Evaluación de la aptitud clínica en anestesiología para trasplante renal

Objective: To design and validate an instrument that evaluates the clinical aptitude of anesthesiologists and anesthesiology residents for the anesthetic management of kidney donors and recipients. Materials and methods. Observational design, where four clinical cases were selected, and 148 reagents were elaborated to have a measurement instrument to evaluate clinical aptitude with the following parameters: 1) recognition of clinical indicators, 2) diagnostic indicators, 3) clinical exams, 4) iatrogenic by commission, 5) iatrogenic by omission, 6) use of anesthetic and therapeutic resources, 7) critical evaluation of actions taken, 8) pathophysiology. The instrument was validated in the second round by concordance of four out of four anesthesiologists. The instrument was applied to 12 second year and 7 third year anesthesiology residents, and 18 anesthesiologists. Statistical methods employed were Kruskal-Wallis, Mann-Whitney U, and Perez-Padilla and Viniegra tests. Results. Kuder-Richardson consistency was 0.76. Number of correct responses expected by chance was 23. The mean score for second year residents was of 52 (range: 32-62), for third year residents was 61 (range: 45-86) and for the anesthesiologists was 65 (range: 20-85). With respect to level of clinical aptitude, we found 67% of second year residents having a medium-low aptitude. Among third year residents, 86% had a medium-low aptitude. In the group of anesthesiologists, 78% demonstrated a medium-low level of aptitude. Conclusions. The clinical aptitude was low in the three groups studied. When the global results were compared, we found a statistically significant difference in favor of the anesthesiologists.