on more prevalent rheumatic diseases in primary care level. Forty five participants had an intensive practical training in osteoarthritis (OA), rheumatoid arthritis (RA), ankylosing spondylitis (AS) and back pain. The workshop was divided into three modules: 1-discussion of clinical cases, 2-training in physical examination with real patients, 3-radiological interpretation. Each module had a duration of 45 minutes and was led by 2-3 Rheumatology professors. Three groups of 15 participants were rotated among them. For the training of physical examination, there were selected 09 patients with OA, RA and AS at different stages of disease. Patients were informed about participation in the activity and signed the consent form. At the end, a questionnaire with a 5-point Likert scale was used to assess participants’ confidence and satisfaction with the teaching method employed. Results Twenty-two doctors and 11 medical students who completed the questionnaire, assessed the workshop as excellent (94%) or good (6%). Compared with the traditional method of lecture, respondents rated the method as “much more efficient” (76%) or “more efficient” (24%) for their learning process. They stated that the use of real patients to give them more intimacy with the symptoms and signs of the diseases studied had a very positive impact. For all participants, the confidence in the diagnosis of diseases covered by workshop has increased from one to three levels in the Likert scale used. Conclusions The use of active teaching methods with real patients proved to be a valid strategy in Rheumatology training for primary care physicians, enabling them to improved diagnosis and patient care. We expect that, in the future and after others effective interventions like this one, our patients would be refered to rheumatologists, if necessary, as early as possible. References Anne, B.; Debbie, M.; Sylvia, V.; Friedo, D.; Liesbeth, B.; Zuzana, Jong. Real patient learning integrated in a preclinical block musculoskeletal disorders. Does it make a difference? Clin Rheumatol. 2011 August; 30(8): 1029–1037. Bezerra, E.L.M.; Vilar, M.J.P.; Azevedo, G.D. Elective Rheumatology Program With A Primary Health Care Focus. Arthritis & Rheumatism. October 200...