Effectiveness of online training in improving primary care doctors' competency in brief tobacco interventions: A cluster-randomized controlled trial of WHO modules in Delta State, Nigeria.

BACKGROUND: The World Health Organization (WHO) strongly recommends that brief tobacco interventions should be routinely offered in primary care. However, medical doctors do not consistently and effectively intervene during their encounters with cigarette smokers. There is a paucity of studies assessing the effect of training on the tobacco intervention competency of primary care doctors in Nigeria. AIM: To evaluate the effectiveness of online training in improving competency in brief tobacco interventions among primary care doctors in Delta State, Nigeria. METHODS: A cluster-randomized controlled trial was conducted among eligible doctors working in government-owned facilities. The 22 eligible Local Government Areas (LGAs) served as clusters. The intervention group received a WHO six-hour online course on brief tobacco cessation intervention, delivered via Zoom. The control group received no intervention. A structured questionnaire was sent to participants via WhatsApp before and six months after the training. The primary outcome variables were scores for knowledge, attitude, self-efficacy, and practice. Differences in change of scores between intervention and control groups were assessed with t-test. To adjust for clustering, these inter-group differences were further analyzed using linear mixed-effects regression modeling with study condition modeled as a fixed effect, and LGA of practice entered as a random effect. RESULTS: The intervention group had a significantly higher mean of change in scores for knowledge (effect size 0.344) and confidence (effect size 0.52). CONCLUSION: The study shows that training, even online, positively affects clinician competency in brief tobacco intervention. This is important for primary care systems in developing countries. Mandatory in-service training and promotion of the WHO modules are recommended.

Assessing the Landscape in Medical Education Literature in Medical Oncology: A Scoping Review.

PURPOSE: Medical oncology and medical education (ME) have both expanded exponentially over the past 50 years; thus, it is important to understand the current status of postgraduate medical oncology education and develop ways to advance this field. This study undertakes a scoping review of ME literature in medical oncology to inform future scholarship in this area. METHODS: MEDLINE, Embase, ERIC, and Web of Science were searched to find peer-reviewed English language articles on postgraduate ME in medical oncology published from 2009 to 2020. Established scoping review methodologies were used in study design; articles were classified by specialty, learner training level, region of authorship, institution type, year of publication, journal type, study methodology, and research topic. Curriculum intervention, scholarship, and domain(s) of physician competency were also assessed. The results were interpreted using descriptive statistics and collated using predetermined conceptual frameworks. RESULTS: A total of 2,959 references were initially found across four databases. After title and abstract screening, 305 articles remained; after full-text review, 144 articles were included in final analysis. Postgraduate medical oncology education research is increasing, with the majority of articles published in North America. Quantitative studies were most common, primarily survey approaches. For physician competencies, professionalism and medical expertise comprised the large majority of article focuses, whereas very few articles addressed leadership or health advocacy. Curriculum development, professional development, and communication skills were dominant research themes while no articles discussed teacher training. CONCLUSION: Although areas such as professionalism and communication skills are well-studied, medical oncology ME research is lacking in leadership, health advocacy, and teacher training. This study provides valuable guidance for future ME research in medical oncology and establishes a benchmark to examine changes in educational scholarship over time.

Thawed Porcine Model for Surgical Training: A Novel Conservative Procedure.

Background: General Surgery course is a mandatory in medical schools and continuing surgery training is important even to experienced surgeons which they need to maintain and/or improve their surgical skills. Additionally, the models used for that practice are human cadavers, anesthetized porcine, or simulators and are not accessible for medicine schools or physicians in many countries. Therefore, we present a new technical procedure for preparation of frozen experimental animal's cadavers for medical surgical training. Materials and Methods: To perform the study, one porcine slaughtered and frozen at -20°C was used. The porcine cadaver was thawed at room temperature (25°C) and then the pneumoperitoneum test was performed and viscera inspection carried out. Results: The porcine cadaver took 20 hours to completely thaw. The pneumoperitoneum was successfully performed with total distention of the abdominal cavity. All viscera were well preserved maintaining important in vivo characteristics for consistency. Conclusion: The use of thawed porcine cadaver as a model to train many surgical procedures including videolaparoscopy is feasible. The tissues were well preserved by this method and was financially accessible and could be used for different techniques, equipment, and material tests.

Aprendizaje en investigación clínica: experiencia de enseñanza híbrida con estudiantes de medicina / Learning in Clinical Research: Hybrid Teaching Experience with Medical Students

Introducción: la pandemia de COVID-19 indujo un cambio en nuestro sistema de salud y de educación. Los programas formativos también tuvieron que adaptarse y exigieron un cambio rápido. Objetivos: describir una experiencia educativa de enseñanza virtual/híbrida en investigación clínica, entre docentes del Servicio de Clínica de un hospital universitario y estudiantes de Medicina de una institución privada, que participaron del Programa ESIN (EStudiantes en INvestigación). Metodología: los contenidos y las estrategias educativas incluyeron las clases teóricas audiograbadas o videograbadas (asincrónicas y autoadministradas), el aprendizaje basado en proyectos, los talleres prácticos (encuentros sincrónicos virtuales y grupales), mediante la adopción de modelos de aprendizaje como el aula invertida, y la tutoría individual entre docente-estudiante. Los datos se recopilaron mediante la observación en contextos académicos, y basándonos en elementos de encuestas anónimas de satisfacción, previo consentimiento informado de los participantes. Resultados: participaron 14 estudiantes, 6 durante el año 2021 y 8 durante 2022. Todas mujeres y estudiantes de medicina (50% de cuarto año, 35% de sexto año y 15% de quinto año). Las técnicas implementadas favorecieron la participación y promovieron el aprendizaje activo, basado en proyectos. Mencionaron aspectos positivos como el enfoque académico práctico, la disponibilidad del equipo docente para atender cualquier duda, el tiempo y el entusiasmo por enseñar y fomentar la participación. Los videos teóricos resultaron útiles como herramientas de repaso, y los encuentros grupales fueron especialmente valorados, si bien los encuentros individuales fueron destacados como ayuda y apoyo previo a los congresos científicos. En general, manifestaron que fue una experiencia enriquecedora que demostró que se puede lograr lo que se creía imposible. Todas participaron activamente de al menos un congreso científico, y el 50% resultó coautora de una publicación académica. Conclusión: los estudiantes asumieron compromisos y responsabilidades, e incorporaron competencias y habilidades en la implementación y en la difusión de los proyectos. Esta experiencia educativa facilitó que el tiempo de clase pudiera optimizarse para intercambio, discusión y dudas. Los recursos producidos, las actividades desarrolladas y los contenidos abordados quedan disponibles a nivel institución. (AU)

Introduction: the COVID-19 pandemic brought about a change in our health and education system. Training programs also had to adapt and required rapid change. Objectives: to describe an educational experience of virtual/hybrid teaching in clinical research between teachers of the Clinical Service of a university hospital and medical students of a private institution who participated in the ESIN Program (Students in Research). Methodology: the contents and educational strategies included audio or videotaped lectures (asynchronous and self-administered), project-based learning, practical workshops (virtual and group synchronous meetings) by adopting learning models such as the inverted classroom, and individual tutoring between teacher and student. We gathered the data through observation in academic contexts and based on elements of anonymous satisfaction surveys, with prior informed consent of participants. Results: fourteen students participated, six in 2021 and eight in 2022. All were women and medical students (50% fourth year, 35% sixth year, and 15% fifth year). The techniques implemented favored participation and promoted active, project-based learning. They mentioned positive aspects such as the practical academic approach, the availability of the teaching team for any doubts, the time and enthusiasm for teaching, and encouraging participation. The theory videos were a valuable review tool, and team meetings received high praise even if the one-on-one meetings received much attention as help and support before the scientific congresses. In general, they stated that it was an enriching experience that showed that you can achieve what you thought impossible. All of them actively participated in at least one scientific congress, and 50% were co-authors of an academic publication. Conclusion: the students assumed commitments and responsibilities and incorporated competencies and skills in project implementation and dissemination. This educational experience helped to optimize class time for exchange, discussion, and doubts. The resources produced, the activities developed, and the contents addressed are now available at the institutional level. (AU)

Nuevos Recursos Tecnológicos para la Enseñanza de Anatomía Durante la Crisis por Pandemia COVID-19. Desde el B-learn hacia el E-learn en una Nueva Escuela de Medicina de Chile / New Technological Resources for Anatomy Teaching During the COVID-19 Pandemic Crisis. From B-learn to E-Learn at a New Medical School, in Chile

Para iniciar la enseñanza de anatomía la nueva Escuela de Medicina de la Universidad de Tarapacá (UTA) adquirió innovadores recursos tecnológicos según el estado del arte en medios digitales y 3D. La primera cohorte de estudiantes de medicina utilizó estos recursos tecnológicos el año 2016, valoró positivamente la asignatura cursada y su metodología didáctica mediante un enfoque combinado (B-Learn). Estos resultados fueron publicados el año 2018, siendo un exitoso modelo local de enseñanza hasta el año 2019. La pandemia COVID-19 golpeó fuertemente a Chile desde el inicio del año 2020 y las universidades debieron adaptar su modelo de enseñanza. En nuestro caso se realizó impartiendo las asignaturas mediante un enfoque de total aprendizaje en línea a través de internet (E-Learn). Se impartió el primer y segundo semestre de anatomía a 36 estudiantes del primer año de medicina 2020. Además de los recursos tradicionales como textos de estudio y guías de laboratorio, para migrar a un modelo de curso E-Learn totalmente en línea, se utilizaron los recursos digitales y 3D almacenados en la base de datos local de la mesa de disección digital SECTRA® y su plataforma RIS/PACS portal IDS7 SECTRA®, para ser enseñados mediante internet vía Zoom® en tiempo real y vía plataformas Intranet-UTA en conjunto con Moodle® para las tareas y posteriores evaluaciones. La transición desde un modelo B-Learn a uno E-Learn se realizó en forma exitosa gracias a la experiencia conseguida los años anteriores en cuanto a diseño y uso de recursos didácticos, además de la base de datos local con recursos anatómicos previamente almacenados en formato digital. El rendimiento de los alumnos fue sobresaliente durante la pandemia, mostrando la versatilidad y adaptación de los nuevos estudiantes nativos digitales a las emergentes condiciones de aprendizaje.

SUMMARY: To start teaching anatomy, the recently established medical school of the University of Tarapacá (UTA) acquired innovative and state of the art technological resources in digital and 3D media. The first cohort of medical students used these resources in 2016 and positively assessed the subject studied and its didactic methodology through a combined approach (B- Learn). These results were published in 2018, and it was deemed a successful local teaching model until 2019. Since the beginning of 2020 the COVID-19 pandemic impacted Chile particularly hard, and universities had to adapt their teaching model. In our case, we carried it out by teaching the subjects using a comprehensive online learning approach through the Internet (E-Learn). The first and second semester of anatomy were taught to 36 students in the first year of medicine 2020. In addition to traditional resources such as study texts and laboratory guides, to migrate to a fully online E- Learn course model, the digital and 3D resources stored in the local database of the SECTRA® digital dissection table and its RIS/ PACS portal IDS7 SECTRA® platform were used to be taught via the internet through Zoom® in real-time and via Intranet UTA platforms in conjunction with Moodle® for the tasks and subsequent evaluations. The transition from a B-Learn model to an E-Learn model was carried out successfully thanks to the experience gained in previous years in terms of design and use of teaching resources, in addition to the local database with previously stored anatomical resources in digital format. Student performance was outstanding during the pandemic, showing the versatility and adaptation of new digital native students to emerging learning conditions.

The effectiveness of problem-based learning compared with lecture-based learning in surgical education: a systematic review and meta-analysis.

BACKGROUND: This meta-analysis was conducted to systematically evaluate the impact of problem-based learning (PBL) and lecture-based learning (LBL) teaching models on students' learning in surgical education. METHODS: We systematically searched the publications related to the application of PBL and LBL in surgical courses in PubMed, Embase, Web of Science and Cochrane Library databases, the last retrieval time is September 20, 2022. After screening the literature according to the inclusion and exclusion criteria, extracting data and evaluating the methodological treatment of the included studies, Stata 17.0 software was used to perform meta-analysis. RESULTS: Nine studies were included totally. The results showed that compared with LBL, PBL was superior in clinical competence (SMD = 0.81, 95% CI: 0.12 ~ 1.49, P = 0.020) and student satisfaction (SMD = 2.13, 95% CI: 1.11 ~ 3.15, P < 0.0001) with significant differences. But the comprehensive scores (SMD = 0.26, 95% CI: -0.37 ~ 0.89, P = 0.421) and theoretical knowledge (SMD=-0.19, 95% CI: -0.71 ~ 0.33, P = 0.482) to PBL and LBL had no significant difference. CONCLUSION: This study showed that the PBL teaching model is more effective than the LBL teaching model in surgical education on the aspects of enhancing clinical competence and student satisfaction. However, further well-designed studies are needed to confirm our findings.

Explaining Skeletal System Anatomy with Classical Method, Video Assisted Method and 3D Imaging Techniques and Comparison of Learning Levels Between Methods

SUMMARY: The aim of this research is to introduce the ideal lecture technique to the literature by explaining the anatomy of the skeletal system using the classical method, video-assisted method and 3D imaging techniques. The research was carried out with 180 students. The number of samples was determined by power analysis (a=0.05,b=0.20, effect size=0.25). Participants were pre-screened and divided into 4 groups with the closest group mean (group 1: control group: the group that did not take anatomy lessons, group 2: video-assisted anatomy education, group 3: 3D anatomy course, group 4: classical anatomy education group). The courses in the training groups were organised as 4 hours/day, 2 days/week for 5 weeks. At the end of the course, the students were re-examined and scaled to determine the difference in scores and self-efficacy between the groups. A one-way ANOVA test was performed because the data were normally distributed when comparing between groups. The mean scores were calculated as group 1=30.22±6.24, group 2=39.02±9.15, group 3=49.77±9.20 and group 4=59.28±8.95. In the post hoc comparison, in pairwise comparisons between all groups, the differences were highly significant (pgroup 3>group 2>group 1 (p<0.001). According to the results of this study, the laboratory method in skeletal anatomy teaching is the best alternative to 3D anatomy teaching.

El objetivo de esta investigación es introducir la técnica de lectura ideal en la literatura, explicando la anatomía del sistema esquelético, utilizando el método clásico, el método asistido por video y las técnicas de imágenes en 3D. La investigación se llevó a cabo con 180 estudiantes. El número de muestras se determinó mediante análisis de potencia (a=0,05, b=0,20, tamaño del efecto=0,25). Los participantes fueron preseleccionados y divididos en 4 grupos con la media de grupo más cercana (grupo 1: grupo de control: el grupo que no tomó lecciones de anatomía, grupo 2: educación de anatomía asistida por video, grupo 3: curso de anatomía 3D, grupo 4: grupo de educación en anatomía clásica). Los cursos en los grupos de formación se organizaron con 4 horas/día, 2 días/semana durante 5 semanas. Al final del curso, los estudiantes fueron reexaminados y escalados para determinar la diferencia en puntajes y autoeficacia entre los grupos. Se realizó una prueba de ANOVA de una vía debido a que los datos se distribuyeron normalmente al comparar entre grupos. Las puntuaciones medias se calcularon como grupo 1=30,22±6,24, grupo 2=39,02±9,15, grupo 3=49,77±9,20 y grupo 4=59,28±8,95. En la comparación post hoc, en comparaciones por pares entre todos los grupos, las diferencias fueron altamente significativas (pgrupo 3>grupo 2>grupo 1 (p<0,001). Según los resultados de este estudio, el método de laboratorio en la enseñanza de la anatomía esquelética es la mejor alternativa a la enseñanza de la anatomía en 3D.

Chat GPT: origen, evolución, retos e impactos en la educación / Chat GPT: Origen, Evolution, Challenges and Impacts on Education

Introducción: Los avances de unas tecnologías y la obsolescencia de otras marchan a una velocidad inimaginable, especialmente en este siglo xxi. En los últimos meses de 2022 y primeros meses de 2023 muchas incógnitas y controversias en diferentes campos han surgido en torno a los Chat GPS, una innovación que presenta desafíos nunca pensados para la sociedad actual, así como nuevos retos que impactarán de manera directa en la formación y/o desempeño de profesores, estudiantes, profesionales de la salud, juristas, políticos, informáticos, bibliotecarios, científicos y cualquier ciudadano. Objetivo: Identificar algunas características del chat GPT y su posible impacto en el educación. Posicionamiento de los autores: Se leen en las noticias y reportajes valoraciones de especialistas; se han realizado encuentros virtuales y exposiciones; y están disponibles diversos artículos y videos sobre este tema, algunos llegan a ser elaborados con el propio asistente. Por la novedad del tema, la reciente incorporación como herramienta para el desarrollo profesional, así como por el interés mostrado en los últimos días por la comunidad de profesores de las ciencias médicas cubanas, y considerando que esta herramienta es resultado del desarrollo de la inteligencia artificial, cabe preguntarse: ¿en qué consiste? y ¿cuáles son sus perspectivas? Conclusiones: Resulta oportuno acercarse al tema desde las posibilidades y los retos que abre a la educación y el aprendizaje, en particular a la docencia médica(AU)

Introduction: The advances of some technologies and the obsolescence of others are marching at an unimaginable speed, especially in this twenty-first century. In the last months of 2022 and first months of 2023, many questions and controversies in different fields have arisen with respect to Chat GPT, an innovation that presents challenges never thought of before for today's society, as well as new challenges that will have a direct impact on the training and/or performance of professors, students, health professionals, law practitioners, politicians, computer scientists, librarians, scientists and any citizen. Objective: To identify some technological characteristics of Chat GPT. Positioning of the authors: In news and reports, assessments by specialists are read; virtual meetings and presentations have been held; and several articles and videos on this topic are available, some of them even elaborated by the assistant itself. Due to the novelty of the subject, its recent assimilation as a tool for professional development, as well as the interest shown in recent days by the community of professors of Cuban medical sciences and considering that this tool is the result of the development of artificial intelligence, it is worth wondering what it consists in and what its prospects are. Conclusions: It is appropriate to approach the subject with a focus on the possibilities and challenges that it opens to education and learning (AU)

Immersive Virtual Reality and Cadaveric Bone are Equally Effective in Skeletal Anatomy Education: A Randomized Crossover Noninferiority Trial.

OBJECTIVE: Immersive virtual reality (IVR) technology is transforming medical education. Our aim was to compare the effectiveness of IVR with cadaveric bone models in teaching skeletal anatomy. DESIGN: A randomized crossover noninferiority trial was conducted. SETTING: Anatomy laboratory of a large medical school. PARTICIPANTS: Incoming first-year medical students. Participants were randomized to IVR or cadaveric groups studying upper limb skeletal anatomy, and then were crossed over to use the opposite tool, to study lower limb skeletal anatomy. Participants in both groups completed a pre-and postintervention knowledge test. The primary endpoint of the study was change in performance from the pre-to postintervention knowledge test. Surveys were completed to assess participant's impressions on IVR as an educational tool. RESULTS: Fifty first-year medical students met inclusion criteria and were randomized. Among all students, the average score on the preintervention knowledge test was 14.6% (standard deviation (SD) = 18.2%) and 25.0% (SD = 17%) for upper and lower limbs, respectively. Percentage increase in scores between pre-and postintervention knowledge test, was 15.0% in the upper limb IVR group, and 16.7% for upper limb cadaveric bones (p = 0.286). For the lower limb, score increase was 22.6% in the IVR and 22.5% in the cadaveric bone group (p = 0.936). 79% of participants found that IVR was most valuable for teaching 3-dimensional orientation, anatomical relationships, and key landmarks. Majority of participants were favorable towards combination use of traditional methods and IVR technology for learning skeletal anatomy (LSM>3). CONCLUSIONS: In this randomized controlled trial, there was no significant difference in knowledge after using IVR or cadaveric bones for skeletal anatomy education. These findings have further implications for medical schools that face challenges in acquiring human cadavers and cadaveric parts.

Percepción de la simulación en obstetricia y ginecología en el pregrado y posgrado de una universidad privada chilena / Perception of simulation in obstetrics and gynecology at the undergraduate and postgraduate levels of a private Chilean university

INTRODUCCIÓN: La simulación es una herramienta que promueve la confianza y desarrollo de habilidades en los participantes. En la evaluación de programas formativos la percepción de utilidad se vincula a la confianza y aprendizaje, y corresponde al primer nivel de evaluación según Kirkpatrick. OBJETIVO: Evaluar la percepción de internos y residentes de obstetricia y ginecología en escenarios de simulación. MATERIAL Y MÉTODOS: Investigación descriptiva cuantitativa, en una muestra a conveniencia de internos y residentes, quienes contestaron una escala de valoración global y de preferencias sobre sus simulaciones. RESULTADOS: Se obtuvieron 63 respuestas de internos (63%) y 7 de residentes (78%). La valoración promedio de las simulaciones fue de 6,42 en los internos y de 6,64 de los residentes. El 67% de los internos y el 86% de los residentes no eliminaría ninguna simulación. Los internos repetirían todas las simulaciones, en tanto que los residentes repetirían tres simulaciones de un total de 11. CONCLUSIONES: La valoración de las simulaciones fue alta en ambos grupos, difiriendo en las actividades que prefieren repetir, lo cual puede relacionarse con las competencias inherentes al rol de especialista en comparación al rol del médico general o a las diferencias en autoconfianza de internos y residentes.

INTRODUCTION: Clinical simulation is a training tool that promotes confidence and the development of procedural skills in participants, from initial training to the training of professional teams. In the evaluation of training programs, the measurement of perceived usefulness is linked to confidence and learning and corresponds to a first level of evaluation of the quality of training according to Kirkpatricks model. OBJECTIVE: To evaluate the perception of medical interns and Obstetrics and Gynecology fellows regarding simulation scenarios. MATERIAL AND METHODS: Quantitative descriptive research, in a convenience sample of interns and fellows, who answered a scale of global assessment and preferences about simulations. RESULTS: The average score was 6.42 for the interns and 6.64 for the scholarship recipients. With odd answers about the repetition of scenarios. 67% of the interns and 86% of the fellows responded that they would not eliminate any simulation. Conclusions: The evaluation of the scenarios was excellent and satisfactory by the participants.

Intervención educativa sobre la COVID-19 en los trabajadores del Centro de Investigaciones Científicas de la Defensa Civil / Educational intervention on COVID-19 in the personnel of the Civil Defense Scientific Research Center

Introducción: La COVID-19 creó desafíos sin precedentes para la comunidad y los trabajadores de la salud, por lo que contribuir a incrementar la percepción del riesgo mediante la capacitación fue una premisa elemental en tiempos de la pandemia. Objetivo: La investigación tuvo la finalidad de contribuir a incrementar el conocimiento en aspectos importantes sobre la COVID-19 en los trabajadores del Centro de Investigaciones Científicas de la Defensa Civil. Métodos: Se realizó una evaluación antes y después de la intervención en el período de febrero a abril de 2021. La muestra estuvo conformada por 50 trabajadores divididos en dos grupos: 1) investigadores y técnicos; 2) personal de apoyo. La investigación se desarrolló en tres etapas: diagnóstico, intervención y evaluación. Se conformó una base de datos con la información recopilada y para su análisis se empleó el método de comparación de proporciones de las respuestas entre los grupos, antes y después de la evaluación. Se calculó el porcentaje de apropiación de conocimientos con nivel de significación (p < 0,05) y se aplicó el t-Student para muestras dependientes. Resultados: De 50 trabajadores 35 (70 %) eran del sexo femenino; predominó el nivel escolar universitario con un total de 33 (66 %). Se observó un incremento estadísticamente significativo, tanto en la apropiación del conocimiento en ambos grupos, como en las preguntas adecuadas, después de la intervención (p < 0,05); siendo superior en el grupo del personal de apoyo. Conclusiones: La intervención educativa contribuyó a incrementar los conocimientos acerca de la COVID-19 en los trabajadores del centro, lo que tuvo un impacto favorable.

Introduction: COVID-19 created unprecedented challenges for the community and health workers; therefore, contributing to increase risk perception through training was an elementary premise in times of the pandemic. Objective: The research aimed at increasing the knowledge of important aspects of COVID-19 among the personnel of the Civil Defense Scientific Research Center. Methods: An evaluation was carried out before and after the intervention from February to April 2021. The sample consisted of 50 workers divided into two groups: 1) researchers and technicians; 2) support personnel. The research comprised three stages: diagnosis, intervention, and evaluation. A database was created with the information collected. For its analysis, the compare proportions test of responses between the groups, before and after the evaluation, was used. The percentage of knowledge appropriation was calculated with significance level (p < 0.05), and the t-Student was applied for dependent samples. Results: Out of 50 workers, 35 (70%) were female; 33 (66%) had a university education level. A statistically significant increase in both knowledge acquisition and appropriate questions was observed in the groups after the intervention (p < 0.05), which was higher in the support staff group. Conclusions: The educational intervention contributed to increasing knowledge about COVID-19 among the workers of the center, which had a favorable impact.

Concepción didáctica del proceso formativo interdisciplinar de la habilidad diagnosticar enfermedades para residentes de Dermatología / Didactic Concept of the Interdisciplinary Formation Process of the Diagnostic Ability of Dermatology Residents

Fundamento: El estudio teórico, el diagnóstico realizado y la experiencia de los investigadores, posibilitan formular como problema de la presente investigación: limitaciones en el desarrollo de la habilidad diagnosticar enfermedades dermatológicas en los residentes de la especialidad de Dermatología del Hospital General Provincial Docente "Dr. Antonio Luaces Iraola" de Ciego de Ávila. Objetivo: Elaborar una concepción didáctica del proceso de formación interdisciplinar de la habilidad diagnosticar enfermedades dermatológicas en los residentes de la especialidad de Dermatología, a partir de la caracterización del estado actual de esta habilidad. Metodología: Se realizó una investigación educativa con un componente descriptivo en el Hospital General Provincial Docente "Dr. Antonio Luaces Iraola" de Ciego de Ávila, en los cursos escolares desde 2016 al 2020. La población de estudio fueron los 16 residentes de 1.er año que matricularon la especialidad de Dermatología en el período de estudio. Se emplearon métodos del nivel teórico y empírico. Resultados: La caracterización realizada reveló limitaciones en el desarrollo de la habilidad diagnosticar enfermedades dermatológicas en los laboratorios de Anatomía Patológica, Microbiología y Parasitología Médica, por los residentes (100 %). La concepción didáctica del proceso de formación interdisciplinar de la habilidad diagnosticar orienta el proceso desde las actividades docentes-atencionales y prácticas de laboratorio en una consecutividad lógica y sistematización desde las diferentes formas de enseñanza y tipologías de clase. Integra la interdisciplinariedad y la utilización del método investigativo establecido en las ideas rectoras. Conclusiones: La concepción didáctica como aporte de la investigación resuelve la contradicción dialéctica entre la aplicación del método clínico y los procedimientos en la práctica de laboratorio que se da en ese proceso formativo y constituye un soporte didáctico que respalda las actividades prácticas en los laboratorios para cumplir con los objetivos del Plan de estudio de la especialidad.

Background: The theoretical study, the diagnosis conducted and the experience of the researchers make possible to formulate the problem of the present research: limitations in the development of the ability to diagnose dermatological diseases in residents of the Specialty of Dermatology of the General Provincial Teaching Hospital "Dr. Antonio Luaces Iraola" of Ciego de Avila. Objective: To elaborate a didactic conception of the interdisciplinary training process of the ability to diagnose dermatological diseases in residents of the specialty of Dermatology, based on the characterization of the current state of that ability. Methodology: An educational research with a descriptive component was conducted at the Provincial General Teaching Hospital "Dr. Antonio Luaces Iraola" of Ciego de Avila, in the 2016-2020 school years. The study population consisted of the 16 first-year dermatology residents who enrolled in the specialty during the study period. Results: The characterization conducted showed limitations in the development of the ability to diagnose dermatological diseases in anatomic pathology laboratories, Microbiology and Medical Parasitology, by residents (100%). The didactic conception of the interdisciplinary training process of diagnostic ability focuses on teaching and learning activities and laboratory practices in a logical consecutiveness and systematization from the different forms of teaching and class typologies. It integrates the interdisciplinary and the use of the research method that is established in the guiding ideas. Conclusions: The didactic conception, as a research contribution, resolves the dialectic contradiction between the application of the clinical method and the procedures in laboratory practice that occurs in this formative process which is a didactic support that backs up the practical activities in the laboratories in order to achieve the objectives of the study plan of the specialty.

Scale to measure medical, nursing and midwifery students' engagement in an e-learning histology course / Escala para medir la participación de estudiantes de medicina, enfermería y obstetricia en un curso de histología e-learning

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.

Innovación en la enseñanza de la anatomía humana: aula invertida y su aplicación / Innovation in the teaching of human anatomy: flipped classroom implementation

El contexto actual involucra un acceso cada vez más universal a las tecnologías e información, lo que repercute fuertemente en el aula. Los estudiantes se muestran pasivos y reacios al Modelo Tradicional de enseñanza. De esta manera las innovaciones toman protagonismo, tal es el caso del modelo Aula Invertida (AI). El objetivo de este trabajo es describir la aplicación de AI en la enseñanza de la Anatomía humana en un entorno universitario. Se intervinieron 4 sesiones de la asignatura de Anatomía General de un curso de 41 estudiantes. Se abordó el contenido en 3 etapas: pre clase, clase y post clase, utilizando recursos y plataformas multimedia como Moodle y Youtube. Las actividades incluyeron lecciones virtuales, trabajos en grupo y cuestionarios minimalistas. Al final del semestre se aplicó una encuesta de percepción del estudiante. El logro alcanzado en pre clase fue 40,45 %, 55,46 %, 43,75 % y 76,04 % para las sesiones 01 a 04, respectivamente. Las calificaciones de los trabajos en grupos de la encuesta el 63,2 % y 76,3 % de los estudiantes manifestó estar "muy de acuerdo" con que AI potencia el trabajo autónomo y colaborativo, respectivamente. El 73,6 % prefiere el modelo AI por sobre el Tradicional. El modelo AI ha mostrado promover una mejor evolución del proceso de enseñanza- aprendizaje, siendo adaptable a disciplinas de ciencias básicas como el caso de Anatomía humana. La buena experiencia de esta innovación se debe sustentar en una programación bien estructurada, apoyo dentro y fuera del aula, y el ajuste de estrategias exitosas. Es inminente la necesidad de adaptarse al nuevo contexto donde prima el acceso a las tecnologías e información.

SUMMARY: The current context involves a generally increasing access of technologies and information, which has a strong impact on the classroom. Students are passive and reluctant to the traditional teaching model. Thus, innovations take center stage, such is the case of the Flipped Classroom (FC) model. The aim of this paper is to describe the application of FC in the teaching of human anatomy in a university environment. Four sessions of the General Anatomy program were intervened with a group of 41 students. The content was approached in 3 stages: pre-class, class and post-class, using multimedia resources and platforms such as Moodle and YouTube. The activities included virtual lessons, group work and minimalist quizzes. At the end of the semester a student perception survey was applied. Achievement percentage in pre-class were 40.45 %, 55.46 %, 43.75 % and 76.04 % for sessions 01 to 04. The grades for class group work were 5.8±0.34, 6.1±0.46, 6.0±0.78 and 6.7±0.38 for the sessions worked. In the survey 63.2 % and 76.3 % of the students stated that they "very satisfied" that FC enhances autonomous and collaborative work, respectively. 73.6 % preferred the FC model over the traditional one. The FC model has shown to promote a better evolution of the teaching-learning process, being adaptable to basic science disciplines such as human anatomy. A positive experience of this innovation must be supported by well-structured programming, support inside and outside the classroom, and the adjustment of successful strategies. There is an imminent need to adapt to the new context where access to technologies and information is a priority.

Use of Thiel-embalmed cadavers in urology training and their ability to retain real-life anatomy: a systematic review.

BACKGROUND: Thiel-embalmed cadavers (TeCs) have been proposed as an alternative and probably safer method of surgical training, compared to formalin-embalmed cadavers. We aimed to perform a systematic review on the use of TeCs in urology training and their ability to represent real-life anatomy. METHODS: PubMed, SCOPUS and Cochrane databases were searched for articles with purpose to explore the use of TeCs in urology training, without date restrictions, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. From each paper, we evaluated the type of procedure, the number of participants, the type of study, the educational outcomes and their level, according to Kirkpatrick hierarchy. RESULTS: Of the 225 records initially retrieved, eight articles were eventually included. All studies evaluated participants' perceptions about the procedure. Overall, urology trainees and specialists have positively commented on the educational value of TeCs, which have been also found able to adequately mimic real-life conditions. In all the eight studies, trainees stated that tissue quality of TeCs was adequately realistic and considered TeCs as a useful surgical training tool. CONCLUSION: Although the use of TeCs in urology training has so far been limited, their value as a surgical training tool has been positively perceived. These outcomes suggest that TeCs may also enhance urology trainees' surgical skills and may encourage their implementation as a simulation tool in urology training.

Telestration with augmented reality improves surgical performance through gaze guidance.

BACKGROUND: In minimally invasive surgery (MIS), trainees need to learn how to interpret the operative field displayed on the laparoscopic screen. Experts currently guide trainees mainly verbally during laparoscopic procedures. A newly developed telestration system with augmented reality (iSurgeon) allows the instructor to display hand gestures in real-time on the laparoscopic screen in augmented reality to provide visual expert guidance (telestration). This study analysed the effect of telestration guided instructions on gaze behaviour during MIS training. METHODS: In a randomized-controlled crossover study, 40 MIS naive medical students performed 8 laparoscopic tasks with telestration or with verbal instructions only. Pupil Core eye-tracking glasses were used to capture the instructor's and trainees' gazes. Gaze behaviour measures for tasks 1-7 were gaze latency, gaze convergence and collaborative gaze convergence. Performance measures included the number of errors in tasks 1-7 and trainee's ratings in structured and standardized performance scores in task 8 (ex vivo porcine laparoscopic cholecystectomy). RESULTS: There was a significant improvement 1-7 on gaze latency [F(1,39) = 762.5, p < 0.01, ηp2 = 0.95], gaze convergence [F(1,39) = 482.8, p < 0.01, ηp2 = 0.93] and collaborative gaze convergence [F(1,39) = 408.4, p < 0.01, ηp2 = 0.91] upon instruction with iSurgeon. The number of errors was significantly lower in tasks 1-7 (0.18 ± 0.56 vs. 1.94 ± 1.80, p < 0.01) and the score ratings for laparoscopic cholecystectomy were significantly higher with telestration (global OSATS: 29 ± 2.5 vs. 25 ± 5.5, p < 0.01; task-specific OSATS: 60 ± 3 vs. 50 ± 6, p < 0.01). CONCLUSIONS: Telestration with augmented reality successfully improved surgical performance. The trainee's gaze behaviour was improved by reducing the time from instruction to fixation on targets and leading to a higher convergence of the instructor's and the trainee's gazes. Also, the convergence of trainee's gaze and target areas increased with telestration. This confirms augmented reality-based telestration works by means of gaze guidance in MIS and could be used to improve training outcomes.

Adherencia a tratamiento de prevención secundaria post síndrome coronario agudo, en pacientes adultos ingresados al Hospital Hernán Henríquez Aravena / Adherence to secondary prevention after acute coronary syndromes: experience in a chilean general hospital

Antecedentes: En prevención secundaria cardiovascular, el control de los factores de riesgo es deficiente y la falta de adherencia terapéutica parece ser uno de los factores causales. El cumplimiento terapéutico se asocia a un 20% de disminución del riesgo de enfermedad cardiovascular y un 38% de disminución de mortalidad por cualquier causa. Sin embargo, la adherencia a los fármacos preventivos ronda el 50% al año después del alta hospitalaria, lo que multiplica por 3 el riesgo de mortalidad. Objetivos: Describir la adherencia a mediano plazo a tratamiento de prevención secundaria post síndrome coronario agudo de los pacientes adultos ingresados al Hospital Hernán Henríquez Aravena durante el año 2018. Determinar las características clínicas y sociodemográficas de la población y explorar las posibles causas asociadas a la falta de adherencia terapéutica en este grupo de pacientes. Métodos y Resultados: Se evaluaron 396 pacientes con síndrome coronario agudo en el Hospital Hernán Henríquez Aravena de Temuco durante el año 2018. La adherencia a terapia farmacológica se evaluó mediante el cuestionario de Morisky-Green de ocho ítems, aplicado vía telefónica. Se evaluó la asociación de variables clínicas y sociodemográficas con el nivel de adherencia mediante regresión ordinal y análisis de correspondencias. Resultados: Un 41.9% de los pacientes mantuvieron adherencia a la terapia a 2 años de seguimiento. Variables sociodemográficas como el bajo nivel educacional, la ruralidad, y la presencia de 1 o 2 apellidos mapuche se asociaron con baja adherencia a terapia farmacológica. Conclusión: La adherencia a medidas de prevención secundaria después del tratamiento por un síndrome coronario aguda es baja. Los principales factores relacionados a la falta de adherencia fueron el bajo nivel educacional y la ruralidad.

Background: a lack of therapeutic adherence to secondary prevention measures after acute coronary events leads to a poor control of risk factors. Adherence to treatment is associated with a reduction of 20% in the risk of cardiovascular disease and 38% reduction in all-cause mortality long term. However, adherence to drug therapy is about 50% a year after hospital discharge, which leads to an approximately three fold increase in mortality. Objectives: to describe the medium-term adherence to secondary prevention treatment following an acute coronary syndrome in adult patients admitted to a general hospital during 2018. In addition, to relate clinical and sociodemographic characteristics related to poor adherence and also to explore possible causes associated with the lack of therapeutic adherence in this group of patients. Methods: 396 patients treated for an acute coronary syndrome were followed after being discharged from the Hernán Henríquez Aravena Hospital in Temuco (Chile) during 2018. Adherence to pharmacological therapy was evaluated using the eight-item Morisky-Green questionnaire applied via phone call. The association of clinical and sociodemographic variables with the level of adherence was evaluated using ordinal regression and correspondence analysis. Results: Only 41.9% of patients maintained adherence to therapy at 2 years of follow-up. Low educational level, rurality, and the presence of 1 or 2 mapuche surnames were associated to poor adherence to drug therapy.