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Abstract Introduction: The use of clinical cases in simulated environments allows for a more realistic approach to the simulated health condition, which results in a more effective training experience for students, as they are immersed in situations they may encounter in their professional practice. Objective: To determine the face validity of a low back pain clinical case as a clinical simulation tool in the training of physical therapy students. Materials and methods: Study conducted to determine the face validity of a low back pain clinical case presented to physical therapy students. The case has 9 items, which were evaluated by 5 expert raters. Agreement between raters regarding the pertinence, relevance, coherence, clarity, and sufficiency of the case was established using the Fleiss' Kappa coefficient. Results: Fleiss ' Kappa for the simulated case was 0.67 (substantial agreement), and for items 1, 2, 4, and 9 was 0.97, 1.0, 0.89, and 1.0, respectively (almost perfect agreement). Furthermore, the percentage of case comprehensibility (9 items) was 95.2. Conclusion: The face validity of the low back pain clinical case was confirmed, so its use in clinical simulation practices in the physical therapy programs offered by the Universidad de La Sabana and Universidad de Boyacá in Colombia is valid.
Resumen Introducción. El uso de casos clínicos en ambientes simulados brinda un mejor acercamiento a la condición de salud que se intenta simular, lo que permite una mejor formación de los estudiantes al verse inmersos en situaciones a las que podrían enfrentarse en su práctica profesional. Objetivo. Determinar la validez aparente de un caso clínico de dolor lumbar como herramienta de simulación clínica en la formación de estudiantes de fisioterapia. Materiales y métodos. Estudio realizado para determinar la validez de apariencia de un caso clínico de dolor lumbar para ser abordado por estudiantes de fisioterapia, el cual presenta nue -ve elementos evaluados por cinco jueces expertos. La concordancia entre los jueces respecto a la pertinencia, relevancia, coherencia, claridad y suficiencia del caso se estableció mediante el coeficiente Kappa de Fleiss. Resultados. El Kappa de Fleiss para el caso simulado fue 0.67 (acuerdo sustancial), y para los elementos 1, 2, 4 y 9 fue 0.97, 1.0, 0.89 y 1.0, respectivamente (acuerdo casi perfecto). Además, el porcentaje de comprensibilidad del caso (9 ítems) fue 95.2. Conclusión. La validez aparente del caso clínico fue confirmada, por lo que su uso en prácticas de simulación clínica en los programas de fisioterapia de la Universidad de La Sabana y la Universidad de Boyacá en Colombia es válido.
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BACKGROUND: Low back pain (LBP) is a condition with a high global prevalence, which is getting health professionals' attention, including physiotherapists as they must have the skills to provide treatment that increases the patient's quality of life. Clinical simulations could be a pedagogic strategy that facilitates adequate training for students to acquire skills to improve their professional reasoning in this clinical situation. OBJECTIVE: This study sought to determine the effects of clinical simulations with simulated patients (SP) on the physiotherapy students' clinical decision-making within a role-playing (RP) scenario while caring of LBP patients. METHODS: This experimental study included 42 participants from two Colombian universities, randomized into two groups (SP, n = 21; RP, n = 21). The clinical skill of performing the Objective Structured Clinical Examination (OSCE-LBP) was evaluated while students cared for patients with LBP; after that, a pedagogical method was conducted that included clinical simulation and, finally, the OSCE-LBP was applied again to compare both groups. RESULTS: Changes occurred in the OSCE-LBP among both groups of students: the scores increased (0.66 and 0.59 in RP and SP, respectively), and neither of the two was superior (p value 0.01; 95%CI - 0.21 to 0.23). CONCLUSION: Both types of simulation favor decision-making in professional reasoning in physiotherapy students during interactions with individuals with LBP. Trial registration https://clinicaltrials.gov/ct2/show/NCT04428892 Identifying number: NCT04428892. It was retrospectively registered.
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Dolor de la Región Lumbar , Humanos , Dolor de la Región Lumbar/terapia , Modalidades de Fisioterapia , Calidad de Vida , Desempeño de Papel , EstudiantesRESUMEN
Los escenarios de simulación clínica han sido explorados en medicina y enfermería como estrategia de aprendizaje y han demostrado ser efectivos para la adquisición de competencias acercando a los estudiantes a su práctica clínica real. En fisioterapia, su utilización ha sido recientemente incluida y aún no se ha documentado su potencial como estrategia de fortalecimiento curricular. Este trabajo buscó revisar en la literatura el empleo de la simulación clínica como estrategia pedagógica para la fisioterapia. Para ello, se desarrolló un proceso integrativo con base en el análisis de competencias transversales o específicas. Sus resultados señalan que la simulación mejora la calidad y competencia del fisioterapeuta en formación; el dominio donde más se usa la simulación es el cardiovascular pulmonar, seguido del musculoesquelético. Sin embargo, en fisioterapia se requiere incrementar el uso de simulación en todos los dominios para poder cualificar aún más la formación
Clinical simulation scenarios have been explored in medicine and nursing as a learning strategy. They have shown to be effective for the acquisition of skills, bringing students closer to their actual clinical practice. Its use has recently been included in physiotherapy, but its potential as a curriculum strengthening strategy has not yet been documented. This work aims to carry out a review of the literature on the use of clinical simulation as a pedagogical strategy for physiotherapy. To do this, an integrated process was developed, based on the analysis of cross-sectional or specific skills. The results indicate that simulation improves the quality and skills of the physiotherapist in training. The domain where the simulation is most used is pulmonary cardiovascular, followed by the musculoskeletal system. However, in physiotherapy it is necessary to increase the use of simulation in all domains in order to qualify the training even more
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Humanos , Entrenamiento Simulado/métodos , Medicina Física y Rehabilitación/educación , Enseñanza Mediante Simulación de Alta Fidelidad/métodos , Enseñanza Mediante Simulación de Alta Fidelidad/tendencias , Competencia ClínicaRESUMEN
El propósito de este artículo es conocer las perspectivas de riesgo laboral en el contexto de las representaciones sociales de los cultivadores de papa. Materiales y métodos: Para ello, se emplea el diseño de caso cualitativo y, como técnica de recolección de información, se aplicó una entrevista semiestructurada a dos hombres que ejecutan la labor agrícola, habitantes del municipio de Toca, Boyacá, donde se indagó sobre los conceptos relacionados con el cuidado, la salud, su actuar ante las enfermedades, la forma de afrontar las situaciones que afectan la salud, derivadas de su oficio, y cómo viven sus procesos de salud-enfermedad. Resultados: Se empleó el análisis de contenido, del cual se obtuvo que los agricultores definen como riesgo y riesgo laboral el acceso a elementos, como los insecticidas que usan para el cultivo, y la exposición a diversos factores ambientales, como la temperatura. Sumado a esto, expresan las dificultades que trae el cultivo de la papa frente a la demanda en el mercado y los costos de cultivar, comparados con los de la venta del producto, todo esto significante en situaciones como el estrés mental laboral, ya que afirman que este los hace pensar en combinar oficios para subsistir en las labores agrícolas. Conclusión: La relación entre salud y salud laboral está asociada con aspectos como el vestido que usan los agricultores cuando utilizan los químicos y cómo este vestuario, en gran proporción, resulta ser el que emplean durante todas las actividades cotidianas.
The purpose of this article is to understand the perspectives of occupational hazard in the context of social representations of potato growers. Materials and methods: For this, design case qualitative was used. As a data collecting technique, a semi-structured interview to two men who run agricultural labor, inhabitants in the municipality of Toca, Boyacá, was conducted. They were inquired about the concepts of care; health; their actions toward disease; on how to handle situations related to their job that affect health; and how do they live their processes of health and disease. Results: Content analysis was used, and showed that farmers connect risk and occupational risk with access to elements such as insecticides used for cultivation, and with exposure to several environmental factors such as temperature.They also expressed difficulties associated with potato cultivation and this meeting market demands and the growing costs in contrast to those of the product sales, this as a significantly affecting factor in situations as work-related mental stress, since they sustain that all this lead them to consider other agricultural activities, in order to make a living from their own craft. Discussion: The relationship between health and occupational health is associated with the specific labor clothing used by farmers when applying chemical substances, and with the way this work-wear clothing, in high proportion, is actually what they wear in their daily activities.
O objetivo deste artigo é compreender as perspectivas de risco ocupacional no contexto das representações sociais dos produtores de batata. Materiais e métodos: Para este projeto de caso qualitativo é usado, e como técnica de coleta de informações, uma entrevista semi-estruturada dois homens que dirigem o trabalho da fazenda, os habitantes do município de Toca Boyacá, onde eu perguntei sobre os conceitos aplicados relacionado ao cuidado, saúde, ato a doença, como lidar com situações que afetam a saúde de seu ofício e como vivem seus processos de saúde e doença. Resultados: a análise de conteúdo, que é obtido, agricultores definem o risco e riscos profissionais relacionados com itens como os inseticidas utilizados para o cultivo, juntamente com fatores ambientais, como temperatura foi utilizado; também expressa as dificuldades que traz a cultura da batata atender à demanda do mercado e os custos de crescimento das vendas de produtos, processos trabalhistas significativas como o estresse mental, que dizem isso, o trabalho sugere que outros campo para sobreviver fazer o seu ofício. Conclusão:A relação entre a saúde e os aspectos de saúde ocupacional associados com o vestido que utilizam produtos químicos e quando usado como uma grande proporção neste vestiário que passa a ser utilizada para todas as atividades diárias.