AB1395 Effect of an educational intervention based on clinical simulation in the diagnosis of spondyloarthritis (SPA) from general practitioners, a study before and after
Authors: S.A. Mora Alfonso, D.G. Fernández Ávila
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Previously our group has shown the use of clinical simulation in rheumatology. 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 SpA (Spondyloarthritis). <h3>Objectives</h3> This paper wants to quantify the rate of improvement in the diagnosis of Spondyloarthritis (SpA) among a group of general practitioners who receive an educational intervention based on clinical simulation. <h3>Methods</h3> Intervention study before and after <h3>Results</h3> 102 general practitioners received an educational intervention based on clinical simulation. The topic of this educational intervention was Spondyloarthritis (SpA). A workshop that includes clinical simulation models of feet, fingers and a mannequin created for this purpose was created, based on the strategy of problem-based learning. The workshop lasted 5 hours, it was divided into two parts: the first was about the of the clinical approach of joint pain and lumbar pain diagnosis and relevant aspects of SpA. In this first part, besides the theoretical support for the diagnosis of SpA, participants viewed pictures of patients with spondylitis and peripheral involvement (enthesitis, dactylitis, arthritis) seeking to achieve awareness of their sense of sight with respect to the diagnostic approach to patients with suspected SpA and sought to strengthen the logical approach to be implemented when approaching this type of patients. 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 where they could appreciate for periods of 15 min each simulators of 3 feet, 6 simulators simulated fingers and a mannequin where they can identify entheses and psoriasis lesions, improving visual and tactile sensitivity in each semiologic findings for the diagnosis of SpA. The participants filled out an pre and post test, which included clinical cases with simulators and photographs of hands and feet of patients with suspected SpA. 102 participants (59% women), average age 32.3 years (SD 7.1). Improvement in the correct diagnosis of SpA of 47% (the correct diagnosis increased from 39% to 86%). laboratories application in the cases presented decreased significantly, from an average of 8–4 exams requested by each clinical case presented. 98.5% of participants would recommend to other colleagues to make this workshop. 97.7% believe that this educational intervention will improve the diagnostic approach to patients with suspected SpA <h3>Conclusions</h3> We have shown the usefulness of clinical simulation given by an improvement in the diagnostic sensitivity towards the diagnosis of SpA. 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