A clinical training unit for diarrhoea and acute respiratory infections: an intervention for primary health care physicians in Mexico.

In Tlaxcala State, Mexico, we determined that 80% of children who died from diarrhoea or acute respiratory infections (ARI) received medical care before death; in more than 70% of the cases this care was provided by a private physician. Several strategies have been developed to improve physicians' primary health care practices but private practitioners have only rarely been included. The objective of the present study was to evaluate the impact of in-service training on the case management of diarrhoea and ARI among under-5-year-olds provided by private and public primary physicians.

[Critical reading in selected groups of medical students].

Background: The shaping of professionals with a critical outlook in their field of endeavor is a goal of some educational institutions in our country. However, little participation from the students is demanded in our medical schools and this probably interferes in the development of skills for critical reading.

Objective: To evaluate critical reading in medical students with high scholastic achievement as a function of years of medical training.

[New approaches to the measurement of clinical competence].

A new phase in the development of an instrument designed for the measurement of clinical competence is presented. The instrument (exam type) was previously validated; we report its use in three generations of students of a specialization course in internal medicine: those recently admitted to the course (group I); those finishing their first training year (group II) and those finishing the second year (group III). In the exam 304 out of the 600 questions included were classified as "experimental" (dealing with knowledge in internal medicine) and the remaining 296 questions corresponded to "control" questions (dealing with knowledge in other specialties).

[Systemic-psychodynamic model for family evaluation].

In this paper a family evaluation instrument called systemic-psychodynamic family evaluation model is described. Also, the second stage of the validation study of this instrument is presented (which deals with the inter-observers variation). Twenty families were studied.

[The challenge of evaluating clinical competence].

The study is divided in two parts. The first one deals with theoretical aspects of evaluation. In the second part, the development of an instrument intended to explore clinical competence is presented.

[Iatrogenic trends as indicator of clinical competence in courses of specialization in medicine].

Iatrogenesis, understood here as an unfavourable effect to the health of patients provoked by the medical institution, has risen little interest in the researchers of the health area in spite of its growing presence. The present study had the aim of exploring the iatrogenic behavior of 659 recently graduated physicians by a questionnaire composed by clinical cases which described diagnostic and/or therapeutic situations that required the making of decisions. The questionnaire consisted of 600 general medical knowledge questions of which 112 explored commission of iatrogenic behavior.

[Involuntary weight loss as a clinical problem].

Weight loss can herald the existence of an underlying serious disease. The purpose of this study was to ascertain the frequency of the involuntary weight loss at the Internal Medicine inpatient service of our Institution and the different conditions associated with it. The study was undertaken from March 1984 to February 1985.