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SUMMARY: The importance and relevance of e-learning courses in medicine and health sciences has increased significantly in the last decade. Despite this, there are few published teaching experiences of e-learning histology courses in the literature worldwide. The histology course we designed was structured on the Moodle platform as a learning management system, and the content was proposed in a synchronous (zoom) and asynchronous (recordings) format. We also included the use of free virtual microscopy tools. This study aimed to investigate the impact of an e-learning histology course on the satisfaction and performance of medical, nursing and midwifery students. The sample included 424 Chilean medical, nursing, and midwifery students from two cohorts. A Likert-type survey was administered at the end of the course. We performed exploratory analysis and ordinary least squares regression. In this study, we present a positive experience of an e-learning histology course. Exploratory factor analysis revealed three main factors related to "e- learning satisfaction", "in-person class activities", and "course design and teaching quality". We also found that there was a positive and significant relationship between students' perceptions of the adaptation of the traditional (face-to-face) histology course into an e-learning format and their academic performance. Our study shows that e-learning histology courses that integrate lectures and practical sessions can be a valuable teaching method for learning histology. Curriculum developers and teachers need to consider the limitations and advantages of this type of teaching and incorporate these three factors into the design and assessment of e-learning histology courses.

La importancia y relevancia de los cursos e-learning en medicina y ciencias de la salud ha aumentado significativamente en la última década. A pesar de ello, existen pocas experiencias docentes publicadas de cursos de histología e-learning en la literatura a nivel mundial. El curso de histología que diseñamos se estructuró en la plataforma Moodle, y los contenidos se propusieron en formato síncrono (zoom) y asíncrono (grabaciones). También incluimos el uso de herramientas gratuitas de microscopía virtual. Este estudio tuvo como objetivo investigar el impacto de un curso de histología e-learning en la satisfacción y el rendimiento de los estudiantes de medicina, enfermería y obstetricia. La muestra incluyó 424 estudiantes chilenos de medicina, enfermería y obstetricia de dos cohortes. Se aplicó una encuesta tipo Likert al final del curso. Se realizó un análisis exploratorio y una regresión por mínimos cuadrados ordinarios. En este estudio, presentamos una experiencia positiva de un curso de e-learning de histología. El análisis factorial exploratorio reveló tres factores principales relacionados con la "satisfacción sobre el aprendizaje e-learning", "clases presenciales versus clases virtuales" y el "diseño del curso y la calidad de la enseñanza". También encontramos que existía una relación positiva y significativa entre las percepciones de los estudiantes sobre la adaptación del curso de histología tradicional (presencial) a un formato e-learning y su rendimiento académico. Nuestro estudio muestra que los cursos de histología e-learning que integran clases teóricas y sesiones prácticas pueden ser una valiosa herramienta de enseñanza. Los responsables de la elaboración de planes de estudios y los profesores de histología deben tener en cuenta las limitaciones y ventajas de este tipo de enseñanza y sugerimos incorporar estos tres factores al diseño y la evaluación de los cursos de histología en línea.

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One of the most common respiratory chronic diseases is asthma, with 5-16 % of world prevalence. In chronic disease, prevention, diagnosis, management, and palliation are the strategies for a care model; the patient-self management is fundamental with the so-called therapeutic education (TE) to train the patient in the necessary skills. The challenge of TE grows when the patient is a child or a person with special needs, even more in public health care in low- and middle-income countries. This is a problematic human situation, that needs soft system thinking. In this research, the analytic hierarchy process was used to determine the perceived importance of the factors that affect children's asthma health care in a public health institution in Mexico. The soft systems methodology (SSM) was applied to learn about the disease self-management, in order to obtain activities models and an action plan. According to AHP, human resources and education were percived as the most important among the factors that affect children health care within the institution. The perceived importance of two main subfactors (human resources training and TE) was around 34 %, which emphasizes the need to generate strategies for the improvement of the education of patients and health care providers. In MSS, the rich vision, the CATWOE, the root definition, and an activities model were proposed, including the application of an instructional design methodology (ADDIE) for the development of learning objects of asthma for children. Desirable and feasible actions and recommendations include the update of the national clinical practice guides, the use of control measures such as the Asthma Control Test, and a daily asthma diary to register the daily status of the breathing capacity, the drug administration, and the potential trigger events. The proposed model can be used as part of a systemic patient-and-family centered approach for chronic care model (CCM), particularly in diseases unsuitable for prevention interventions.

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Introduction: The COVID-19 pandemic has accelerated universities' adaptation process toward online education, and it is necessary to know the students' attitudes toward this online education. Objective: To describe the evolution of the attitude toward online education among social science students at a public university in Peru in the academic year 2020, in the context of the COVID-19 pandemic. Methods: The study uses a quantitative approach, a descriptive level, a non-experimental design, and a longitudinal trend. The sample consisted of 1063 students at the beginning of the class period, 908 during the classes, and 1026 at the end of the class period. The questionnaire for data collection was the Attitude scale toward online education for university students during the COVID-19 pandemic. The data was collected using Google Forms. Results: As a result, the attitude towards online education was predominantly weak negative at the beginning (51.1 %) and during the classes (49.1 %), and weak positive (48.1 %) at the end of the class period. The changes were not significant when comparing the three moments, the levels of attitude toward, intention to adopt, ease of use, technical and pedagogical support, stressors, and need for online education (p-value <0.05). Conclusion: The evolution of the attitude towards online education in the sample had a non-significant positive trend. In the initial and process stages, a weak negative attitude prevailed due to the institution's inexperience and poor digital infrastructure; in the end, the attitude became weak and positive due to the adaptation and need for online education.

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Background: The pandemic caused by Covid-19 impacted all areas of social, economic and educational activity. When there is a high risk of spreading highly infectious diseases, education is usually the first service to be suspended. The objective was to evaluate the sociodemographic factors associated with the satisfaction level of Peruvian dental students with virtual classes during the Covid-19 pandemic. Methods: This observational, cross-sectional, analytical study evaluated 237 dental students from the capital city and one Peruvian province using a validated 13-item questionnaire to measure the level of satisfaction with virtual classes. Pearson's chi-square test and a logit model were used to evaluate the associated factors such as age group, sex, marital status, monthly family income, area of residence, place of origin, occupation and computer use, considering a significance level of p<0.05. Results: Of all students, 50.6%, 40.1% and 9.3% presented a good, average and poor level of satisfaction, respectively, with the virtual classes received. In addition, those with a monthly family income of less than 500 US dollars were 3.15 times more likely to have poor satisfaction compared to those with a monthly family income of more than 1000 US dollars (AOR = 3.15; 95% CI: 1.23-8.05). The rest of the variables evaluated were not considered influential factors in the levels of satisfaction with the virtual classes received. Conclusión: Of all students, 50.6% and 9.3% reported good and poor satisfaction with virtual classes during the COVID-19 pandemic, respectively. Monthly family income of less than 500 US dollars was an influential factor. In addition, the variables age group, sex, marital status, area of residence, place of origin, occupation and computer use were not found to be influential factors.

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BACKGROUND: Novel internet-based applications and associated technologies have influenced all aspects of society, ranging from commerce and business to entertainment and health care, and education is no exception. In this context, this study was designed to evaluate the impact of a dermatology e-learning program on the academic performance of medical students in dermatology. OBJECTIVE: The aim of this study is to develop a dermatology blended-learning course for undergraduate medical students, evaluate the knowledge gained by students exposed to this course, and compare the results to those of traditional teaching methods. METHODS: In this prospective study, we evaluated the performance of fourth-semester medical students at the Federal University of Bahia, Brazil. Students who had been in their second year of the medical course in 2019 were considered the control group, while students in their second year in 2020 were considered the blended or hybrid group. The first group attended traditional classes, using printed material (books and handouts), while the second group used our web-based course and e-book as a supplement in a hybrid web-plus-traditional fashion. Neither participants nor evaluators were blinded. The students in both groups were subjected to the same pre- and postcourse face-to-face, multiple-choice, paper-based evaluations, and we compared their performances. The content of the classes was the same for both groups. All didactic activities were developed by a team of certified dermatologists and professors from the university. RESULTS: A total of 129 students were selected and divided into 2 groups: the control group (n=57) and the hybrid group (n=72). The precourse tests did not indicate any difference between the control group (mean score 2.74, SD 1.25) and the hybrid group (mean score 3.2, SD 1.22 SD; P>.05). The hybrid group had better final-term grades (mean 8.18, SD 1.26) than the traditional group (mean 7.11, SD 1.04). This difference was statistically significant (P<.05). CONCLUSIONS: This study explores pedagogical possibilities in the field of dermatology teaching for medical school students. The results suggest that the performance of undergraduate students who attended the course with additional e-learning material was superior when compared to the performance of those who participated in the traditional course alone.

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BACKGROUND: Interoperability between health information systems is a fundamental requirement to guarantee the continuity of health care for the population. The Fast Healthcare Interoperability Resource (FHIR) is the standard that enables the design and development of interoperable systems with broad adoption worldwide. However, FHIR training curriculums need an easily administered web-based self-learning platform with modules to create scenarios and questions that the learner answers. This paper proposes a system for teaching FHIR that automatically evaluates the answers, providing the learner with continuous feedback and progress. OBJECTIVE: We are designing and developing a learning management system for creating, applying, deploying, and automatically assessing FHIR web-based courses. METHODS: The system requirements for teaching FHIR were collected through interviews with experts involved in academic and professional FHIR activities (universities and health institutions). The interviews were semistructured, recording and documenting each meeting. In addition, we used an ad hoc instrument to register and analyze all the needs to elicit the requirements. Finally, the information obtained was triangulated with the available evidence. This analysis was carried out with Atlas-ti software. For design purposes, the requirements were divided into functional and nonfunctional. The functional requirements were (1) a test and question manager, (2) an application programming interface (API) to orchestrate components, (3) a test evaluator that automatically evaluates the responses, and (4) a client application for students. Security and usability are essential nonfunctional requirements to design functional and secure interfaces. The software development methodology was based on the traditional spiral model. The end users of the proposed system are (1) the system administrator for all technical aspects of the server, (2) the teacher designing the courses, and (3) the students interested in learning FHIR. RESULTS: The main result described in this work is Huemul, a learning management system for training on FHIR, which includes the following components: (1) Huemul Admin: a web application to create users, tests, and questions and define scores; (2) Huemul API: module for communication between different software components (FHIR server, client, and engine); (3) Huemul Engine: component for answers evaluation to identify differences and validate the content; and (4) Huemul Client: the web application for users to show the test and questions. Huemul was successfully implemented with 416 students associated with the 10 active courses on the platform. In addition, the teachers have created 60 tests and 695 questions. Overall, the 416 students who completed their courses rated Huemul highly. CONCLUSIONS: Huemul is the first platform that allows the creation of courses, tests, and questions that enable the automatic evaluation and feedback of FHIR operations. Huemul has been implemented in multiple FHIR teaching scenarios for health care professionals. Professionals trained on FHIR with Huemul are leading successful national and international initiatives.

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Background: E-learning Continuing Professional Development (CPD) is an activity demonstrated to improve the quality of healthcare delivery. The CPD of medical and nursing staff in high income countries (HICs) is commonplace. CPD of administrative staff is less common, but increasingly frequent. In low- and middle-income countries (LMICs), CPD of any kind is infrequent, particularly in rural and remote areas. Objective: The aim of this study was to describe a hospital-based e-learning CPD program for clinical and non-clinical personnel as a unique example of a successful, ongoing educational pilot, quality improvement program involving a broad cohort of employees, in a country that does not require such activities. Methods: Using the online educational platform Chamilo, e-learning modules were created for eight groups including clinical and non-clinical employees. Upon completion of each module, one to two paragraph discussions were provided for each incorrect answer submitted. Two additional chances were offered for the employee to achieve a passing score of 70%. This study reports on the first 10-month period of the program. Findings: All participants achieved the 70% passing threshold after the first or second attempt. There was 100% participation by the employees required to complete the e-learning modules. Employee feedback suggested the modules were good for continuing education, but some felt the CPD was imposed on them. Conclusion: E-learning CPD is an important and emerging element for CPD and may provide opportunities for healthcare service quality improvement as part of broader pedagogical modalities, such as conferences and directed readings, in rural and remote areas of LMICs. These pilot programs could provide important information to develop Spanish-language e-learning CPD programs across a broader region, promote collaboration with regional professional societies, and possibly contribute to the establishment of national health program CPD standards.

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BACKGROUND/AIM: Evaluate the informative content in tooth avulsion videos intended for dentists available on YouTube™ and analyse their compliance with the International Association of Dental Traumatology (IADT) guidelines 2020. MATERIALS AND METHODS: Google Trends was used to identify the most searched term for tooth avulsion. Tooth avulsion-related videos in Brazilian Portuguese intended for dentists were searched on YouTube™ with a 12-month filter. Two raters reviewed these videos to extract their features and evaluate and qualify them with two 9-point checklists based on the IADT 2020 guidelines. The emergency steps for tooth avulsion at the accident site were assessed before, during and after clinical management; each step received 1 point if present and 0 points if absent. The final score ranged from 0 to 9 points on each checklist (18 points total), and the total score was used to classify the videos as having poor, moderate or rich content. Reliability and video quality were evaluated by an adapted version of the DISCERN tool and global quality scale (GQS), respectively. The data were analysed with the Mann-Whitney U-test, Pearson chi-square test, and the Kappa statistic (p < .05). RESULTS: Of 60 videos, 8 were included. All were uploaded by dental professionals or undergraduate students; the average duration was 11 min (range: 0.40-65 min), and the average number of views was 56.75. Half the videos (50%) had maximum completeness scores for questions about emergency dentist referral before clinical management, and more than half (75%) had maximum completeness regarding the steps required during and after treatment. Rich videos had higher GQS scores (p = .049) without significant correlation. CONCLUSIONS: Although most videos in Brazilian Portuguese were considered high-quality according to the IADT checklist, half of them presented partial absence of information regarding orientations at the accident site.

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SUMMARY: Anatomy is a three-dimensional subject which needs face-to-face interaction and faced major challenges during the pandemic warranted changes in medical education. A narrative review was conducted to assess the attitude and perception of students and teaching faculty of healthcare professional courses towards Anatomy online teaching in the Kingdom of Saudi Arabia (KSA). A five stage framework narrative reviews outlined by Arksey & O'Malley (2005) was adopted for the current study. Inclusion criteria was studies conducted in Saudi Arabian healthcare professional colleges regarding online Anatomy teaching during the pandemic from March 2020 to April 2023. PRISMA-ScR search strategy was employed for identifying relevant studies which were managed using Endnote reference manager version 20. Nine articles were included in the review out of which two were mixed method studies, two were qualitative and five were quantitative studies. Students and teachers were mostly found to be satisfactory of the Anatomy e-learning experience. Major setbacks found were student and teaching faculty's negative attitude towards online practical teaching and concerns regarding academic dishonesty in students during online examination. Role of digital proficiency of teachers and students in the success of e-learning was emphasized by the review. This narrative review has mapped out the strengths and gaps in remote Anatomy teaching in Saudi Arabia during COVID-19 pandemic. There is a generally successful transition to e-learning in KSA from conventional teaching in Anatomy during the pandemic notwithstanding a few challenges that need to be addressed to improve the teaching and learning experience of Anatomy. Keywords: Anatomy, Online, E-learning, Saudi Arabia.

La anatomía es un tema tridimensional que necesita una interacción cara a cara y enfrentó grandes desafíos durante la pandemia, que justificó cambios en la educación médica. Se realizó una revisión narrativa para evaluar la actitud y la percepción de los estudiantes y profesores de cursos para profesionales de la salud, hacia la enseñanza en línea de Anatomía en el Reino de Arabia Saudita. Para el estudio actual, se adoptó una revisión narrativa del marco de cinco etapas delineada por Arksey & O'Malley (2005). Los criterios de inclusión fueron estudios realizados en colegios profesionales del área de la salud de Arabia Saudita, con respecto a la enseñanza de anatomía en línea durante la pandemia desde marzo de 2020 hasta abril de 2023. Se empleó la estrategia de búsqueda PRISMA-ScR para identificar estudios relevantes que se administraron utilizando el administrador de referencia Endnote versión 20. Se incluyeron nueve artículos en la revisión, de los cuales dos eran estudios de métodos mixtos, dos eran estudios cualitativos y cinco eran estudios cuantitativos. Se encontró que los estudiantes y profesores, en su mayoría estaban satisfechos con la experiencia de aprendizaje electrónico de Anatomía. Los principales contratiempos encontrados fueron la actitud negativa de los estudiantes y profesores hacia la enseñanza práctica en línea y las preocupaciones sobre la deshonestidad académica de los estudiantes durante los exámenes en línea. La revisión enfatizó el papel de la competencia digital de profesores y estudiantes en el éxito del aprendizaje electrónico. Esta revisión narrativa ha mapeado las fortalezas y brechas en la enseñanza remota de anatomía en Arabia Saudita, durante la pandemia de COVID-19. En general, hay una transición exitosa al aprendizaje electrónico en Arabia Saudita desde la enseñanza convencional de Anatomía durante la pandemia, a pesar de algunos desafíos que deben abordarse para mejorar la experiencia de enseñanza y aprendizaje de Anatomía.

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INTRODUCTION: Flipped learning (FL) is a model which allows students to adjust their study rhythm by taking advantage of class time to apply their knowledge. Although FL meets many of the needs of the traditional lecture-based model and the exclusively virtual model, its effectiveness in medical residency programs has not been thoroughly studied. Our study evaluates the efficacy of an FL model in a cardiology residency program based on the satisfaction and academic performance of the participants. METHOD: A prospective, observational, and descriptive study was conducted at Ignacio Chávez National Institute of Cardiology in Mexico City to evaluate the satisfaction and effectiveness of an FL model for acquiring competencies in electrocardiographic diagnosis among thirty-one first-year cardiology residents. The Advanced Electrocardiography Workshop and a virtual classroom were designed for the intervention. Four teachers taught the workshop and video classes, and ten medical specialists from the participants' areas of work performed evaluations of practical skills before and after the intervention. RESULTS: 75% of the participants rated the intervention as very favorable compared to the traditional and virtual models. The main advantages offered by the FL model were identified. An improvement of high statistical significance was observed in participants' academic performance after the intervention (P value < 0.001). CONCLUSION: The FL model has a high degree of acceptance among participants and teachers. Our study shows an improvement in academic performance after the intervention. Considering that the FL model is flexible and reproducible in other areas of medicine, it represents an excellent educational alternative that meets current needs.

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Traditional learning techniques have evolved slowly and have yet to adapt the course content delivery to today's students' approaches to acquiring new knowledge. However, micro-learning has become popular in e-Learning environments as a course design technique due to short attention spans, demand for small chunks of information, and time constraints. Hence, it has been selected for creating reading mobile applications provided to the nature of its learning approach. In order to describe the multiple iterations of design, development, and evaluation of this general framework, a methodology named Design-Based Research (DBR) is implemented. First, the article presents the abstract framework components and a cloud-based software architecture that allows a modular approach to creating such applications. The pathway developed through adapting the iPAC framework, which involves personalization, authenticity, and collaboration, is part of the methodology used to design the app under pedagogical and technological considerations. The process demanded the following phases: analysis and exploration, design and construction, evaluation and reflection, redesign and reconstruction, and final critical reflections. Four applied instruments also validate the framework implementation: The iPAC Rubric, an aphorisms checklist, a pre and post-test, a focus group, and a usability test taken by 28 students in a private university in Colombia. Findings indicated that Design-Based Research (DBR) methodology emerged as an appropriate tool to encounter the needs behind reading applications design due to its sequence of operations yields results successively closer to adequate usability standards and smooth implementation. They also reveal the positive impact of new types of texts on students' motivation and awareness toward other reading strategies and micro-learning. This impact indeed proved the proposed framework's effectiveness for designing micro-learning applications.

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BACKGROUND: Martinique shares with the other Caribbean countries specific public health issues, particularly in the diagnostic and therapeutic management of cancer patients. Mutualization of human and material resources by promoting cooperation is the most appropriate response to the challenges of the health systems of the Caribbean territories. Through the French PRPH-3 program, we propose to set up a collaborative digital platform adapted to the specificities of the Caribbean to strengthen professional links and skills in oncofertility and oncosexology and reduce inequalities in access to reproductive and sexual health care for cancer patients. METHODS: Within the context of this program, we have developed of an open-source platform based on a Learning Content Management System (LCMS), with an operating system developed by UNFM for low speed internet. LO libraries have been created and interaction between trainers and learners were done in asynchronous mode. This training management platform is based on: a TCC learning system (Training, Coaching, Communities); a web-hosting with pedagogical engineering appropriate to low bandwidth; a reporting system and a responsibility for processing. RESULTS: We have carried out a flexible, multilingual and accessible digital learning strategy functionality called e-MCPPO according to low-speed internet ecosystem. In close connection with the e-learning strategy we conceived (i) a multidisciplinary team; (ii) an appropriate training program for expert health professionals and (iii) a responsive design. DISCUSSION AND CONCLUSION: This low-speed web-based infrastructure allows communities of experts to cooperate in creating, validating, publishing and managing academic learning content. The self-learning modules provide the digital layer for each learner to extend their skills. Learners, as well as trainers, would gradually take ownership of this platform and encourage its promotion. Innovation in this context is both technological (low-speed Internet broadcasting, free interactive software) and organizational (moderating educational resources). This collaborative digital platform is unique in its form and content. This challenge could contribute to the digital transformation of the Caribbean ecosystem for capacity building in this specifics topics.

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In an academic semester, living in social isolation and under restrictions of the pandemic, we organized weekly multidisciplinary seminars from a postgraduate course program in Curitiba, Southern Brazil, integrating students from different regions of Brazil and South America. Outstanding researchers from Brazil, Germany, France, Argentina, Mexico, Portugal, England, and United States' institutions gave seminars on chronic and infectious diseases with immunological, pharmacological, biochemical, cellular, and molecular biology point of views. The meetings were longer than traditional seminars, containing a part with scientific debate and other with a humanization or deconstruction of the researcher including trajectory, hobbies, scientific, and social thoughts. To facilitate learning and conceptualization, the seminars were available through YouTube and we applied weekly questionnaires to be answered rescuing scientific and motivational topics to give companionship and support to the students in pandemic times. Here, we are defending the creation of permanent platforms for scientific diffusion, with higher accessibility, connecting centers of different levels and giving academic excellence and opportunities for young researchers. Feedback received from participants indicates that this seminar structure can increase confidence and improve their perception of scientific processes and inspire researchers with development trajectories. We have discussed multidisciplinarity, scientific excellence, regional isolation and economic inequality, integration, humanization, and the value of science in society.

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SUMMARY: E-learning courses become increasingly important and relevant in medicine and health sciences over the last decade. However, there are few teaching experiences of e-learning histology courses published in the literature worldwide. Moreover, most of these studies focus on the didactic aspects of the course without exploring student participation. The study presented below aimed to validate a scale to measure student participation in an e-learning histology course. We provide evidence of validity of the instrument based on its internal structure for use with medical, nursing, and midwifery students. The participants in this study were a group of 426 Chilean medical, nursing and midwifery students from a public university who completed the questionnaire in two consecutive semesters (2020-2021). Data from the first group of students were used to perform an exploratory factor analysis (EFA), while data from the second group of participants were used to perform a confirmatory factor analysis (CFA). The three factors identified according to the CFA were: "Habits of online," "Motivation for online learning," and "Interaction of online". After eliminating one of the initial items of the instrument, the scale showed acceptable psychometric properties suggesting that it is a useful instrument to measure students' perception of their participation in e-learning histology courses. The factors identified through the validation of the instrument provide relevant information for teachers and curriculum developers to create and implement different ways of encouraging student participation in e- learning histology courses to support online learning.

Los cursos e-learning han tomado mayor importancia y relevancia durante la ultima década en carreras de medicina y ciencias de la salud. No obstante, existen escasas experiencias docentes de cursos de histologia e-learning publicadas en la literatura mundial. Además, la mayoría de estos estudios se centran en los aspectos didácticos del curso sin explorar la participación de los estudiantes. El estudio que presentamos a continuación tuvo por objetivo validar una escala para medir la participación de los estudiantes en un curso de histología e-learning. Aportamos evidencia de validez del instrumento basada en su estructura interna para su uso con estudiantes de medicina, enfermería y obstetricia. Los participantes de este estudio fueron un grupo de 426 estudiantes chilenos de medicina, enfermería y obstetricia de una universidad pública quienes completaron el cuestionario en dos semestres consecutivos (año 2020-2021). Los datos del primer grupo de estudiantes se utilizaron para realizar un análisis factorial exploratorio (AFE), mientras que los datos del segundo grupo de participantes se utilizaron para realizar un análisis factorial confirmatorio (AFC). Los tres factores identificados según el AFC fueron: "Hábitos de los estudiantes en línea", "Motivación por el aprendizaje en línea", "Interacción de los estudiantes en línea". Luego de la eliminación de uno de los ítems iniciales del instrumento, la escala mostró propiedades psicométricas aceptables sugiriendo que es un instrumento útil para medir la percepción de los estudiantes sobre su participación en cursos de histología en formato e-learning. Los factores identificados mediante la validación del instrumento entregan información relevante para que los profesores y curriculistas desarrollen e implementen diferentes formas de estimular la participación de los estudiantes en cursos de histología e- learning y así apoyar el aprendizaje en formato online.

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BACKGROUND: Universities' training process intensely relies on face-to-face education. The COVID-19 pandemic interrupted it and forced them to reinvent their process online. But this crisis seems not to be the last we will face, and we take it as a lesson to prepare for future crises. These critical contexts are especially challenging because they imply changing teaching strategies, and students may not have the technology access or the living conditions to connect as they need. They also lived through a pandemic where the virus and the life changes added stress to their learning process and threatened their well-being. So, this study aims to analyze how well-being variations reported by Health sciences students relate to their learning opportunities, access conditions, and daily activities. METHOD: We surveyed 910 Health sciences students from six different Chilean universities at the end of the first semester of 2020, the first in pandemic conditions. Respondents answered online questionnaires about 1) Remote teaching activities, 2) Learning resources availability, 3) Daily life activities, and 4) Well-being changes. We performed descriptive analysis and Structural Equation Modelling. RESULTS: Live videoconference classes were the most frequent teaching activity; only a third of the students had quiet spaces to study online, and most had to housekeep daily. More than two third reported some well-being deterioration. The structural equation model showed a good fit. CONCLUSION: Results show an online learning scenario that tries to emulate traditional learning focusing on expositive strategies. Most students reported that their well-being deteriorated during the semester, but tutorials, workplace availability, and social support were protective factors.

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INTRODUCTION: A simulation model improves the learning of dental anaesthesia in dental students. This study explored first, the making at home of a dental anaesthesia simulation model by dental students, and second, the impact of that simulation model on the learning of dental students following an online course. We compared the level of knowledge, the level of perception of confidence to perform the basic injection technique (BIT) of dental anaesthesia, and the level of attitude towards e-learning of the BIT between a group of dental students who had an online course with a home-made dental anaesthesia simulation model (HMDASM) and a group of dental students who did not use that model. MATERIALS AND METHODS: A group of participants (n = 28) used the HMDASM to learn the BIT with an e-learning course. Another group of participants (n = 28) followed the same e-learning course, but that group used a lemon to practise the BIT. The two groups answered questionnaires that explored the level of theoretical knowledge on the BIT, the level of perception of confidence to perform the BIT, and the level of attitude towards e-learning of the BIT. Questionnaire scores from each group were compared by a Student's t-test (p ≤ .05). RESULTS: The group that used the HMDASM had a level of knowledge similar to that of the other group (p > .05). The group that used the HMDASM had a level of perception of confidence to perform the BIT and a level of attitude towards online learning of the BIT higher than those of the group that did not use the simulation model (p < .05). CONCLUSION: The use of a HMDASM had a positive effect on dental students following an online course to learn the BIT.

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INTRODUCTION: This scoping review aimed to determine the frequency of different teaching methodologies, tools and platforms applied in dental education during the COVID-19 pandemic. MATERIALS AND METHODS: The search strategy was performed in six databases and grey literature. A total of 28 questionnaire-based studies were included, without language or time restriction, from 20 different countries. RESULTS: Six thousand five hundred sixty-five participants were assessed: 84% undergraduates, 9% of faculty members, 5% of postgraduate students/residents/trainees and 2% of dental schools/residency programs. The pooled eligible data for teaching methodologies were 62% of a combination of different methods (95% CI, 35.5% to 82.3%), 23% a combination of synchronous and asynchronous formats (95% CI, 8.2% to 50.2%) and 15% for only synchronous lectures (95% CI, 4.3% to 42.2%). The reported tools were laptops (40%), smartphones (40%), tablets (40%), desktops (20%), Blackboard (20%), Respondus Lockdown Browser (20%), eProctor (20%) and PowerPoint (20%). The most used platforms were Zoom (70.6%), Microsoft Teams (23.5%) and Cisco Webex (23.5%). A better time management (17.9%; 95% CI, 7.9% to 35.6%) and the possibility of revision with additional notes (14.3%; 95% CI, 5.7% to 31.5%) was the greatest advantages related to dental e-learning, while the increased levels of anxiety/stress/burnout/exhaustion (35.7%; 95% CI, 21% to 54.2%) and internet connection problems (35.7%; 95% CI, 21% to 54.2%) was the most cited disadvantages. CONCLUSION: This scoping review showed promising blended teaching methodologies, tools and platforms in the dental education profile. The evidence suggests that e-learning technologies can widely contribute to dental education during the COVID-19 pandemic. Therefore, this study makes a major contribution to research by assessing the impact of COVID restrictions on dental education and further studies are needed to identify how restrictions in dental practice will affect future professionals.

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Background: Antimicrobial resistance is a growing health problem worldwide. One strategy to face this problem in a reasonable way is training health personnel for the rational use of antimicrobials. There are some difficulties associated with medical staff to receiving training with E-learning education, but there is a lack of studies and insufficient evidence of the effectiveness of this method compared to face-to-face learning. Methods: An educational intervention on antimicrobial resistance (AMR) and antimicrobial prescription practice (APP) was designed and implemented using two approaches: face-to-face and E-learning among physicians of the intensive care unit (ICU) and internal medicine ward (IMW) at Eugenio Espejo Hospital in Quito. Modalities of interventions were compared to propose a strategy of continuous professional development (CPD) for all hospital staff. An interventional study was proposed using a quasi-experimental approach that included 91 physicians, of which 49 belong to the IMW and 42 to the ICU. All of them received training on AMR­half in a face-to-face mode and the other half in an asynchronous E-learning mode. They then all participated on APP training but with switched groups; those who previously participated in the face-to-face experience participated in an E-learning module and vice-versa. We evaluated self-perception about basic knowledge, attitudes and referred practices towards AMR and APP before and after the intervention. A review of medical records was conducted before and after training by checking antimicrobial prescriptions for all patients in the ICU and IMW with bacteremia, urinary tract infection (UTI), pneumonia, and skin and soft tissue infection. The study received IRB clearance, and we used SPSS for statistical analysis. Results: No statistically significant difference was observed between the E-learning and the face-to-face methodology for AMR and APP. Both methodologies improved knowledge, attitudes and referred practices. In the case of E-learning, there was a self-perception of improved attitudes (p < 0.05) and practices (p < 0.001) for both AMR and APP. In face-to-face, there was a perception of improvement only in attitudes (p < 0.001) for APP. In clinical practice, the use of antimicrobials significantly improved in all domains after training, including empirical and targeted treatment of bacteremia and pneumonia (p < 0.001) and targeted treatment of UTI (p < 0.05). For the empirical treatment of pneumonia, the mean number of antibiotics was reduced from 1.87 before to 1.05 after the intervention (p = 0.003), whereas in the targeted management of bacteremia, the number of antibiotics was reduced from 2.19 to 1.53 (p = 0.010). Conclusions: There was no statistically significant difference between the effect of E-learning and face-to-face strategy in terms of teaching AMR and APP. Adequate self-reported attitudes and practices in E-learning exceed those of the face-to-face approach. The empiric and targeted use of antimicrobials improved in all reviewed cases, and we observed an overall decrease in antibiotic use. Satisfaction with training was high for both methods, and participants valued the flexibility and accessibility of E-learning.

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ABSTRACT BACKGROUND: Use of the web for radiological education is an obvious application. Many computer-based teaching materials have been developed over recent years, and e-learning is becoming increasingly popular in medical schools. OBJECTIVE: To assess whether the effectiveness of distance-learning and/or e-learning, m-learning and web-based methods are equivalent to traditional methods. DESIGN AND SETTING: Systematic review of comparative studies of teaching techniques guided by Best Evidence Medical Education. METHODS: A search was carried out in the MEDLINE, EMBASE, Cochrane Library, Tripdatabase, CINAHL and LILACS online databases in April 2020, for original publications in all languages. The following MeSH terms were used: Ultrasonography; Teleradiology; Telemedicine; Education, Medical; Teaching; and Simulation Training; along with the terms e-learning, m-learning and web-based. All eligible studies were assessed using the Kirkpatrick model and Buckley's quality indicators. RESULTS: The search in the databases and a manual search resulted in 4549 articles, of which 16 had sufficient methodological quality for their inclusion. From analysis of these data, it was observed that teaching of ultrasonography using telemedicine methods is similar to the traditional method, except for venous access procedures, for which the studies did not show agreement. CONCLUSION: We found that learning via telemedicine methodologies presents great acceptance among students, besides demonstrating quality similar to the traditional method. Thus, at least at the moment, this has the capacity to serve as an important adjunct in the teaching of ultrasonography. REGISTRATION NUMBER: DOI: 10.17605/OSF.IO/CGUPA at the OPENSCIENCE Framework.

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ABSTRACT Various theories have endeavored to explain how knowledge is accessed. Students, in order to learn, need a good repertoire of appropriate metacognitive and self-regulating strategies and knowledge, which they use consciously or unconsciously. Teachers, in addition to knowing how to teach, need to be aware of students' learning strategies, metacognition, and self-regulation, and of the impact of changes associated with recent pandemic scenarios. Aim: The aim of this study was to identify the study strategies preferred by dental students in two different scenarios: prior to and during the pandemic. Materials and Method: The sample consisted of third-year dentistry students at Buenos Aires University (UBA) during 2019 (Group GP, 141 students, face-toface activity) and 2021 (Group GE, 60 students, e-learning during the pandemic). Participants were asked (a) to provide demographic information (sex and age) and (b) to answer the abridged ACRA scale. Statistical treatment included descriptive tests; Chi2, binomial exact and Student's t-test (p<0.05). Results: The proportion of students who participated with respect to total students enrolled was 58.50% in 2019 and 26.20% in 2021, with female gender being significantly higher. There were significant differences in total number of participants during the different periods (p=0.001), and in gender distribution during the pandemic (p=0.007). Comparison between groups GP and GE showed no significant difference regarding preferences expressed in total values for the scale or for the domains. Analysis of preferences according to gender showed significant differences in total group (p=0.007) and the domains CLCS (Cognitive and Learning Control Strategies) (p= 0.008) and LSS (Learning Support Strategies) (p=0.002). The mean values of preferences selected by females were higher. Similar results were found upon analyzing preferences during the pandemic (n= 60) considering total score (p= 0.033) and the domains CLCS (p= 0.035) and LSS (p= 0.007). Conclusions: The study identified trends towards an increase in the score and consequently greater use of techniques included in the domains related to metacognition, especially among women. There is potential neutralization of the impact created by the methodological shift between the two periods (face-to-face and e-learning) probably as a result of the implicit adaptability, latent in students, regarding digital methodology, which enables them to adapt to learning in challenging situations.

RESUMEN Varias teorías se han esforzado por explicar cómo se accede al conocimiento. Para aprender, los estudiantes necesitan tener un conjunto de estrategias y conocimientos apropiados, y utilizarlos consciente o inconscientemente. Los docentes deben conocer las estrategias de aprendizaje, la metacognición y la autorregulación de los estudiantes, así como el impacto de los cambios asociados con los escenarios pandémicos recientes sobre esas estrategias. Objetivo: El objetivo de este estudio fue identificar las estrategias de estudio preferidas por los estudiantes de odontología en diferentes escenarios: previo y durante la pandemia. Materiales y Método: La muestra estuvo conformada por estudiantes de tercer año de la carrera de odontología (UBA) durante el año 2019 (Grupo GP, 141 estudiantes, actividad presencial) y 2021 (Grupo GE, 60 estudiantes, e-learning durante la pandemia). Los participantes proporcionaron información demográfica (sexo y edad) y respondieron el cuestionario ACRA abreviado. El tratamiento estadístico incluyó medidas de tendencia central, dispersión y distribución de frecuencias, prueba Chi2, binomial exacta y prueba t de Student (p<0,05). Resultados: La distribución de estudiantes que participaron con respecto al total de estudiantes matriculados fue de 58,50% en 2019 y 26,20% en 2021, siendo significativamente mayor el género femenino. Hubo diferencias significativas en el número total de participantes durante los diferentes períodos (p=0,001) y en la distribución por género durante la pandemia (p=0,007). La comparación entre los grupos GP y GE no mostró diferencia significativa en cuanto a las preferencias expresadas en valores totales para la escala o para los dominios. El análisis de preferencias según género mostró diferencias significativas en: grupo total (p=0,007) y los dominios ECCA (Estrategias de Control Cognitivo y de Aprendizaje) (p= 0,008) y EAA (Estrategias de Apoyo al Aprendizaje) (p=0,002). Los valores medios de las preferencias seleccionadas por las mujeres fueron más altos. Resultados similares se encontraron al analizar las preferencias durante la pandemia (n= 60) considerando la puntuación total (p= 0,033) y los dominios ECCA (p= 0,035) y EAA (p= 0,007). Conclusiones: El estudio identificó un aumento en el puntaje y consecuentemente un mayor uso de técnicas incluidas en los dominios relacionados con la metacognición, especialmente entre las mujeres. Existe una potencial neutralización del impacto creado por el cambio metodológico entre los dos períodos (presencial y e-learning) probablemente como resultado de la adaptabilidad implícita, latente en los estudiantes, respecto a la metodología digital, que les permita adaptarse al aprendizaje en situaciones desafiantes.