RESUMO
OBJECTIVE: To evaluate the utility of low-cost simulation models to teach surgical techniques for placenta accreta spectrum (PAS), included in a multimodal education workshop for PAS. METHODS: This was an observational, survey-based study. Participants were surveyed before and after the use of low-fidelity mannequins to simulate two surgical techniques for PAS (one-step conservative surgery [OSCS] and modified subtotal hysterectomy [MSTH]), within a multimodal educational workshop. The workshops included pre-course preparation, didactics, simulated practice of the techniques using low-cost models, and viewing live surgery. RESULTS: Six OSCS/MSTH training workshops occurred across six countries and a total of 270 participants were surveyed. The responses of 127 certified obstetricians and gynecologists (OB-GYNs) were analyzed. Participants expressed favorable impressions of all components of the simulated session. Perceived anatomical simulator fidelity, scenario realism, educational component effectiveness, and self-assessed performance improvement received ratings of 4-5 (positive end of the Likert scale) from over 90% of respondents. When asked about simulation's role in technique comprehension, comfort level in technique performance, and likelihood of recommending this workshop to others, more than 75% of participants rated these aspects with a score of 4-5 (positively) on the five-point scale. CONCLUSION: Low-cost simulation, within a multimodal education strategy, is a well-accepted intervention for teaching surgical techniques for PAS.
RESUMO
To evaluate the level of stress induced by the tongue inspection method during cysticercosis diagnosis in pigs at 60 and 90 kg, 27 animals were assigned to one of three experimental groups. In the first group (T1), pigs were held with a snout noose. In addition, animals in T2 were subjected to tongue inspection, while in T0, none of the procedures described above were performed. Resistance to be handled and serum cortisol concentration were higher (P < 0.05) than those from T0 in T1 and T2 groups, for 60- and 90-kg pigs. Time to return to the feeder observed the same pattern than previous variables in 60-kg pigs, but T1 and T0 were similar (P > 0.05) for the heavier animals. T2 did not build up a significant amount of stress with respect to T1, where only more (P > 0.05) vocalizations were emitted by 90-kg pigs. It was concluded that the use of snout noose induces major changes in some behavioral and physiological measures of stress in swine, while the opening of the mouth including tongue inspection does not contribute significantly to this effect.