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Introduction: This study aimed to develop, implement, and test a visuo-haptic simulator designed to explore the buoyancy phenomenon for freshman engineering students enrolled in physics courses. The primary goal was to enhance students' understanding of physical concepts through an immersive learning tool. Methods: The visuo-haptic simulator was created using the VIS-HAPT methodology, which provides high-quality visualization and reduces development time. A total of 182 undergraduate students were randomly assigned to either an experimental group that used the simulator or a control group that received an equivalent learning experience in terms of duration and content. Data were collected through pre- and post-tests and an exit-perception questionnaire. Results: Data analysis revealed that the experimental group achieved higher learning gains than the control group (p = 0.079). Additionally, students in the experimental group expressed strong enthusiasm for the simulator, noting its positive impact on their understanding of physical concepts. The VIS-HAPT methodology also reduced the average development time compared to similar visuo-haptic simulators. Discussion: The results demonstrate the efficacy of the buoyancy visuo-haptic simulator in improving students' learning experiences and validate the utility of the VIS-HAPT method for creating immersive educational tools in physics.

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Introduction: The teaching process plays a crucial role in the training of professionals. Traditional classroom-based teaching methods, while foundational, often struggle to effectively motivate students. The integration of interactive learning experiences, such as visuo-haptic simulators, presents an opportunity to enhance both student engagement and comprehension. Methods: In this study, three simulators were developed to explore the impact of visuo-haptic simulations on engineering students' engagement and their perceptions of learning basic physics concepts. The study used an adapted end-user computing satisfaction questionnaire to assess students' experiences and perceptions of the simulators' usability and its utility in learning. Results: Feedback from participants suggests a positive reception towards the use of visuo-haptic simulators, highlighting their usefulness in improving the understanding of complex physics principles. Discussion: Results suggest that incorporating visuo-haptic simulations into educational contexts may offer significant benefits, particularly in STEM courses, where traditional methods may be limited. The positive responses from participants underscore the potential of computer simulations to innovate pedagogical strategies. Future research will focus on assessing the effectiveness of these simulators in enhancing students' learning and understanding of these concepts in higher-education physics courses.

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Background/purpose: Ergonomics in dentistry encourages the work to be in an organized manner, where a dentist achieves highest performance with maximum comfort and minimum physical and psychological effort. The purpose of this study was to evaluate the ergonomic sitting position of dental students from third, fourth and fifth year undergraduate programs while they prepared teeth 46 and 27 as Black Class I preparation for amalgam using dental simulators. Materials and methods: Ten students were randomly selected from each year for this study. Photos and videos were taken from them to record their sitting position as they performed a Black Class I amalgam preparation in Nissin simulators. Results: It was found that more students had a poor ergonomic sitting position while working in mandibular area (60%, torso and neck angle; 53% knee-angle; 50% elbow-angle). When comparing the average score between maxilla and mandible within students of the same year, fourth year students had a significant difference in their average, with a better performance in maxilla (P ≤ 0.01). They also showed better performance in maxillary area compared to fifth-year students (P ≤ 0.008). The main reasons that the students presented as justification for their bad posture were little work time, lack of knowledge, not knowing how to use indirect vision, and poor comfort. Conclusion: Every undergraduate year had a compromised sitting position, with the exception of fourth-year students when working in maxillary area. No correlation between undergraduate year and performance was found.

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RESUMEN El constante perfeccionamiento del proceso educativo del hombre demanda el enriquecimiento de las prácticas de la educación avanzada. Es preciso efectuar transformaciones en el trabajo educativo, por lo que resulta indispensable que se oriente de forma tal que permita potenciar en cada estudiante aquellos aspectos que le faciliten conocer, de una manera más significativa, el momento histórico en que viven. Los simuladores virtuales, como método de aprendizaje en ciencias médicas, son potenciadores del aprendizaje y ayudan a evadir el obstáculo de horas limitadas en la práctica clínica, grupos numerosos, inconsistencias en la observación de enfermedades de alto riesgo o inusuales. En Cuba, la utilización de estos no ha sido explotada al máximo. Los estudios que han evaluado la efectividad de estos simuladores en la mejoría del desempeño de los profesionales de la salud, han arrojado resultados muy positivos, pero el elevado precio de los simuladores ha constituido la mayor barrera para su completa introducción en Cuba. Este trabajo expresa la posición de los autores sobre la pertinencia de los laboratorios de simulación como herramienta de educación avanzada en salud. El uso de los laboratorios de simulación en la educación médica, es una práctica positiva en el perfeccionamiento de las competencias profesionales y ofrece la seguridad de la atención sanitaria; no es un sustituto de la práctica supervisada en entorno real, sino un complemento deseable para una pericia segura y efectiva que permite desarrollar habilidades, conocimientos y actitudes, es decir, capacidades para su óptimo desempeño.

ABSTRACT The constant improvement of the educational process of man demands the enrichment of the practices of advanced education. It is necessary to carry out transformations in the educational work, so it is essential that it be oriented in such a way that it allows each student to enhance those aspects that make it easier for them to know, in a more significant way, the historical moment in which they live. Virtual simulators, as a learning method in medical sciences, are learning enhancers and help to avoid the obstacle of limited hours in clinical practice, large groups, inconsistencies in the observation of high-risk or unusual diseases. In Cuba, the use of these has not been exploited to the maximum. The studies that have evaluated the effectiveness of these simulators in improving the performance of health professionals have yielded very positive results, but the high price of the simulators has constituted the greatest barrier to their full introduction in Cuba. This work expresses the position of the authors on the relevance of simulation laboratories as a tool for advanced health education. The use of simulation laboratories in medical education is a positive practice in the improvement of professional skills and offers the security of health care, it is not a substitute for supervised practice in a real environment, but a desirable complement to an expertise safe and effective, which allows developing skills, knowledge and attitudes, that is, capacities for optimal performance.

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Dentro de este magnífico mundo de enseñanza ­aprendizaje existen muchos elementos de influencia más allá de solo un maestro, un alumno o un aula; crear ambientes de aprendizaje dinámicos, efectivos y orientados a la generación de aprendizaje significativo es tarea de todos los profesionales de la educación; para ello debemos romper esquemas, modelos anacrónicos y pensar en estrategias propositivas adaptadas a las nuevas y diferentes formas de aprender de las generaciones actuales y futuras creando entornos amigables, prácticos y efectivos. Este artículo plantea la utilización de simuladores en los ámbitos educativos, como una forma de facilitar el aprendizaje mediante el uso de los métodos y herramientas de transmisión de conocimiento adaptadas a las necesidades de aprendizaje actuales, es decir, de explotar las herramientas propias de la época en la que vivimos; en este caso las tecnológicas; esto se vuelve necesario considerando que tanto los métodos de enseñanza ­aprendizaje, como los sistemas educativos de hoy en día, ya no son del todo suficientes para cubrir las expectativas de educación actuales, debido a que hoy en día en muchos países aún se siguen utilizando métodos y estrategias educativas diseñadas para cubrir las necesidades de las sociedades del siglo pasado. En este documento se habla sobre la necesidad actual de contar con herramientas que potencialicen la calidad y efectividad del proceso de enseñanza ­aprendizaje en las aulas y de la propuesta de un método de investigación participativa en la cual es posible identificar cómo la implementación de herramientas TIC por medio del uso de simuladores en aula, es efectiva y benéfica para mejorarla adquisición y dominio de conocimiento en los estudiantes de la licenciatura de Psicología del trabajo de la Universidad Autónoma de Querétaro, logrando en ellos un mejor desempeño profesional y mayor éxito en las actividades propias de su profesión.

Around the magnific world of the teaching -learning, exist many influencing elements more than the only a professor, a student or an classroom; work to make a dynamic and effective learning environments and oriented to create significative learning is a job of all the professionals of learning, to do that, we have to broke schemes, anachronic models and think In propositives strategies aligned to the new and different ways of learn of the actually and future generations, creating friendly, practical and effective environments. This article proposes the use of simulator systems in educational environments, is a way to facilitate the learning through the use of methods and tools to help the transmission of knowledge adapted to current learning needs, that is to, exploit the modern tools; the technology tools. That becomes necessary considering that both the teaching ­learning methods and the actually educational systems, are very far from covering the current education expectations and needs because in many countries are using educational methods and strategies designed to comply the needs of the last century societies. This article, talk about the current need to count with tools that enhance the quality and effectiveness of the teaching -learning process in the classrooms and the proposal of a participatory investigation method with which is possible to identify how the implementation of TIC tools across the use of simulators in classroom is effective and beneficial to get better and acquire mastery of learning on the psychology students of autonomous university of Querétaro, achieving a better professional performance in them and greater success in professional activities.

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Simulation offers the opportunity to practice in a safe, controlled, and standardized environment. Surgical simulation, in particular, is very attractive because it avoids learning and practicing surgical skills in the operating room. Many simulators are currently available such as box-lap trainers, virtual-reality platforms, cadavers, live animals, animal-based tissue blocks, and synthetic/artificial models. Endoscopic interventions can be practiced with high-fidelity virtual simulators. Box-lap trainers help practicing basic laparoscopic skills. Cadavers and live animals offer realism to train entire foregut and bariatric procedures. However, limited availability and high expenses often restrict their use. Ex vivo simulators with animal tissue blocks have been recently developed and appear to be a realistic and cost-effective alternative. Three-dimensional printing and real-time navigation systems have also emerged as promising training tools. Overall, further efforts are needed to develop a formal simulation curriculum with validated simulators for foregut and bariatric surgery.

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Resumen: Introducción: Los medios o recursos aplicables a la enseñanza son componentes activos en el proceso de enseñanza-aprendizaje. En medicina, a través de la historia, el paciente es el medio de enseñanza fundamental del médico. Objetivo: Realizar una actualización sobre el papel de los medios de enseñanza en anestesiología y reanimación. Desarrollo: Los medios de enseñanza se elaboran en las etapas vinculadas con la fase sensorial del conocimiento científico, ya sea abstracto o concreto. Se obtiene a través de sensaciones y percepciones de los órganos de los sentidos y la fase racional del conocimiento abstracto. Existen diversas teorías del aprendizaje que, por lo general, están estructuradas sobre la base de la teoría del conocimiento y la personalidad. Los objetivos de los medios de enseñanza están determinados por las necesidades y las exigencias sociales. Los medios de enseñanza responden al con qué se enseña. Son los recursos que sustentan los métodos a su soporte material. Resulta muy difícil en la práctica separar la selección de los métodos y la de los medios de enseñanza. Ambos constituyen una unidad dialéctica, estrechamente relacionados. En anestesiología, el hecho de utilizar maquetas, maniquíes y simulación ayudan al residente a crear habilidades antes de tratar al paciente. Conclusiones: Los medios de enseñanza constituyen una fuente de inestimable valor para que el estudiante constate la realidad y para que el profesor la demuestre.

Abstract: Introduction: The means or resources applicable to teaching are active components in the process of teaching and learning. In medicine, throughout history, the patient is the fundamental teaching medium of the physician. Objective: To provide an update on the role of teaching resources in anesthesiology and resuscitation. Development: The means of teaching are elaborated in the stages linked to the sensory phase of scientific knowledge, whether abstract or concrete. It is obtained through sensations and perceptions of the sense organs and the rational phase of abstract knowledge. There are various theories of learning that are generally structured on the basis of the theory of knowledge and personality. The objectives of the teaching media are determined by social needs and requirements. The means of teaching respond to what is taught. They are the resources that support the methods to their material support. It is very difficult in practice to separate the selection of methods and the selection of teaching resources. Both constitute a dialectical unit, closely related. In anesthesiology, the use of models, mannequins and simulation help the resident build skills, before treating the patient. Conclusions: The means of teaching constitute a source of inestimable value for the student to verify reality and for the teacher to demonstrate it.

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Abstract The A-type potassium current (IA) participates in important brain functions, including neuronal excitability, synaptic integration, and regulation of action potential patterns and firing frequency. Based on the characterization of its electrophysiological properties by current and voltage clamp techniques, mathematical models have been developed that reproduce IA function. For such models, it is necessary to numerically solve equations and utilize hardware with special speed and performance characteristics. Since specific software for studying IA is not found on the Internet, the aim of this work was to develop a set of simulators grouped into three computer programs: (1) IA Current, (2) IA Constant-V Curves and (3) IA AP Train. These simulators provide a virtual reproduction of experiments on neurons with the possibility of setting the current and voltage, which allows for the study of the electrophysiological and biophysical characteristics of IA and its effect on the train of action potentials. The mathematical models employed were derived from the work of Connor et al., giving rise to Hodgkin-Huxley type models. The programs were developed in Visual Basic® and the differential equation systems were simultaneously solved numerically. The resulting system represents a breakthrough in the ability to replicate IA activity in neurons.

Resumen La corriente de potasio tipo-A (IA) tiene importantes funciones cerebrales como: excitabilidad neuronal, integración sináptica y regulación de patrones de potenciales de acción y la frecuencia de disparo. Sus propiedades electrofisiológicas se han caracterizado mediante técnicas de fijación de corriente y de voltaje. A partir de estos conocimientos se desarrollaron modelos matemáticos que reproducen su función. La cantidad de ecuaciones a resolver hace que se requiera de hardware con velocidad y potencia especiales. Un software específico para el estudio propio de la corriente IA no se ha encontrado en Internet. En este trabajo se presenta un conjunto de simuladores agrupados en tres programas de cómputo: (1) Corriente IA, (2) Curvas Constante-V y (3) Tren-IA, que permiten reproducir los experimentos con técnicas de fijación de corriente y de voltaje para estudiar las características electrofisiológicas y biofísicas de la corriente IA, e investigar el efecto que tiene en el tren de potenciales de acción. Los modelos matemáticos utilizados fueron derivados de los trabajos de Connor et al., dando origen a modelos tipo Hodgkin y Huxley. Los programas fueron desarrollados en Visual Basic®. Los sistemas de ecuaciones diferenciales fueron resueltos simultáneamente de forma numérica. Los programas desarrollados contribuyen a solucionar la carencia de este tipo de programas.

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BACKGROUND: Endoscopic ultrasound (EUS) and endoscopic ultrasound elastography (EUS-E) simulation lessens the learning curve; however, models lack realism, diminishing competitiveness. AIM: To standardize the mechanical properties of polyvinyl alcohol (PVA) hydrogel for simulating organs and digestive lesions. METHODS: PVA hydrogel (Sigma Aldrich, degree of hydrolysis 99%) for simulating EUS/EUS-E lesions was investigated in Unidad de Investigación y Desarrollo Tecnológico at Hospital General de México "Dr. Eduardo Liceaga", Mexico City. We evaluated physical, contrast, elasticity and deformation coefficient characteristics in lesions, applying Kappa's concordance and satisfaction questionnaire (Likert 4-points). RESULTS: PVA hydrogel showed stable mechanical properties. Density depended on molecular weight (MW) and concentration (C). PVA bblocks with the greatest density showed lowest tensile strength (r = -0.8, P = 0.01). Lesions were EUS-graphically visible. Homogeneous and heterogeneous examples were created from PVA blocks or PVA phantoms, exceeding (MW2 = 146000-186000, C9 = 15% and C10 = 20%) with a density under (MW1 = 85000-124000, C1 = 7% and C2 = 9%). We calculated elasticity and deformation parameters of solid (blue) areas, contrasting with the norm (Kappa = 0.8; high degree of satisfaction). CONCLUSION: PVA hydrogels were appropriate for simulating organs and digestive lesions using EUS/EUS-E, facilitating practice and reducing risk. Repetition amplified skills, while reducing the learning curve.

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STUDY DESIGN: Literature review and transversal study. OBJECTIVE: Advances in new technologies give the surgeons confidence to manage complex spine conditions with a lower morbidity rate. This has changed the expectations of patients and medical payers and foreshadows the shift now underway: the use of minimally invasive techniques. The ethical considerations of learning directly on patients require a change in the education and training programs. METHODS: The education paradigm has changed, and surgical training on minimally invasive surgery of the spine (MISS) techniques should follow a "curriculum." The assessment of skill proficiency while learning the MISS techniques must be measurable to objectively show the performance gained over time and the changes that should be performed during training. Different strategies include "ex vivo" and "in vivo" training. RESULTS: We have worked on a curriculum in which the participants can perceive the growth in their knowledge through the different educational opportunities. There are 3 levels: basic, advanced, and masters. CONCLUSIONS: We developed an educational curriculum for MISS rationale and techniques, that showed to be effective and interesting in our region.

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BACKGROUND: The aims of this study are (a) to assess the psychometric quality of an instrument of acceptance of new technologies adapted from the UTAUT model, (b) to validate the UTAUT model as a valid measure to be applied in dental education, and (c) to determine which factors of the UTAUT model predict the behavioural intention of using a haptic virtual simulator (HVS). METHODS: A cross-sectional design study with a sample of 265 dentistry students was carried out. RESULTS: Using structural equation modelling, confirmatory factor analysis verified the adequacy of four-factor model, although the only factor that directly predicts behavioural intention is performance expectancy. Internal consistency coefficients of each factor ranged from 0.800 to 0.969. DISCUSSION: These findings, as well as the predictive power of performance expectancy on behaviour intention, are in line with previous evidence found in the literature. CONCLUSION: These findings suggest that the UTAUT scale has adequate reliability and construct factorial validity; therefore, UTAUT model could be a valuable approach to assess haptic virtual simulator acceptance in dental education.

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INTRODUCTION: Simultaneous mechanical ventilation of several patients with a single ventilator might reduce the deficit of these devices for the care of patients with acute respiratory failure due to Covid-19. OBJECTIVE: To communicate the results of a mechanical ventilation exercise with a ventilator in a lung simulator, and simultaneously in two and four. RESULTS: No statistically significant differences were observed between programmed, recorded and measured positive end-expiratory pressure, mean airway pressure and peak pressure, except when simultaneously ventilating four lung simulators. CONCLUSIONS: Simultaneous mechanical ventilation should be implemented by medical personnel with experience in the procedure, be restricted to two patients and carried out in the intensive care unit.

INTRODUCCIÓN: La ventilación mecánica simultánea a varios pacientes con un solo ventilador podría disminuir el déficit de esos dispositivos para atender a los enfermos con insuficiencia respiratoria aguda por Covid-19. OBJETIVO: Comunicar los resultados de un ejercicio de ventilación mecánica con un ventilador en un simulador de pulmón, y simultáneamente en dos y cuatro. RESULTADOS: No se observaron diferencias estadísticamente significativas entre la presión positiva al final de la espiración, presión media de la vía aérea y presión pico programadas, registradas y medidas, excepto al ventilar simultáneamente cuatro simuladores de pulmón. CONCLUSIONES: La ventilación mecánica simultánea debe ser instaurada por personal médico con experiencia en el procedimiento, restringirse a dos pacientes y ser realizada en la unidad de cuidados intensivos.

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BACKGROUND: Surgical simulation is particularly attractive because it allows training in a safe, controlled, and standardized environment. However, the status of surgical simulation among Departments of Surgery (DoS) in the United States is unknown. The objective of this study was to characterize the status of simulation-based training in DoS in the United States. MATERIALS AND METHODS: A Qualtrics online survey was sent to 177 chairs of DoS in the United States in March 2018 regarding the utilization of surgical simulation in their department. Questions in the survey were focused on simulation capacities and activities as well as chairs' perception of the value and purpose of simulation. RESULTS: A total of 87 of 177 chairs responded to the survey (49% response rate). Most programs had either 20-50 trainees (42 of 87; 48%) or more than 50 trainees (37 of 87; 43%). Most chairs reported having a simulation center in their institution (85 of 87; 98%) or department (60 of 86; 70%) with a formal simulation curriculum for their trainees (83 of 87; 95%). Ninety percent (78 of 87) of DoS had protected time for simulation education for their residents, with most residents engaging in activities weekly or monthly (65 of 85; 76%). Although most chairs felt simulation improves patient safety (72 of 84; 86%) and is useful for practicing surgeons (68 of 84; 81%), only 40% reported that faculty use simulation to maintain technical skills and only 17% reported that faculty use simulation to address high complication rates. CONCLUSIONS: The vast majority of the DoS in the United States have established simulation activities for their trainees. However, engagement of faculty in simulation to maintain or improve their skills remains low.

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Resumen Introducción: La ventilación mecánica simultánea a varios pacientes con un solo ventilador podría disminuir el déficit de esos dispositivos para atender a los enfermos con insuficiencia respiratoria aguda por Covid-19. Objetivo: Comunicar los resultados de un ejercicio de ventilación mecánica con un ventilador en un simulador de pulmón, y simultáneamente en dos y cuatro simuladores. Resultados: No se observaron diferencias estadísticamente significativas entre la presión positiva al final de la espiración, presión media de la vía aérea y presión pico programadas, registradas y medidas, excepto al ventilar simultáneamente cuatro simuladores de pulmón. Conclusiones: La ventilación mecánica simultánea debe ser instaurada por personal médico con experiencia en el procedimiento, restringirse a dos pacientes y ser realizada en la unidad de cuidados intensivos.

Abstract Introduction: Simultaneous mechanical ventilation of several patients with a single ventilator might reduce the deficit of these devices for the care of patients with acute respiratory failure due to Covid-19. Objective: To communicate the results of a mechanical ventilation exercise with a ventilator in a lung simulator, and simultaneously in two and four. Results: No statistically significant differences were observed between positive end-expiratory pressure, mean airway pressure, and programmed, recorded and measured peak pressure, except when simultaneously ventilating four lung simulators. Conclusions: Simultaneous mechanical ventilation should be implemented by medical personnel with experience in the procedure, be restricted to two patients and carried out in the intensive care unit.

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BACKGROUND AND OBJECTIVE: The minimal erythema dose (MED), an essential measurement in studies of skin photosensitivity, requires establishing MED values for specific populations, given genetic variation. Different ways to assess erythema are also relevant. We aimed to determine MED values in a sample of Colombian patients and correlations between MED and Fitzpatrick skin type. We also studied concordance correlation between MEDs and two alternative ways to assess erythema. PATIENTS AND METHODS: Cross-sectional study of 113 individuals in Bogotá, Colombia. We used a solar simulator to measure UV-A radiation and combined UV-A and UV-B (UVA+UVB) radiation, o se podría suprimir este término porque UVA y UVB son términos conocidos for MED calculation. Narrowband UV-B (NBUVB) radiation was measured in a phototherapy cabin. Erythema was assessed visually and with a Mexameter MX 18 device. RESULTS: The median MEDs of UVA+UVB radiation were 22mJ/cm2 for Fitzpatrick skin typesI andII, and 33 and 43mJ/cm2, respectively, for typesIII andIV. The MEDs of UV-A radiation were 22, 42, 86, and 100J/cm2 for typesI, II, III, andIV, respectively. The MEDs of NBUVB light were 390, 550, 770, and 885mJ/cm2 for the 4 skin types. The correlation between MEDs and skin types ranged from 0.5 to 0.69. Lin's concordance correlation coefficients between visual and Mexameter assessments of erythema were greater than 0.8 in all cases. CONCLUSION: This study allowed us to understand MED values for UV-A, UVA+UVB, and NBUVB according to different skin types in the Colombian population. Concordance correlation coefficients between the different methods of erythema assessment were very good. Correlations between MEDs and skin types were moderate to good.

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The present study aimed to evaluate the applicability of artisanal simulators to teach veterinary and medical students the ultrasound-guided percutaneous biopsy using a tru-cut needle. The artisanal simulators consisted of bovine liver between two layers of commercially available grape gelatin. Students were paired, with one doing the biopsy and the other the ultrasound guidance. After performing the biopsies, each student answered a questionnaire with close-ended questions using a visual analog scale. The evaluated items were realism of the model, liver scanning, procedure instructions, biopsy feasibility, tru-cut needle handling, technique learning, and confidence to perform in vivo procedures. Items that received a score of 7 or higher were considered strong items; items with a score between 5 and 6.9 were classified as average items; and items with a score of 5 or lower were considered weak items. The answers to all questions had an average score of 7 or higher, suggesting that the simulator was classified as strong for all of the evaluated items. Answers to question 7 suggested that some of the students did not develop confidence to perform a tru-cut biopsy on a patient. Students evaluated the artisanal simulator as a strong method to be used in ultrasound-guided percutaneous biopsy with a tru-cut needle. Additionally, the model presented a low cost of production and was proven accurate to teach biopsy skills in health professional schools dealing with veterinary or human medicine.

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Resumo Apesar da controversa legislação brasileira sobre formação por simuladores de direção, seu uso ainda é escasso. Além disso, não há obrigatoriedade de seu emprego em formação de condutores rodoviários profissionais. Segundo a literatura internacional, onde o assunto é estudado há mais tempo, ainda não há evidência suficiente que justifique o amplo uso de simuladores em formações de condutores profissionais. Por outro lado, não se observa nessa literatura uma análise crítica dos efeitos dos fundamentos teórico-metodológico utilizadas nessas formações. Visando contribuir para esse debate, revisamos a literatura sobre uso de simuladores em formações de condutores rodoviários profissionais, analisando-a criticamente a partir das contribuições da Ergologia e da Didática Profissional francesa. Observamos problemas nas formações experimentadas: (a) não reconhecimento da atividade real a simular e dos saberes socialmente construídos necessários para executá-la; (b) concepção insuficiente sobre competências e saberes mobilizados em situação de trabalho; (c) incapacidade de apreensão de uma atividade profissional. Apresentamos alternativas para uso de simuladores nas formações de condutores profissionais: formações coletivas mediadas pela simulação e em torno de saberes, normas e valores partilhados pelos condutores.

Resumen A pesar de polémica legislación brasileña sobre formación de simuladores de conducción, su uso es escaso. Además, no se obliga su uso en formación de conductores profesionales. En la literatura internacional, donde el tema es pesquisado hace mucho tiempo, no existe evidencia suficiente para justificar el uso generalizado de simuladores en formaciones de conductores profesionales. Sin embargo, no se observa en esta literatura un análisis crítico de los efectos de los fundamentos teóricos y metodológicos utilizadas en estas formaciones. Contribuyendo a este debate, se revisa la literatura sobre uso de simuladores en formación de conductores profesionales, analizando-as críticamente a partir de contribuciones de la Ergología y de la Didáctica Profesional francesa. Observamos problemas en la formación pesquisadas: (a) no reconocimiento de la actividad para simular y de los saberes socialmente construidos necesario para la realizar la actividad; (b) concepción insuficiente sobre saberes y competencias movilizados en situaciones de trabajo; (c) incapacidad de aprehender una actividad professional. Presentamos alternativas para uso de simuladores en formación de conductores profesionales: formaciones colectivas mediadas por simulación y alrededor de saberes, normas y valores compartidos por los conductores.

Abstract Despite controversial Brazilian legislation on simulation-based driver training, it is used only rarely. Furthermore, there is no requirement to use it in professional road driver training. According to the international literature, in which the subject has been studied for a much longer period, there is still insufficient evidence to justify the widespread use of simulators to train professional drivers. However, this literature contains no critical analysis of the effects of the theoretical and methodological foundations utilised in this training. To contribute to this debate, we review the literature on simulation-based training for professional drivers, critically analysing it through the contributions of Ergology and French Professional Didactics. We note some problems with the different training programmes examined: (a) no recognition of the actual activity being simulated or the socially constructed knowledge that is necessary to perform it; (b) an insufficient conception of the skills and knowledge mobilised in work situations; and (c) a failure to understand a professional activity. We present alternative methods of using simulation-based training for professional drivers: collective training mediated by simulation and based on the knowledge, norms, and values shared by drivers.

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Introducción: El paro cardiorrespiratorio es la documentación de la pérdida del pulso y respiración. La resucitación cardiopulmonar (RCP) está compuesta por compresiones torácicas interpuestas por ventilaciones, las cuales pueden producir el retorno de circulación espontánea, un ritmo y pulso viable. Los parámetros de cómo realizar RCP están definidas por guías consensuadas, pero estos no son rutinariamente medidos, por lo que la calidad es desconocida. Objetivos: Determinar el grado de conocimiento teórico y práctico del manejo del paro cardiorrespiratorio en estudiantes de 6to. año de la Facultad de Medicina de la Universidad Francisco Marroquín utilizando simuladores clínicos. Metodología: Estudio descriptivo y abierto, donde se incluyeron 26 estudiantes usando simuladores de alta fidelidad de RCP, las cuales proveen respuestas fisiológicas realísticas, por medio de algoritmos matemáticos generados por programas en computadoras. Resultados: De los 26 estudiantes 0% aprobó el examen teórico con un promedio de 77.4 puntos; en la evaluación práctica ninguna pareja logró una efectividad mayor al 80%. El promedio de la profundidad de las compresiones fue de 3.38 cm, el promedio de liberación post-compresión fue de 51% y el promedio de tiempo de interrupción total fue 79 segundos. El análisis estadístico demostró que no hay relación entre los resultados del test teórico y la efectividad en las compresiones y ventilaciones en el manejo del paro cardiorrespiratorio. Conclusiones: Se pudo evidenciar que los estudiantes no tienen la competencia apropiada en Soporte Vital Básico y Avanzado, por lo que se recomienda enfocar los cursos de Advance Cardiac Life Support (ACLS) a un mayor abordaje práctico con simuladores fisiológicos y que los estudiantes realicen el curso en periodos de tiempo más seguidos. Palabras clave: Paro Cardiorrespiratorio, Simulaciones fisiológicas, compresiones efectivas, ventilaciones efectivas, ACLS, RCP

A cardiorespiratory arrest is the documentation of absence of pulse and respiration. The cardiopulmonary resuscitation (CPR) is composed of chest compressions interposed by ventilations that will increase the probability of spontaneous circulation return and a viable pulse and rhythm. The parameters of how of perform CPR are defined by consensus guides but these aren't routinely measured in the practice setting, so the quality thereof is unknown. Objective: Determine the degree of theoretical and practical knowledge of the management of cardiorespiratory arrest in students coursing 6th year of Medical School at the University Francisco Marroquín using clinical simulators. Methodology: Descriptive, open study with 26 students using RCP high fidelity simulators providing real physiologic responses throw the use of mathematic algorithms generated by computerized programs. Results: Of the 26 students, 0% approved the theoretical test, with an average grade of 77.4 points. In the practical evaluation, none of the couples achieved greater effectiveness than 80% when doing compressions or ventilations. The average of compression depth was 3.38cm, the post-compression release average was 51%; and the total interruption time average was 79 seconds. The statistical analysis showed there wasn't a relationship between the grades of the theoretical test and the effectiveness of compressions and ventilations in the management of a cardiorespiratory arrest. Conclusions: It is evident that the students don't have proper competition in the management of the Basic and Advance Life Support. It's recommended to focus ACLS courses to a more practical approach with physiological simulators and encourage students to take the course at least once a year while in their hospital rotations. Keywords: Cardiorespiratory arrest, effective compressions, effective ventilations, clinical simulators, ACLS, CPR

RESUMO

Medical procedures often involve the use of the tactile sense to manipulate organs or tissues by using special tools. Doctors require extensive preparation in order to perform them successfully; for example, research shows that a minimum of 750 operations are needed to acquire sufficient experience to perform medical procedures correctly. Haptic devices have become an important training alternative and they have been considered to improve medical training because they let users interact with virtual environments by adding the sense of touch to the simulation. Previous articles in the field state that haptic devices enhance the learning of surgeons compared to current training environments used in medical schools (corpses, animals, or synthetic skin and organs). Consequently, virtual environments use haptic devices to improve realism. The goal of this paper is to provide a state of the art review of recent medical simulators that use haptic devices. In particular we focus on stitching, palpation, dental procedures, endoscopy, laparoscopy, and orthopaedics. These simulators are reviewed and compared from the viewpoint of used technology, the number of degrees of freedom, degrees of force feedback, perceived realism, immersion, and feedback provided to the user. In the conclusion, several observations per area and suggestions for future work are provided.

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