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BACKGROUND: Accrediting medical specialties programs are expected to influence and standardize training program quality, align curriculum with population needs, and improve learning environments. Despite global agreement on its necessity, methods vary widely. In the Chilean context, a recent new accreditation criteria includes research productivity in relation to educational research on resident programs, so we aimed to define it. What is the profile of publications in educational research produced by Chilean medical specialty residency programs in the last five years? Based on these results, we intend to analyze the potential impact of the new accreditation policy on medical specialty programs in Chile. METHODS: We performed a preliminary bibliometric search to identify the use of the term "resident" in literature. After that, we conducted a literature search, using a six-step approach to scoping reviews, including the appraisal of the methodological quality of the articles. RESULTS: Between 2019 and 2023, an average of 6.2 articles were published yearly (19%). The bibliometric analysis revealed that the dominant thematic area of the journals was clinical, accounting for 78.1%. Most articles focused on residents (84.38%), with only two articles including graduates as participants. One university was responsible for 62.50% of the articles and participated in all multicenter studies (9.38%). Surgical specialties produced 15 research articles focused on procedural training using simulation. Psychiatry was the second most productive specialty, with 5 articles (15.63%) covering standardized patients, well-being, and mental health assessment. The most frequent research focus within residency programs over the five-year period was teaching and learning methodologies, with 19 articles representing almost 60% of the total analyzed. CONCLUSIONS: Research on medical education in Chile's postgraduate residency programs is limited, with most studies concentrated in a few universities. The new accreditation criteria emphasize educational research, posing challenges for many institutions to meet higher standards. Understanding unexplored areas in educational research and learning from successful programs can enhance research productivity and align efforts with accreditation expectations. Continuous evaluation and new research on residents' satisfaction, skills acquisition, and well-being are needed to ensure training quality and accountability.
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Acreditación , Internado y Residencia , Humanos , Acreditación/normas , Bibliometría , Investigación Biomédica/educación , Investigación Biomédica/normas , Investigación Biomédica/estadística & datos numéricos , Chile , Curriculum , Internado y Residencia/métodos , Internado y Residencia/normas , Internado y Residencia/estadística & datos numéricosRESUMEN
The rapid advancement of Artificial Intelligence (AI) has taken the world by "surprise" due to the lack of regulation over this technological innovation which, while promising application opportunities in different fields of knowledge, including education, simultaneously generates concern, rejection and even fear. In the field of Health Sciences Education, clinical simulation has transformed educational practice; however, its formal insertion is still heterogeneous, and we are now facing a new technological revolution where AI has the potential to transform the way we conceive its application.
El rápido avance de la inteligencia artificial (IA) ha tomado al mundo por "sorpresa" debido a la falta de regulación sobre esta innovación tecnológica, que si bien promete oportunidades de aplicación en diferentes campos del conocimiento, incluido el educativo, también genera preocupación e incluso miedo y rechazo. En el campo de la Educación en Ciencias de la Salud la Simulación Clínica ha transformado la práctica educativa; sin embargo, aún es heterogénea su inserción formal, y ahora nos enfrentamos a una nueva revolución tecnológica, en la que las IA tienen el potencial de transformar la manera en que concebimos su aplicación.
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Infections due to Ehrlichia, Anaplasma, Dirofilaria, Mycoplasma, Babesia and Hepatozoon continue to be highly prevalent in dogs, especially in tropical and subtropical areas, where vectors of many of them are present. However, many clinical aspects of dogs have not been characterized in detail, including assessing the haematological alterations associated with them, particularly in Colombia and Latin America. A group of 100 dogs with Ehrlichia, Anaplasma, Dirofilaria, Mycoplasma, Babesia and Hepatozoon infections/exposure were assessed by blood smear serology (SNAP4DX) and PCR in Pereira, Colombia. We performed blood counts to evaluate anaemia, leukopenia/leukocytosis, neutropenia, neutrophilia, lymphopenia/lymphocytosis, monocytosis, eosinophilia, and thrombocytopenia, among other alterations. Bivariate analyses were performed on Stata®14, with significant p < 0.05. From the total, 85% presented ≥1 infection (past or present), 66% with coinfections (≥2 pathogens) (Ehrlichia 75%), and 89% presented clinical alterations. A total of 100% showed anaemia, 70% thrombocytopenia, 61% monocytosis, and 47% neutropenia, among other alterations. Additionally, 11% presented pancytopenia and 59% bicytopenia. The median platelet count was lower in infected dogs (126,000 cells/µL) versus non-infected (221,000 cells/µL) (p = 0.003). Thrombocytopenia was higher among infected dogs (75%) versus non-infected (40%) (p = 0.006), with a 91% positive predictive value for infection. Median neutrophil count was lower in infected dogs (6591 cells/µL) versus non-infected (8804 cells/µL) (p = 0.013). Lymphocytosis occurred only among those infected (27%) (p = 0.022). Leukopenia was only observed among infected dogs (13%). Pancytopenia was only observed among infected dogs. Ehrlichiosis and other hematic infections have led to a significant burden of haematological alterations on infected dogs, including pancytopenia in a tenth of them, most with thrombocytopenia and all anemic.
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BACKGROUND: Latin American clinical simulation has had an important development; there are no studies that characterize simulation centers and programs in the entire region. The aims of this work are to characterize the current state of simulation-based education in the health sciences, to determine the structure of Latin American simulation centers in terms of teaching, research, and continuing medical education (CME), as well as to determine the perception of quality based on international standards of simulation practices for the directors of Latin American centers. METHODS: A quantitative, descriptive, cross-sectional study with a demographic questionnaire and a Likert-type survey was conducted to the directors of the simulation centers found in Latin America. RESULTS: Four hundred eight simulation centers were documented, the survey was answered by 240 directors, and the data from 149 were complete responses on the 42 quality self-perception scale and considered valid on further analyses related to the quality of the programs. Most of the centers that responded correspond to Chile, Brazil, and Mexico (37.5%, 18.1%, 12.7%). 84% of the centers are university-based, and 71% of the centers are medium-sized, with less than 10 instructors (54%). The directors are mostly women (61.7%), medical doctors (50%), and nurses (40%), with clinical specialization (37%), master's degree (53%), and doctorate (13%). 75% have completed a simulation instructor course, and 6% have developed a fellowship. Most consider the maintenance of international quality standards to be relevant in their centers, mainly in reflective training techniques, ethical aspects, and adequate learning environments. CONCLUSIONS: Simulation-based education in health sciences has had an increasing development in Latin America, within a university environment, in an important academic specialization process that seeks to adhere to high-quality standards to improve training and development of clinical skills, human factors, and critical thinking. We recommend starting accreditation processes in Latin America and studies that measure the quality of simulation-based education in our region, based on objective observations more than in self-reporting.
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Face-to-face clinical simulation has been a powerful methodology for teaching, learning, and research, and has positioned itself in health science education. However, due to the COVID-19 pandemic, social distancing has forced universities to abandon simulation centers and make use of alternatives that allow the continuation of educational programs safely for students and teachers through virtual environments such as distance simulation. In Latin America, before the pandemic, the use of non-presential simulation was very limited and anecdotal. This article has three main objectives: to establish the efficacy of online-synchronized clinical simulation in the learning and performance of medical students on the management of patients with COVID-19 in simulation centers of three Latin American countries, to determine the quality of the online debriefing from the students' perspective, and to deepen the understanding of how learning is generated with this methodology.
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[This corrects the article DOI: 10.1007/s40475-020-00208-z.].
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PURPOSE OF REVIEW: COVID-19 is a new, highly transmissible disease to which healthcare workers (HCWs) are exposed, especially in the intensive care unit (ICU). Information related to protection mechanisms is heterogeneous, and the infected HCWs' number is increasing. This review intends to summarize the current knowledge and practices to protect ICU personnel during the patient management process in the context of the current pandemic. RECENT FINDINGS: The transmission mechanisms of SARS-CoV-2 are mainly respiratory droplets, aerosols, and contact. The virus can last for a few hours suspended in the air and be viable on surfaces for several days. Some procedures carried out in the ICU can generate aerosols. The shortage of respirators, such as the N95, has generated an increase in the demand for other protective equipment in critical care settings. SUMMARY: The probability of transmission depends on the characteristics of the pathogen, the availability of quality personal protective equipment, and the human factors associated with the performance of health workers. It is necessary to have knowledge of the virus and availability of the best possible personal protection equipment, develop skills for handling equipment, and develop non-technical skills during all intensive care process; this can be achieved through structured training.
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INTRODUCTION: The Personal Protective Equipment (PPE) is essential to avoid the COVID-19 spread to health care workers. Its use can be difficult, posing a high risk of contamination, mainly during doffing, then with the risk of becoming infected. METHODS: We conducted a prospective before-and-after design that used clinical simulation as a research methodology in a clinical simulation center of Colombia. A simulation-based educational intervention with two cases related to COVID-19 was proposed in the emergency room and the intensive care unit. We conducted A workshop for donning and doffing of personal protective equipment (PPE) and a debriefing after the first case. RESULTS: In the pre-test, 100% of participants failed donning and doffing PPE, 98.4% were contaminated, only one-person did not contaminate out of. The mean cognitive load was high (7.43±0.9 points). In the post-test, 100% were successful in donning the PPE and 94.8% in doffing; only 9.8% were contaminated. The mean of the cognitive load was low (4.1±1.4 points), and the performance was high (7.9±1.1). Of the total, 73.8% of participants reported overload in the doffing. The most difficulties were in gown/overall, and N95 mask removal. DISCUSSION: The PPE donning and doffing is critical and may be changed significantly by active training. In responding to the current COVID-19 pandemic in 2020, activities of training in donning and doffing PPE would provide a means of training personnel, reducing the cognitive load and maybe the risk of contamination and infection of health care workers.
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Infecciones por Coronavirus/prevención & control , Personal de Salud/psicología , Memoria a Corto Plazo , Enfermedades Profesionales/prevención & control , Pandemias/prevención & control , Equipo de Protección Personal , Neumonía Viral/prevención & control , Entrenamiento Simulado , Adulto , COVID-19 , Contención de Riesgos Biológicos , Servicio de Urgencia en Hospital , Contaminación de Equipos , Dispositivos de Protección de los Ojos , Femenino , Guantes Protectores , Higiene de las Manos , Personal de Salud/educación , Humanos , Control de Infecciones/métodos , Unidades de Cuidados Intensivos , Masculino , Máscaras , Estudios Prospectivos , Ropa de Protección , Análisis y Desempeño de TareasAsunto(s)
Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/transmisión , Conocimientos, Actitudes y Práctica en Salud , Personal de Salud/educación , Neumonía Viral/epidemiología , Neumonía Viral/transmisión , Adulto , Anciano , Betacoronavirus , Bolivia , COVID-19 , Colombia , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , SARS-CoV-2 , Estudiantes del Área de la Salud , Encuestas y CuestionariosRESUMEN
Abstract Learning is a change in the way of thinking that lasts over time and allows for solving problems; on the other hand, education based on structured clinical simulation is a pedagogic mediation between the classroom and clinical practice, which allows experience, reflection, monitoring, control, and restructuring of thought, which can contribute to deep and lasting learning. It is desirable that students, both undergraduate and graduate, are given the opportunity to be trained under structured simulation.
Resumen El aprendizaje es el cambio en el pensamiento que perdura en el tiempo y permite la solución de problemas; por su parte, la educación basada en simulación clínica estructurada es una mediación pedagógica entre el aula de clase y la práctica clínica, que permite experiencia, reflexión, monitoreo, control y reestructuración del pensamiento, lo que puede aportar en aprendizajes profundos y duraderos. Es deseable que los estudiantes, tanto en pregrado como en posgrado, tengan la oportunidad de ser formados con simulación estructurada.