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IDENTIFICATION OF PROBLEMS OTHER THAN CHIEF COMPLAINT

In a previous report, we found that residents of the 1st year in general pediatrics had several problems to identify socioeconomical factors, immunizations and nutritional status, during an interview with mothers when this issues were not the chief complaint. We carried out this study in order to clarify whether this holds true for residents in 3rd year of general pediatric training. Member of the hospital staff acted as simulated mothers and were interviewed by 28 1st year residents and 14 3rd year residents. Chief complaint was diarrhea secondary to urinary tract infection associated to malformations. Anemia, hypovitaminosis D and incomplete immunizations were considered secondary issues. Third year residents identified more properly the chief complaint than their 1st year conterpart (p<0.0001), whereas there were no statistically significant differences in the identification of secondary issues and planning for their solutions. We emphasize the need of considering a comprehensive vision of the patient and his family in the pediatric curriculum.