Portfolio as a tool to evaluate clinical competences of traumatology in medical students

Figures & data

Table 1 Frequency and percentage of achievement of clinical competences

Competences	Learning outcomes	Frequency	Percentage
1. Recognize injuries, assessment, and consequences	1.1 Diagnosis of fracture	112	85.3
	1.2 Diagnosis of muscle lesions	93	71.3
	1.3 Assessment of postoperative patients	115	87.6
	Competence 1: average percentage ± SD	81.4±8.9
2. Identify lesions during physical examination (supervised)	2.1 Assessment of omalgia	56	42.7
	2.2 Assessment of gonalgia/coxalgia	95	72.8
	2.3 Assessment of cervical/back pain	45	34.4
	2.4 Examination of foot	70	53.3
	2.5 Examination of hand	72	55.1
	2.6 Examination of backbone	30	23.3
	2.7 Importance of examination	63	47.9
	Competence 2: average percentage ± SD	47.1±15.9
3. Recognize lesions through image techniques	3.1 Reading radiographies	111	84.9
	3.2 Reading magnetic resonance images	69	52.9
	Competence 3: average percentage ± SD	68.9±22.6
4. Orthopedic treatment of lesions (nonsurgical, supervised)	4.1 Evaluation of immobilizations	67	51.5
	4.2 Healing wounds	61	46.7
	4.3 Reduction of dislocations/fractures	56	43.1
	4.4 Perform articular infiltration (seen or performed under supervision)	85	64.7
	Competence 4: average percentage ± SD	51.5±9.5
5. Establish a treatment plan	5.1 Visit of the doctor to the hospitalized patients of traumatology and orthopedic surgery	114	87.4
	Competence 5: average percentage ± SD	–	–
6. Observe and assist in surgical treatments	6.1 Surgical washing (at least once)	47	35.7
	6.2 Suture of wounds in emergency unit (supervised)	42	32.4
	6.3 Attending operating room	130	99.2
	Competence 6: average percentage ± SD	55.8±37.6
7. Write reports to patients, families, and other professionals (supervised)	7.1 Report of patient discharge: fracture	8	6.3
	7.2 Report of patient discharge: orthopedics	9	6.7
	7.3 Importance of doctor–patient relationship	85	65, 1
	Competence 7: average percentage ± SD	26.0±33.8
	Global average percentage		59.7

Abbreviation: SD, standard deviation.

Table 2 Days spent by students during the traumatology rotation

Days in	Range	Sum	Mean	SD
Operating room	1–7	335	2.6	1.3
Consultation	1–6	445	3.4	0.9
Hospital ward	1–6	179	1.4	0.9
Emergencies	1–5	235	1.8	0.9

Abbreviation: SD, standard deviation.

Table 3 Distribution of frequencies and percentages of kappa values in every category

Kappa	Agreement	Frequency	Percentage
<0.00	Poor	0	0
0.00–0.20	Slight	14	10.2
0.21–0.40	Fair	41	29.7
0.41–0.60	Moderate	39	28.3
0.61–0.80	Substantial	35	25.4
0.81–1.00	Almost perfect	9	6.5

Table 4 Mean of kappa indexes of the four evaluators

	n	Mean kappa	Standard deviation
Competence 1	3	0.38	0.12
Competence 2	7	0.47	0.09
Competence 3	2	0.50	0.17
Competence 4	4	0.48	0.14
Competence 5	1	0.28	–
Competence 6	4	0.65	0.30
Competence 7	3	0.36	0.09
Global kappa	23	0.48	0.17

Table 5 Agreement, obtained as the kappa index, between the original evaluator and the result obtained in the second revision (reference)

	C1	C2	C3	C4	C5	C6	C7	Global
Evaluator 1	0.52	0.62	0.46	0.52	0.49	0.83	0.69	0.60
Evaluator 2	0.38	0.52	0.66	0.50	0.63	0.83	0.48	0.55
Evaluator 3	0.19	0.50	0.63	0.50	0.63	0.87	0.54	0.53
Evaluator 4	0.51	0.62	0.46	0.52	0.49	0.83	0.63	0.60

Abbreviations: C1, competence 1; C2, competence 2; C3, competence 3; C4, competence 4; C5, competence 5; C6, competence 6; C7, competence 7.