TEACHING MEDICAL DECISION MAKING: A CHALLENGE TO A MEDICAL ASSOCIATION

Innovation in education is one of the biggest concerns amongst medical schools. Throughout years several strategies have been tried in order to improve the effectiveness in transmission of information, however the path for building knowledge requires more than just the quality of the contents. Understanding the process of clinical reasoning would be the first step on developing evidence based educational strategies. Medical decision making is almost unknown in the Ecuadorian medical community and like most Latin American country no Medical School offers it in their curricula.

Purpose: The purpose is to describe, share and discuss the experience of teaching medical decision making in a 10 weeks course as part of Colegio Medico de Pichincha 's proposal to continued medical education.

Method:  (N/A)    Colegio Médico de Pichincha  -a regional medical association-  designed and  held the: “ Complementary course of Medical Decision Making for integrative health care”   a course 10 weeks long, so far 43 medical doctors have  participated, most of them general practitioners ( 25  to 55 years old)    The name of the course summarizes the main objective: To improve decision making, into the particular context of practice.    The methodology used was problem based learning (PBL). Specific problem cases were developed with the purpose of integrate the contents (learning objectives) of the five units proposed:   medical decision making, integral health care, critical reading, communitarian epidemiology and basic and advanced live support. Each case was design around priority health problems – chosen by the criteria of avoidable dead or disability-   

Result:  A mix of simulated patient and a contents test were applied to evaluate the participant’s knowledge after five weeks.  Problems defining basic concepts were found, threshold concept is still not easy to describe. However, participants started to incorporate the threshold concept during their activities.

Conclusion: The integration of the concepts in to the practice remains uncertain, design a strategy and instruments to measure this theoretical integration should be the next step.