title: The Computer Book of the Internal Medicine Resident: competence acquisition and achievement of learning objectives.
abstract: BACKGROUND
  The Computer Book of the Internal Medicine resident (CBIMR) is a computer program that was validated to analyze the acquisition of competences in teams of Internal Medicine residents.
  
  
  OBJECTIVE
  To analyze the characteristics of the rotations during the Internal Medicine residency and to identify the variables associated with the acquisition of clinical and communication skills, the achievement of learning objectives and resident satisfaction.
  
  
  METHODS
  All residents of our service (n=20) participated in the study during a period of 40 months. The CBIMR consisted of 22 self-assessment questionnaires specific for each rotation, with items on services (clinical workload, disease protocolization, resident responsibilities, learning environment, service organization and teamwork) and items on educational outcomes (acquisition of clinical and communication skills, achievement of learning objectives, overall satisfaction). Associations between services features and learning outcomes were analyzed using bivariate and multivariate analysis.
  
  
  RESULTS
  An intense clinical workload, high resident responsibilities and disease protocolization were associated with the acquisition of clinical skills. High clinical competence and teamwork were both associated with better communication skills. Finally, an adequate learning environment was associated with increased clinical competence, the achievement of educational goals and resident satisfaction.
  
  
  CONCLUSIONS
  Potentially modifiable variables related with the operation of clinical services had a significant impact on the acquisition of clinical and communication skills, the achievement of educational goals, and resident satisfaction during the specialized training in Internal Medicine.
authors.affiliation: Servicio de Medicina Interna, Hospital de Sabadell, Corporació Sanitària i Universitària Parc Taulí, Sabadell, Barcelona, España. Electronic address: joristrell@tauli.cat.
authors.forename: J
authors.initials: J
authors.lastname: Oristrell
authors.affiliation: Unidad de Estadística, Fundació Parc Taulí, Corporació Sanitària i Universitària Parc Taulí, Sabadell, Barcelona, España.
authors.forename: J C
authors.initials: JC
authors.lastname: Oliva
authors.affiliation: Servicio de Medicina Interna, Hospital de Sabadell, Corporació Sanitària i Universitària Parc Taulí, Sabadell, Barcelona, España.
authors.forename: A
authors.initials: A
authors.lastname: Casanovas
authors.affiliation: Servicio de Medicina Interna, Hospital de Sabadell, Corporació Sanitària i Universitària Parc Taulí, Sabadell, Barcelona, España.
authors.forename: R
authors.initials: R
authors.lastname: Comet
authors.affiliation: Servicio de Medicina Interna, Hospital de Sabadell, Corporació Sanitària i Universitària Parc Taulí, Sabadell, Barcelona, España.
authors.forename: R
authors.initials: R
authors.lastname: Jordana
authors.affiliation: Servicio de Enfermedades Infecciosas, Hospital de Sabadell, Corporació Sanitària i Universitària Parc Taulí, Sabadell, Barcelona, España.
authors.forename: M
authors.initials: M
authors.lastname: Navarro
mesh_terms: D002983:Clinical Competence; D003201:Computers; D004521:Educational Measurement; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency; D007858:Learning; D012647:Self-Assessment
keywords: Autoevaluación; Clinical competence; Competencia clínica; Competency-based education; Educación basada en competencias; Educational measurement; Evaluación; Internal Medicine; Internship and residency; Medicina Interna; Residentes; Self-assessment