AB1393 Effect of an educational intervention based on clinical simulation in the diagnosis of rheumatoid arthritis in latin american non- rheumatologists physicians
Authors: S.A. Mora Alfonso, D.G. Fernández Ávila
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Previously our group demonstrated the effectiveness of an educational intervention based on clinical simulation to improve the diagnostic approach to RA (Rheumatoid Arthritis) <sup>(1)</sup> so we wanted to apply this same principle in the learning of RA among a group of Latin American non-Rheumatologists <h3>Objectives</h3> This paper wants to quantify the rate of improvement in the diagnosis of Rheumatoid Arthritis (RA) among a group of Latin American non-Rheumatologists (general practitioners, internists, physiatrists, orthopedists, neurosurgeons, dermatologists) who received an educational intervention based on clinical simulation. <h3>Methods</h3> Observational study before and after <h3>Results</h3> 286 Latin American non-rheumatologists physicians recieved an educational intervention based on clinical simulation. The topic of this educational intervention was based on Rheumatoid Arthritis. They revieved a workshop that includes clinical simulation models of 5 hands and each hand, had various semiological findings of RA (synovitis, pannus, joint deformities). The workshop lasted 5 hours and it was divided into two parts: the first was about the clinical approach of joint pain and relevant aspects of RA. 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 20 min each simulator and improve their visual and tactile sensitivity in each semiologic findings for the diagnosis of RA. The participants filled out a pre and post test, which included 6 (six) clinical cases with simulators and photographs of hands of patients with suspected RA. 286 non-rheumatologists (general practitioners, internists, physiatrists, orthopedists, neurosurgeons, dermatologists) from 3 Latin American countries (Colombia, Costa Rica and Dominican Republic) participated in the study, 71% women, average age 40,3 years (SD 7,5 years). Non-rheumatologists physicians obtained an improvement in the correct diagnosis of RA of 45,6% (the correct diagnosis increased from 44,5% to 90,1%). The total number of exams requested in the cases presented decreased significantly, from an average of 7 to 3 exams requested by each clinical case presented. 95% of participants would recommend to other colleagues to make this workshop. 97% believe that this educational intervention will improve the diagnostic approach to patients with suspected RA. <h3>Conclusions</h3> The present research is a pioneer and innovator in the field of rheumatology education. We have shown the usefulness of clinical simulation by an improvement in the diagnostic sensitivity towards the diagnosis of RA, 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 analysed was documented, which can have a positive effect on costs for the national health systems. <h3>Reference</h3> [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 Care. 2017;1–5.DOI: 10.1002/msc.1228 <h3>Disclosure of Interest</h3> None declared