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FRI0604 The Effect of An Educational Intervention Based on Clinical Simulation in Rheumatoid Arthritis and Osteoarthritis Diagnosis by General Practitioners: A Randomized Clinical Trial
  1. S.A. Mora Alfonso1,
  2. D.G. Fernández1,
  3. L.F. Sastre2,
  4. on behalf of Hospital Universitario de la Samaritana
  1. 1Rheumatology
  2. 2Society for Research, Education and Care in Rheumatic Diseases, INVEDER SAS. Bogotá, Colombia, Bogota, Colombia

Abstract

Background Clinical simulation is a teaching strategy generally used in the medical field that has not been used in rheumatology education yet. This innovative idea will enable the basis of models designed hands-size providing a very accurate way to study the most important semiological findings, such those of the rheumatoid arthritis and its main distinction diagnoses (osteoarthritis - OA); the most challenging to evaluate among general practitioners. Clinical simulation models are protected under the patent certificate number 50152 of the Superintendency Industry and Trade of the Republic of Colombia

Objectives To evaluate the effectiveness of a rheumatology educational tool based on clinical simulation designed for general practitioners, professionals who will improve the diagnosis of rheumatoid arthritis and osteoarthritis

Methods Randomized clinical trial. The research subjects were randomly assigned to two different groups: The experimental group, and the control group. A) The experimental group: educational intervention in rheumatoid arthritis based on clinical simulation, B) Control group: educational intervention on basic aspects of diagnosis and treatment of osteoporosis. After four weeks of the educational intervention, members of the two groups faced an evaluation process that included four cases with real patients (two patients with rheumatoid arthritis and two patients with osteoarthritis), two cases with two clinical simulation models (a case of rheumatoid arthritis and an osteoarthritis case), and six virtual clinical cases (three rheumatoid arthritis cases and three osteoarthritis cases). At that point participants ascertained the detected semiological findings, establishing a complete diagnosis very helpful in order to corroborate the diagnosis if it is required.

Results 160 physicians (80 from the active group and 80 from the control group), 89 were women (56%). The average age was 35.0 years (standard deviation 7.7 years). Clinical stimulation was considered to work successfully when a practitioner diagnosed accurately at least 10 out of 12 cases submitted under his examination. A difference of 81.3% (confidence interval 95% 72–90%) was found successfully, amount statistically significant in favor of the active group (88.8% vs 7.5%) (p = <0.001). A greater number of hits were found in the detection of the semiological findings in the active group compared with the control (p<0.001)

Conclusions The present study showed the effectiveness of an educational intervention based on clinical simulation to improve the diagnostic approach in rheumatoid arthritis and osteoarthritis; this innovative idea opens the gate for a new horizon in the teaching of modern rheumatology. Moreover, the clinical simulation is a meaningful benefit for patients representing an improvement in the quality and use of health system resources.

Disclosure of Interest None declared

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