title: [Reliability and validity of an instrument to evaluate integral clinical competence in medical residents].
abstract: BACKGROUND
  The evaluation of clinical competence in medical residents is a complex procedure. Teachers need reliable and valid instruments to evaluate objectively the, clinical competence. The aim of this study was to determine the reliability and validity of an instrument designed to evaluate the clinical competence of medical residents.
  
  
  METHODS
  We designed an instrument taking into consideration every part of the clinical method, and three different levels of competence were determined for each one. The instrument was examined with regards to the clarity, pertinence and sufficiency of each clinical indicator by five expert pediatricians. The instrument was finally constituted by 11 indicators. Each resident was evaluated independently by three pediatricians.
  
  
  RESULTS
  A total of 651 measurements were done in 234 residents. The instrument distinguished between extreme groups, had a value of Cronbach's alpha of 0.778 and the factorial analysis set apart two factors: clinical competence and complementary competences. No statistical differences were found between evaluators neither in global evaluation or in each indicator.
  
  
  CONCLUSIONS
  The instrument here proposed is valid and reliable. It may be used in formative evaluation of medical residents in clinical specialization programs.
authors: Dirección de Educación e Investigación en Salud, Hospital de Pediatría "Dr. Silvestre Frenk Freund", Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Distrito Federal, México. ana.sepulvedav@imss.gob.mx.
authors: Ana Carolina
authors: AC
authors: Sepúlveda-Vildósola
authors: Nadia
authors: N
authors: Gaspar-López
authors: Lucina Isabel
authors: LI
authors: Reyes-Lagunes
authors: Héctor Jaime
authors: HJ
authors: Gonzalez-Cabello
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D006801:Humans; D007396:Internship and Residency / Q000592:standards*; D008800:Mexico; D015588:Observer Variation; D010372:Pediatrics / Q000193:education* / Q000592:standards; D015203:Reproducibility of Results
keywords: Clinical competence; Evaluation; Medical residents