title: [Evaluation of the clinical aptitude in physicians of the first level of attention].
abstract: OBJECTIVE
  To evaluate the development through time of the clinical aptitude in physicians of the first level of attention and the influence of categories of first level physicians.
  
  
  METHODS
  In a cross-section design the clinical aptitude was studied in three categories of physicians of the first level of attention: general practitioners with functions of family medicine, family physicians, and family physicians working as head of a clinical department in Family Medicine Units with 10 or more consulting rooms. To evaluate the clinical aptitude, an instrument with 12 real clinical cases and 412 questions was used with nine indicators; this instrument was validated in a previous study.
  
  
  RESULTS
  499 physicians of the three categories were included, the scores range was between 52 and 245, with an average of 169 (41%). When comparing the categories of physicians, significant differences were found, in favor of the physicians with a specialty. There were no differences among heads of clinical departments and family physicians. In the global analysis among indicators no differences were found. When correlating the clinical aptitude with the years of experience, without considering the category, a correlation of 0.02 was obtained.
  
  
  CONCLUSIONS
  Experience seems to have no influence in the development of clinical aptitude; passive continuing education seems to have little influence in the physicians deepening into frequent health-problem solving in their practice.
authors.affiliation: Coordinación de Educación en Salud, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social. jose.garciam@imss.gov.mx
authors.forename: José Alberto
authors.initials: JA
authors.lastname: García-Mangas
authors.forename: Leonardo
authors.initials: L
authors.lastname: Viniegra-Velázquez
authors.forename: Jorge
authors.initials: J
authors.lastname: Arellano-López
authors.forename: Juan
authors.initials: J
authors.lastname: García-Moreno
mesh_terms: D001077:Aptitude Tests; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D005069:Evaluation Studies as Topic; D006801:Humans; D010821:Physicians, Family / Q000193:education*; D011320:Primary Health Care; D011795:Surveys and Questionnaires