THU0574 Deveploment of a Series of Simulators and Design a Course Based on a Clinical Simulation, For Teaching Diagnostic Approach to Patients with Joint Pain and Suspected Rheumatic Disease
Authors: D.G. Fernández-Avila, L. Sastre, S. Mora
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> The clinical simulation is a teaching strategy widely used in the medical field. After searching any job in the world that use clinical simulation for training in diagnosis of rheumatic diseases was found. It is then an innovative idea that will enable the basis of models designed hands-size, teaching the most important semiological findings of rheumatoid arthritis and one of its main differential diagnoses (osteoarthritis), with which is the most confusing one between the general practitioners. <h3>Objectives</h3> To develop a group of human hands simulators that allow defiir a teaching strategy based rheumatologyclinical simulation <h3>Methods</h3> Design and installation of a simulator of human hands in real size <h3>Results</h3> Using a focus group consisting of two rheumatologists, simulators (7 hands) with a series of semiological findings of rheumatoid arthritis and osteoarthritis were designed. Simulators are hands-size, located on a wooden stand, which has hand movements flexion - extension at the wrist joint in the metacarpophalangeal and proximal interphalangeal. They are made on a skeleton made with epoxy putty, which includes the bones of a human hand (own carpal bones, metacarpals and phalanges) and ligamentous structures, muscle and bra made of silicone rubber. About this skeleton and myotendinous structures a mold polyurethane that will serve as skin, which has consistency similar to that of the human hand, internally reinforced with various materials that prevent skin breakdown by movements color is applied joints and by contact with the skin of the hands of the examiner, after repeated probing. The development of these models is handled by a doctor, who is also an artist and has extensive knowledge of human anatomy; under constant advice two rheumatologists who have been working on finding the best materials three years to design these hands, so as to be as similar to a human hand. Each hand has several semiological findings of rheumatoid arthritis (synovitis, pannus, joint deformities) and/or osteoarthritis (Heberden9s and Bouchard nodes) made in materials that create a texture very similar to those found tenderness in patients with these entities (see photo) <h3>Conclusions</h3> The present research is a pioneer and innovator in the rheumatology education. The use of clinical simulation will be the base for an education process that aims to amass the practical teaching in this field, focusing on doctors no rheumatologists who in their daily practice often seen rheumatic patients (general practitioners, internists, physiatrists, orthopedists, neurosurgeons, dermatologists). in this vein, we hope that this research is the first in the context of a new way of teaching rheumatology, educational process that we hope will spread to Colombia and Latin America initially and eventually have a global international projection that allows the creation of a course for early diagnosis and initial treatment of rheumatic diseases, similar to what is currently done in cardiology with ACLS and in trauma with ATLS. Thus the beneficiaries will be patients who will find a better diagnostic and therapeutic approach in their initial primary care physicians before reaching the rheumatologist. <h3>Disclosure of Interest</h3> None declared