Background: Previously our group has shown the use of clinical simulation in rheumatology, an area in which it had not been used. We demonstrated the effectiveness of an educational intervention based on clinical simulation to improve the diagnostic approach to RA¹, so we wanted to apply this same principle in the learning of Psoriatic Arthritis (PsA) and SpA (Spondyloarthritis).

Objectives: This paper wants to quantify the rate of improvement in the diagnosis of Psoriatic Arthritis (PsA) among a group of Latin American dermatologists who received an educational intervention based on clinical simulation.

Methods: Observational study before and after

Results: 192 Latin American dermatologists recieved an educational intervention based on clinical simulation. The topic of this educational intervention was based on PsA. A workshop that includes clinical simulation models of feets, fingers and a mannequin with prominent enthesis was created for this purpose. It was used an strategy of problem-based learning. The workshop lasted 5 hours and it was divided into two parts: the first was about the clinical approach of joint pain and lumbar pain diagnosis and relevant aspects of PsA. The second part focused on clinical cases applied to clinical simulation models, applying the knowledge acquired during the theoretical phase. Participants made a several stations where they could appreciate for periods of 15 minutes each simulator of 3 feets, 6 simulated fingers and a mannequin where they can identify entheses, dactylitis, arthritis, psoriasis lesions and improve visual and tactile sensitivity in each semiologic findings for the diagnosis of PsA. The participants filled out a pre and post test, which included 6 (six) clinical cases with simulators and photographs of hands and feets of patients with suspected PsA. 192 participants (82 % women) from 5 Latin American countries (Argentina, Brazil, Colombia, Mexico and Peru), average age 42,43 years (SD 6,2 years). Dermatologists obtained an improvement in the correct diagnosis of PsA of 56,1 % (the correct diagnosis increased from 33,1 % to 89,2 %). the total number of exams requested in the cases presented decreased significantly, from an average of 9 to 3 exams requested by each clinical case presented. 95 % of participants would recommend to other colleagues to make this workshop. 98,8 % believe that this educational intervention will improve the diagnostic approach to patients with suspected PsA.

Conclusions: The present research is a pioneer and innovator in the rheumatology education. We have shown the usefulness of clinical simulation given by an improvement in the diagnostic sensitivity towards the diagnosis of PsA, highlighting the semiology as a key element at the time of making the diagnosis. A significant decrease in the total number of exams requested for each of the clinical cases analyzed was documented, which can have a positive effect on costs for the national health systems in each country of the participating dermatologists.

Reference 1. Fernández-Ávila DG, Ruiz ÁJ, Gil F, Mora SA, Tobar C, Gutiérrez JM, Rosselli D.The effect of an educational intervention, based on clinical simulation, on the diagnosis of rheumatoid arthritis and osteoarthritis.Musculoskeletal Care2017;1–5. doi:10.1002/msc.1228

Disclosure of Interest: None declared