A problem-based learning experience in a radiology rotation for sixth-year medical students.

OBJECTIVE: To analyse a problem-based learning experience (PBL) in the sixth year of medicine, within a course organised in successive rotations of 12 school days for 7 annual groups. MATERIAL AND METHODS: Each group was divided into subgroups of 6-8 students. Each subgroup was assigned two cases with radiographic images that they had to prepare and present in a joint session in which the students discussed each case and the teacher acted as moderator, without providing solutions. Finally, they had 15 days to complete the debate in an online forum and prepare a written report on each case. RESULTS: During 6 consecutive years, 1001 students participated, whose annual grades ranged between 7.7 ±â€¯1.6 and 9.0 ±â€¯0.7 (mean ±â€¯standard deviation). No correlation was found between the degree of difficulty assigned to the cases and the mean score obtained by each group (R2 = 0.0115). Sixty-six point two percent completed a questionnaire rating various aspects of this experience above 4 out of 5 points and providing overall scores above 8.3 out of 10 points in the different years. The students found this experience appropriate to the objectives of the subject and useful for their educational needs. CONCLUSIONS: PBL allows students to acquire skills of understanding, reasoning and deepening in radiological diagnosis. This study demonstrates that an experience based on PBL can be included in a radiology course organised in a traditional way, allowing students to be graded regardless of the difficulty of the cases.

[Early source control of infection in patients seen in the emergency department: a systematic review]. / Control precoz del foco de infección en los pacientes atendidos en el servicio de urgencias: una revisión sistemática.

OBJECTIVE: The term source (or focus) control encompasses all those physical measures that can be used to reduce the inoculum and modify those factors in the infectious medium that promote microbial growth or foreign antimicrobial defenses of the host. The main objective of this systematic review (SR) is to know and compare whether early detection and control of the focus (in less than 6 hours) in adult patients treated in the ED for severe infection or sepsis, compared to not controlling the focus or delayed focus control (more than 12 hours) is more effective and safer (improves clinical evolution, mortality, complications, hospital stay or need for ICU admission). METHODS: A systematic review is carried out following the PRISMA regulations in the databases of PubMed, Web of Science, EMBASE, Lilacs, Cochrane, Epistemonikos, Tripdatabase and ClinicalTrials.gov from January 2000 to December 31, 2023 without language restrictions and using a combination of MESH terms: "Source Control", "Early" "Infection OR Bacterial Infection OR Sepsis", "Emergencies OR Emergency OR Emergency Department" and "Adults". Observational cohort studies were included. No meta-analysis techniques were performed, but results were compared narratively. RESULTS: A total of 1,658 articles were identified, of which 2 that met the inclusion criteria and were classified as high quality were finally analyzed. The included studies represent a total of 2,404 patients with 678 cases in which an intervention was performed to control the focus (28.20%). In the first study, 28-day mortality was lower in patients who underwent an intervention to control the focus (12.3% vs. 22.5%; P <0.001), with an adjusted HR of 0.538 (95% CI: 0.389-0.744; P<0.001). In the second, it was demonstrated that the time elapsed from when the patient was evaluated for the first time and was hemodynamically stabilized, until the start of surgery was associated with his survival at 60 days with an OR of 0.31 (95% CI: 0.19-0.45; P <0.0001). In fact, for each hour of delay an adjusted OR of 0.29 (95% CI: 0.16-0.47; P<0.0001) is established. So if the intervention is performed before 2 hours at 60 days, 98% of the patients are still alive, if it is performed between 2-4 hours it is reduced to 78%, if it is between 4-6 hours it drops to 55%, but if it is done for more than 6 hours there will be no survivors at 60 days. CONCLUSIONS: This review shows that source control carried out after the evaluation of patients attending the ED reduces short-term mortality (30-60 days) and that it would be advisable to implement any required source control intervention as soon as possible, ideally early (within 6 hours).

Possibilities of the three-dimensional virtual environment tridimensional Second Life® for training in radiology. / Posibilidades del entorno virtual tridimensional Second Life® para la formación en radiología.

Three-dimensional virtual environments enable very realistic ludic, social, cultural, and educational activities to be carried out online. Second Life® is one of the most well-known virtual environments, in which numerous training activities have been developed for healthcare professionals, although none about radiology. The aim of this article is to present the technical resources and educational activities that Second Life® offers for training in radiology based on our experience since 2011 with diverse training activities for undergraduate and postgraduate students. Second Life® is useful for carrying out radiology training activities online through remote access in an attractive scenario, especially for current generations of students and residents. More than 800 participants have reported in individual satisfaction surveys that their experiences with this approach have been interesting and useful for their training in radiology.