Las competencias comunes en el sistema de formación sanitaria especializada. Aprendiendo comunicación clínica y bioética a partir de la reflexión sobre la actividad clínica cotidiana

Resumo

It is necessary to find a methodology and tools to help specialists undergoing training learn the practical aspects of common or cross-disciplinary competences. To this end, it would be preferable to start out with proposals that provide guidance based on the teaching experience in the clinic, alongside the patient. An example could be learning about endof-life decision-making shared with representatives of incapacitated patients, taking prognosis, frailty and values as guides to decision-making. Knowing how to deal with an incapacitated patient is one of the competences to be acquired as part of the cross-disciplinary training in health sciences specialties. In this paper, reflecting on the experience of a resident in the care of an incapacitated patient allows for a better structured approach to the difficult conversation with the relative of a second incapacitated patient. Explicitly stating seemingly known or inconsequential details helps to systematise processes aimed at improving them, learning at the bedside and formative evaluation. A practical proposal for further work is put forward, using clinical narrative as a support.