Cómo afectan los incidentes críticos a los residentes de Medicina Familiar y Comunitaria Translated title: How critical incidents affect Family and Community Medicine residents

Abstract

RESUMEN Objetivo: conocer y analizazr las repercusiones que tienen los incidentes críticos (IC) identificados y recogidos por los residentes Medicina Familiar y Comunitaria (MFyC) en su portafolio formativo de formación reglada. Métodos: estudio cuanti-cualitativo, retrospectivo, descriptivo y analítico, multicéntrico, de los informes de IC de los residentes. Emplazamiento: Atención Primaria. Centros de salud docentes de la Unidad Docente AFyC 695 de Murcia. Se incluyen 62 del total de 76 residentes en formación en 2015, y sus portafolios formativos. Los casos son los informes de IC en los que constan respuestas manuscritas de respuesta abierta. Se obtiene consentimiento informado de los residentes. Las respuestas se codifican, agrupan y tabulan, analizándose las consecuencias. Los resultados se presentan en cifras absolutas y porcentajes. Resultados: se incluyen 150 de los 165 informes de IC obtenidos (90,91%), en los que constan respuestas cualitativas y manuscritas a la pregunta: ¿Qué consecuencias ha tenido para ti el incidente crítico? Se obtienen 311 respuestas con una media de 5,01 (+/- 2,71) respuestas por residente. Se clasifican en 42 grupos diferentes. La mayoría de los IC analizados tienen repercusiones para los residentes. Son negativas 36,33%. Ambivalentes, aquellas que potencialmente pueden ser positivas o negativas, 40,19%. Y positivas 23,47%. Conclusiones: Los IC analizados tienen importantes repercusiones para casi todos los residentes, que pueden ser negativas, ambivalentes o positivas. Se identifican 42 grupos de consecuencias. Los residentes muestran una alta motivación respecto a estas repercusiones. La identificación precoz de los IC del residente, la caracterización y la reflexión sobre las repercusiones tienen un gran interés como oportunidades para mejorar su formación.

Translated abstract

ABSTRACT Objectives: To ascertain and analyze the consequences of the critical incidents (CI) that have been identified and collected by Family and Community Medicine (FCM) residents in their training portfolio, as part of this programmed teaching task. Materials and methods: This is a descriptive, quantitative-qualitative, retrospective, analytical and multicentre study on the CIs reported by the residents. Setting: Primary Care. Specialized health training. Health Centres belonging to a Teaching Unit in Murcia. From a total of 76 FCM residents who were training in the Teaching Unit in 2015, a total of 62 residents and their training portfolios were included. Cases are the CI reports that contain qualitative and handwritten answers in the open response sections. Residents were asked for informed consent to access their CIs and data for this research. The most outstanding characteristics presented by the CIs were analyzed by collecting the open answers from the CI reports, which were then discreetly coded. These characteristics were collected and tabulated and data were presented in absolute and percentages figures. Responses were collected, grouped, encoded, tabulated and the consequences of the CIs were analyzed. Results are shown in absolute figures and percentages. Results: a total of 150 out of 165 CI reports (90.91%) were included in this study, which encompass those containing qualitative and handwritten answers to the question “What consequences did the critical incident have for you? A total of 311 responses were obtained, which can be classified into 42 different groups, with an average of 5.01 (+/- 2.71) responses per resident. Most analyzed CIs had important consequences and repercussions for residents. Out of these, 113 responses reported negative consequences (36.33%); 125 responses reported ambivalent consequences (40.19%), that is, consequences than can potentially be positive or negative; and 73 responses reflected positive consequences (23.47%). Conclusions: Most analyzed CIs have important consequences for almost all residents, which can be negative, ambivalent or positive. Residents show high motivation regarding these consequences. Early detection of the resident’s CI, characterization and consideration of its consequences are of major interest as opportunities to improve the training of residents.