• Lilia Degollado-Bardales, Félix Arturo Leyva-González, Leonardo Viniegra-Velázquez, Raúl Gonzaga-Juárez, Jesús Arturo Zavala-Arenas, Jesús Salvador-Valencia Sánchez, and Gress Marissell Gómez-Arteaga.
• Centro de Investigación Educativa y Formación Docente, Centro Médico Nacional Siglo XXI, México D.F., México.
• Gac Med Mex. 2009 Nov 1;145(6):481-9.

IntroductionThe study of clinical competence is essential because it summarizes the attributes that characterize a specialist capable of providing quality health careObjectiveInvestigate the development of clinical competence among anesthesiology residents that care for patients in a tertiary level facility.Material And MethodsIn February 2007 we conducted a cross-sectional study among 42 anesthesiology residents, 21 were in second and 21 in third year. In order to measure the degree of development of clinical competence we created an instrument with four case studies that summarized patients undergoing surgical anesthetic procedure. The instrument included 200 items that explored eight indicators and covered a range of time periods: pre-trans and post anesthesia. The instrument was validated by a group of experts with clinical, teaching and publication experience. We carried out a pilot test and estimated the instrument's internal reliability using the Kuder-Richardson test (KR-21). We obtained a coefficient of 0.95. We collected the study data and instrument rating technique using a blinded design. Statistical analysis was performed using nonparametric tests.ResultsIn the overall ranking, third-year medical residents versus sophomores, achieved the highest scores, which resulted in statistically significant differences (p = 0.045). Regarding the degree of expertise we found that most participants had scores of "very low" and "low". In the study of ratings by indicator, we noted that when comparing second vs third year residents we only found statistically significant differences in default decisions that were also potentially iatropathogenic (p = 0.026).ConclusionThe clinical competence of anesthesiology residents who care for patients attending a tertiary level facility is low when compared with the maximum theoretical scores they should obtain.

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