title: [Clinical and radiologic skills for fracture management. Multicenter study at orthopedics residents].
abstract: BACKGROUND
  There is a shortcoming in the diagnostic integration of the mechanism of injury and the radiographic findings. This leads to diagnostic errors and a poor surgical planning with labor and legal repercussions. The purpose is to find out which is the prevailing clinical skill in various Orthopedics residencies by applying a measurement tool prepared ex profeso.
  
  
  METHODS
  This is an exploratory study conducted in nine Orthopedics residency sites; a measurement tool was designed with theoretical and empirical adequacy with 0.96 reliability (Kuder-Richardson). It includes ten clinical cases with 200 questions providing only X-ray images of a traumatic event exploring the following aspects: I. Kinematics of trauma, II. Clinical diagnosis, III. Radiographic interpretation, IV. Treatment, and V. Prognosis. It was applied to residents of all grades at each of the participating sites.
  
  
  RESULTS
  Most of the sites had a low to intermediate level of clinical skills. Upon assessing the results (82 residents) differences were found in indicators I, II, IV and in the overall skills. No significant differences were seen at the sites in indicators III and V. The assessment of sites by indicators showed that site one had more refined skills for clinical diagnosis, while site six for radiographic interpretation.
  
  
  CONCLUSIONS
  There are differences in the development level of the clinical skills studied. The low to intermediate skills may be explained by the different educational strategies applied at the sites studied without ruling out the experience acquired in each academic grade. It is possible to improve the results by implementing participative strategies.
authors.affiliation: Centro de Investigación Educativa de Formación Docente, IMSS Yucatan. arredondo61@prodigy.net.mx
authors.forename: E
authors.initials: E
authors.lastname: Arredondo-Gómez
authors.forename: E
authors.initials: E
authors.lastname: Pavía-Carrillo
authors.forename: U
authors.initials: U
authors.lastname: Mendoza-Cruz
mesh_terms: D002983:Clinical Competence; D003430:Cross-Sectional Studies; D050723:Fractures, Bone / Q000000981:diagnostic imaging* / Q000628:therapy*; D007396:Internship and Residency; D009985:Orthopedics / Q000193:education*; D011446:Prospective Studies; D011859:Radiography