Evaluation by competences in a clinical environment of a public university in Peru.

We aim to design and validate the instruments to assess an evaluation by competences in the Course: Introduction to Clinical Medicine at the National University of San Marcos (UNMSM) in Lima-Peru. Methodology: Qualitative approach, with a narrative design and dialogue. 14 teachers were interviewed. Half of them were responsible for the chapters within the course. Results: In the clinical environment, theoretical lectures and planned didactic sessions are used based on clinical cases. In clinical practice, the priority is given to clinical thinking, also problem-based learning (PBL) was used in seminars. The teachers started the evaluation by competences process developing an evaluation instrument for the specific clinical practice. The participants observed resistance to the change because of certain administrative barriers y poor institutional support. The critical point in this investigation was the training in evaluation and learning methodologies, requiring a training plan before starting their teaching activities. The teachers recognized the value of the teaching service with responsible and ethical dedication to the patient, by the students.