[Simulation in medical education: a synopsis]. / Simulación en educación médica: una sinopsis.

Clinical simulation is defined as a technique (not a technology) to replace or amplify real experiences with guided experiences that evoke or replicate substantial aspects of the real world in a fully interactive fashion. Over the past few years, there has been a significant growth in its use, both as a learning tool and as an assessment for accreditation. Example of this is the fact that simulation is an integral part of medical education curricula abroad. Some authors have cited it as an unavoidable necessity or as an ethical imperative. In Chile, its formal inclusion in Medical Schools' curricula has just begun. This review is an overview of this important educational tool, presenting the evidence about its usefulness in medical education and describing its current situation in Chile.

[Evaluation of competencies for tracheal intubation among medical students]. / Evaluación de competencias de intubación traqueal mediante un escenario simulado en internos de medicina.

BACKGROUND: Chilean medical schools curricula are focused on the acquisition of competencies. Tracheal intubation is considered a terminal competence. AIM: To evaluate the competencies related to airway management including tracheal intubation in undergraduate medical students. MATERIAL AND METHODS: Prospective observational study. Thirty medical students in the sixth year of a seven years undergraduate program (25.2% of the cohort) were randomly chosen and invited to participate in a simulated environment of elective tracheal intubation using a manikin. The students were assessed according to a checklist validated with the Delphi technique and a written self-assessment questionnaire. RESULTS: Seventeen students (57%) accepted to participate, corresponding to 14.3% of the cohort. Tracheal intubation was achieved by 64%, with 60 seconds as the mean time of apnea. Less than half of the students checked the instruments, performed pre-oxygenation or evaluated the airway. Eighty-seven percent of the students said that the current curriculum offers them minimal competencies for airway management in a real clinical situation and all prefer simulated scenarios for the acquisition of clinical skills. CONCLUSIONS: The methodology currently used to teach tracheal intubation is not assuring the acquisition of the competencies to the students in this curriculum stage. More effective teaching methods are required, and the use of simulated scenarios can be a useful tool.

Implementation of Distance-Based Simulation Training Programs for Healthcare Professionals: Breaking Barriers During COVID-19 Pandemic.

SUMMARY STATEMENT: The sudden rise of critically ill patients secondary to the SARS-CoV-2 pandemic has triggered a surge in healthcare response. This project's goal was to provide essential cognitive and technical skills to healthcare professionals returning to the workforce or reassigned to critical care clinical duties during the COVID-19 pandemic. The plan included the implementation of 4 distance-based simulation training programs, with asynchronous personalized feedback. The courses allowed the acquisition of skills for the complete critical care patient management chain: use of personal protection equipment, use of a high-flow nasal cannula, endotracheal intubation, and prone positioning. Participants logged into the platform, reviewed material, practiced while recording the session, and uploaded the video through the training platform. The expert tutor remotely delivered asynchronous feedback. Participants trained remotely until achieving course approval. Remote-based simulation seems a feasible and attractive alternative to provide adequate educational solutions, especially for remote and rural areas.

Assessment of central venous catheterization in a simulated model using a motion-tracking device: an experimental validation study.

BACKGROUND: Central venous catheterization (CVC) is a basic requirement for many medical specialties. Simulated training in CVC may allow the acquisition of this competency but few reports have established a valid methodology for learning and acquiring procedural skills for CVC. This study aims to validate the use of a tracking motion device, the imperial college surgical assessment device (ICSAD), by comparing it with validated global rating scales (GRS) to measure CVC performance in a simulated torso. METHODS: Senior year medical students, first and last year residents (PGY1, LYR), and expert anesthesiologists performed a jugular CVC assessment in a simulated model (Laerdal IV Torso). A validated GRS for objective assessment of technical skills and motion analysis by ICSAD was used. Statistical analysis was performed through Mann-Whitney and Kruskal-Wallis tests for construct validity and Spearman correlation coefficients between the ICSAD and GRS scores for concurrent validity between both. RESULTS: 32 subjects were recruited (10 medical students, 8 PGY1, 8 LYR and 8 experts). Total path length measured with ICSAD and GRS scores were significantly different between all groups, except for LYR compared to experts (p = 0.664 for GRS and p = 0.72 for ICSAD). Regarding jugular CVC procedural time, LYR and experts were faster than PGY1 and MS (p < 0.05). Spearman correlation coefficient was -0.684 (p < 0.001) between ICSAD and GRS scores. CONCLUSIONS: ICSAD is a valid tool for assessment of jugular CVC since it differentiates between expert and novice subjects, and correlates with a validated GRS for jugular CVC in a simulated torso.

Simulación en educación médica: una sinopsis / Simulation in medical education: a synopsis

Clinical simulation is defined as a technique (not a technology) to replace or amplify real experiences with guided experiences that evoke or replicate substantial aspects of the real world in a fully interactive fashion. Over the pastfew years, there has been a significant growth in its use, both as a learning tool and as an assessment for accreditation. Example of this is the fact that simulation is an integral part of medical education curricula abroad. Some authors have cited it as an unavoidable necessity or as an ethical imperative. In Chile, its formal inclusion in Medical Schools' curricula has just begun. This review is an overview of this important educational tool, presenting the evidence about its usefulness in medical education and describing its current situation in Chile.

Evaluación de competencias de intubación traqueal mediante un escenario simulado en internos de medicina / Evaluation of competencies for tracheal intubation among medical students

Background: Chilean medical schools curricula are focused on the acquisition of competencies. Tracheal intubation is considered a terminal competence. Aim: To evaluate the competencies related to airway management including tracheal intubation in undergraduate medical students. Material and Methods: Prospective observational study. Thirty medical students in the sixth year of a seven years undergraduate program (25.2 percent of the cohort) were randomly chosen and invited to participate in a simulated environment of elective tracheal intubation using a manikin. The students were assessed according to a checklist validated with the Delphi technique and a written self-assessment questionnaire. Results: Seventeen students (57 percent) accepted to participate, corresponding to 14.3 percent of the cohort. Tracheal intubation was achieved by 64 percent, with 60 seconds as the mean time of apnea. Less than half of the students checked the instruments, performed pre-oxygenation or evaluated the airway. Eighty-seven percent of the students said that the current curriculum offers them minimal competencies for airway management in a real clinical situation and all prefer simulated scenarios for the acquisition of clinical skills. Conclusions: The methodology currently used to teach tracheal intubation is not assuring the acquisition of the competencies to the students in this curriculum stage. More effective teaching methods are required, and the use of simulated scenarios can be a useful tool.

Cirugia laser endoscopica de la placenta en el tratamiento del sindrome de transfusion feto-fetal

Se reporta un embarazo de 20 semanas de edad gestacional con Síndrome de Transfusión feto-fetal, tratatado con fotocoagulación láser endoscópica en el Hospital Clínico de la Pontificia Universidad Católica de Chile.

Histerectomía sin cono previo en neoplasias intraepiteliales del cuello del útero en pacientes con colposcopía satisfactoria / Histerectomy without previous conization in intraepithelial neoplasia of the uterine cervix in patients with satisfactory colposcopy

Se revisan 15 histerectomías efectuadas en pacientes portadoras de NIE I, II, III obtenidas por biopsia y sometidas a histerectomía por otra patología agregada ginecológica. Se obtiene una gran relación histológica evitando la conización previa