Patient safety, what does clinical simulation and teaching innovation contribute?

Clinical simulation in Intensive Care Medicine is a crucial tool to strengthen patient safety. It focuses on the complexity of the Intensive Care Unit, where challenging clinical situations require rapid decision making and the use of invasive techniques that can increase the risk of errors and compromise safety. Clinical simulation, by mimicking clinical contexts, is presented as essential for developing technical and non-technical skills and enhancing teamwork in a safe environment, without harm to the patient. in situ simulation is a valuable approach to practice in realistic environments and to address latent security threats. Other simulation methods as virtual reality and tele-simulation are gaining more and more acceptance. Herein, we provide current data on the clinical utility of clinical simulation related to improved safety in the practice of techniques and procedures, as well as improvements of teamwork performance and outcomes. Finally, we propose the needs for future research.

Implementación del mini-CEX en el pregrado médico: Una experiencia con simulación / Implementation of the Mini-CEX in Medical Undergraduate Education: A Simulation-Based Experience

Resumen La evaluación es un proceso sistemático que resulta en un juicio de valor para tomar decisiones. Los instrumentos empleados para obtener datos sobre el desempeño de los estudiantes requieren de un proceso sistemático y objetivo para su implementación. El mini-CEX es un instrumento de observación directa que ha sido empleado para la evaluación de la competencia clínica en los estudiantes de pre y posgrado desde su invención en 1955. Cuenta con diferentes evidencias de validez para su uso en distintos contextos educativos y clínicos. Permite realizar evaluaciones rápidas, acompañadas de realimentación y que proporcionan información relevante del desarrollo de la competencia clínica. El objetivo de este escrito es exponer la experiencia de la implementación del mini-CEX en el pregrado médico para la evaluación formativa de los estudiantes utilizando la simulación con pacientes estandarizados. Para lograr este objetivo se empleó la siguiente secuencia: búsqueda, planeación, integración y aplicación. Posterior a estos pasos se dan una serie de recomendaciones para la implementación del mini-CEX. Se concluye que la evaluación de la competencia clínica es importante para la mejora continua y permanente de los estudiantes de pre y posgrado. Es necesario sistematizar la evaluación ajustada siempre a objetivos y necesidades específicas de la evaluación.

Abstract Evaluation is a systematic process that results in a judgment to make decisions. The instruments used to obtain data on student performance require a systematic and objective process for their implementation. The mini-CEX is a direct observation tool that has been used for the evaluation of clinical competence in undergraduate and postgraduate students since its invention in 1955. It has different validity evidence for use in different educational and clinical contexts. It allows rapid evaluations, accompanied by feedback and providing relevant information on the development of clinical competence. The objective of this paper is to expose the experience of the implementation of the mini-CEX in the medical undergraduate for the formative evaluation of students using simulation with standardized patients. To achieve this goal, the following sequence was used: search, planning, integration, and application. After these steps we make some recommendations for the implementation of the mini-CEX. Its is concluded that the evaluation of clinical competence is important for the continuous and permanent improvement of undergraduate and graduate students. It is necessary to systematize the evaluation always adjusted to objectives and specific needs of the evaluation.

PERCEPCIÓN DE LOS ESTUDIANTES DE ENFERMERÍA SOBRE LA SIMULACIÓN CLÍNICA: UN ANÁLISIS DE SU EXPERIENCIA FORMATIVA / NURSING STUDENTS' PERCEPTION OF CLINICAL SIMULATION: AN ANALYSIS OF THEIR FORMATIVE EXPERIENCE

INTRODUCCIÓN: La simulación clínica fortalece la adquisición de competencias clínicas para enfrentar con éxito las situaciones reales de atención sanitaria. OBJETIVO: Determinar la percepción de los estudiantes de enfermería sobre el aprendizaje a través de la simulación clínica. METODOS: Estudio con enfoque cuantitativo de alcance descriptivo transversal, en una muestra de 316 estudiantes, seleccionados mediante muestreo probabilístico estratificado, entre octubre 2022 y febrero 2023. Se utilizó una escala con propiedades psicométricas adecuadas, denominada Escala de Satisfacción de Experiencias Clínicas Simuladas (ESECS), con tres dimensiones: práctica, cognitiva y realismo. Los datos obtenidos fueron procesados con el soporte del programa estadístico SPSS. RESULTADOS: La percepción de los estudiantes es positiva con una media de 8,11 y una desviación estándar de 1,23; el mayor grado de satisfacción corresponde a la dimensión práctica, en las variables motivación y dinamismo de las clases prácticas con un 87,7%, cifras similares con un 82,6%, obtiene satisfacción con los aprendizajes adquiridos y un 78,2% correspondiente a la interacción con docentes y compañeros. CONCLUSIÓN: Se evidencia que la simulación clínica se constituye una metodología de aprendizaje, idónea para el desarrollo profesional en los estudios de enfermería, y es necesario reforzarla de tal forma que permita mejorar la calidad de la formación.

INTRODUCTION: Clinical simulation strengthens the acquisition of clinical competencies necessary to successfully manage real health care situations. OBJECTIVE: Determine the perception of nursing students about learning through clinical simulation. METHODS: A quantitative study with a cross-sectional descriptive approach, using a sample of 316 students selected by stratified probability sampling between October 2022 and February 2023. A scale with adequate psychometric properties was used, the Simulated Clinical Experiences Satisfaction Scale (ESECS), which considered three dimensions: practical, cognitive and realism. The data obtained were processed with the support of the SPSS. RESULTS: Student perception is positive with an average of 8.11, and a standard deviation of 1.23; The greater degree of satisfaction corresponds to the practical dimension: with respect to their practical classes, subjects expressed high satisfaction with the variables of motivation and dynamism (87.7%), with the acquired learning (82.6%) and with the interaction among teachers and classmates (78.2%). CONCLUSION: It is evident that clinical simulation is an ideal learning methodology for professional development in nursing studies, and it is necessary to reinforce it to improve the quality of training.

Assessment of high fidelity simulation with actors in palliative care in nursing students: a mixed methods study.

OBJECTIVE: The most effective training methods are experiential, including those focused on experiences and emotions. Clinical simulation, especially high-fidelity simulation, is one of the most effective methodologies for the acquisition of competencies in care like palliative care. The simulation with actors can train future healthcare science professionals: in technical, intellectual, or interpersonal skills. The objective is to evaluate high-fidelity simulation with actors as a tool in palliative care training for nursing students. METHOD: Over three years, the study was conducted in a Faculty of Nursing of the south of Spain with nursing students. A mixed methods study with sequential explanatory design in three moments was conducted: (1) Quasi-experimental study in a single group (n = 12) before and after attending the palliative care course with Clinical Simulation with actors to assess the communication skills (CICAA scale), (2) Qualitative study with phenomenological perspective after Clinical Simulation (174 reflective students' narratives), (3) Cross-sectional observational study, one year later, to assess the transfer of knowledge and skills to the clinical practice (71 students). RESULTS: Students who interacted with actors in Clinical Simulation improved their communication skills and the ability to establish an effective helping relationship with both end-of-life patients and their families. The students perceived the Clinical Simulation as an innovative learning methodology that is useful to encourage reflection and transfer of learning during their clinical internship. CONCLUSIONS: Standardization of the use of active learning methodologies is recommended for a better acquisition of transversal skills such as communication skills in palliative care.

Diseño, implementación y evaluación de un programa de aprendizaje de habilidades procedimentales básicas en enfermería utilizando la plataforma C1DO1 durante la pandemia por COVID-19 / Design, implementation and evaluation of a learning program for basic procedural skills in nursing using the C1DO1 platform during the COVID-19 pandemic

Introducción: La simulación remota brindó una alternativa concreta para entrenar las habilidades procedimentales básicas durante la pandemia. El objetivo de este artículo es describir el proyecto que mantuvo el entrenamiento de las habilidades procedimentales básicas de enfermería en alumnos de pregrado UC, utilizando la aplicación C1DO1, durante el segundo semestre del 2021. Materiales y Métodos: Se diseñaron cinco etapas en la plataforma C1DO1. Cada etapa consideró un procedimiento clínico básico. Los estudiantes practicaron las técnicas en su hogar y se grabaron ejecutando el procedimiento. El video fue revisado por un docente que proporcionaba una retroalimentación personalizada y medía su aprendizaje de manera formativa. Al finalizar todas las etapas, se aplicó una encuesta para evaluar la percepción y satisfacción con el proyecto. Resultados: 183 estudiantes se inscribieron en el proyecto, de los cuales 122 participaron activamente. El porcentaje de respuesta del instrumento de evaluación fue de un 71%. La satisfacción global alcanzó una nota de 6,1. El grado de acuerdo con la simulación remota fue de un 94%. La percepción de autoeficacia alcanzó un 89%. La retroalimentación personalizada fue considerada como muy importante por el 94% de los participantes y el 98% de los estudiantes aprobó la etapa que efectúo. Discusión: Existe un alto grado de acuerdo con el entrenamiento de habilidades procedimentales mediante la simulación remota, sin embargo, los estudiantes consideran esta metodología como un complemento al aprendizaje motor, aún faltan estudios que midan transferencia.

Introduction: Remote simulation provided a concrete alternative to train basic procedural skills, given the pandemic. This article aims to describe the project that maintained the training of basic nursing procedural skills in UC undergraduate students using the C1DO1 application during the second semester of 2021. Methods: Five stages were designed on the C1DO1 platform. Each stage considered a basic clinical procedure. The students practiced the techniques at home and recorded themselves performing the procedure. The video was reviewed by a teacher who provided personalized feedback and measured their learning in a formative way. At the end of all the stages, a survey was applied to the students to evaluate their perception and satisfaction with the project. Results: The total number of students enrolled in the project was 183 of which 122 actively participated. The response rate of the evaluation instrument was 71%. Global satisfaction with the project obtained a score of 6.1. The degree of agreement with the remote simulation was 94%. The perception of self-efficacy reached 89%. The personalized feedback was considered very important by 94% of the participants and 98% of the students approved the stage they carried out. Discussion: There is a high degree of agreement with the training of procedural skills through remote simulation, however, students see this methodology as a complement to motor learning, and studies that measure transfer are still lacking.

TeamSTEPPS®-based clinical simulation training program for critical care professionals: A mixed-methodology study.

INTRODUCTION: The Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS®) programme has been shown to improve interprofessional work among healthcare professionals by enhancing teamwork. Intensive care professionals were trained in this methodology through the course "Simulation Trainer: Improving Teamwork through TeamSTEPPS®". OBJECTIVES: To analyse the teamwork performance and good practice in simulation of the intensive care professionals attending the course and to explore their perceptions of the training experience carried out during the course. METHODS: A cross-sectional descriptive and phenomenological study was carried out using a mixed methodology. The 18 course participants were administered the questionnaires "TeamSTEPPS™ 2.0 Team Performance Observation Tool" to evaluate teamwork performance and "Educational Practices Questionnaire" for good practices in simulation after the simulated scenarios. Subsequently, a group interview was conducted through a focus group with 8 attendees using the Zoom™ videoconferencing platform. A thematic and content analysis of the discourses was carried out using the interpretative paradigm. Quantitative and qualitative data were analysed using IBM SPSS Statistics™ 27.0 and MAXQDA Analytics Pro™ respectively. RESULTS: Both the level of teamwork performance (mean = 96.25; SD = 8.257) and good practice in simulation (mean = 75; SD = 1.632) following the simulated scenarios were adequate. The following main themes were identified: satisfaction with the TeamSTEPPS® methodology, usefulness of the methodology, barriers to methodology implementation and non-technical skills improved through TeamSTEPPS®. CONCLUSIONS: TeamSTEPPS® methodology can be a good interprofessional education strategy for the improvement of communication and teamwork in intensive care professionals, both at the care level (through on-site simulation strategies) and at the teaching level (through its inclusion in the students' curriculum).

Efecto de la simulación háptica en la autoeficacia académica de odontólogos en formación / Effect of Haptic Simulation on the Academic Self-efficacy of Dentist in Training

La simulación es un recurso ampliamente utilizado en los procesos formativos en odontología, especialmente para adquirir destrezas motrices y potencialmente en el desarrollo de la autoeficacia. Objetivo: Evaluar el efecto de la simulación háptica en la autoeficacia académica de odontólogos en formación. Materiales y métodos: Este estudio se centró en estudiantes de un curso de anticipación disciplinar (n=134). Se aplicó la escala de autoeficacia general después de dos actividades de tallado con apresto tradicional, mediadas por una sesión de tallado con simulación háptica. Resultados: Al determinar el rol de las dimensiones de autoeficacia en dos actividades de simulación tradicional (ABT1 y ABT2), mediadas por la háptica se obtuvo un promedio de ABT1: x̄=3,27 (n=123) y de ABT2: x̄=3,20 (n=105). De los diez ítems de la escala, hubo diferencia estadística respecto a la disminución del grado de autoeficacia en el Nº1 (p=0,05) y Nº6 (p=0,01). Conclusiones: Se puede establecer que, al utilizar un simulador háptico de manera complementaria a las de apresto tradicional, la intervención influye en la autoeficacia, puesto que se adquiere mayor conciencia de las complejidades asociadas, debiendo desafiar su propia autorregulación para hacerles frente.

Simulation is a widely used resource in dental training processes, especially to acquire motor skills and potentially in the development of self-efficacy. Objective: To evaluate the effect of haptic simulation in the academic self-efficacy of dentists in training. Materials and methods: This study focused on students of a curricular anticipatory course (n=134). The general self-efficacy scale was applied after two carving activities with a traditional approach, complemented by a carving session with haptic simulation. Results: When determining the role of the self-efficacy dimensions in two traditional simulation activities (ABT1 and ABT2) complemented by haptics, we obtained an average of ABT1: x̄=3,27 (n=123) and ABT2: x̄=3,20 (n=105). Of the ten items of the scale, there was a statistical difference regarding the decrease in the degree of self-efficacy in Nº1 (p=0,05) and Nº6 (p=0,01). Conclusions: It can be established that complementing traditional training with a haptic simulator influences self-efficacy, since the students become more aware of the associated complexities, and need to challenge their own self-regulation to deal with them.

Valoración de estudiantes de enfermería sobre la simulación clínica en tres universidades latinoamericanas / Nursing Students' Evaluation about Clinical Simulation in Three Latin-American Universities

Introducción: A la simulación clínica, fundamental en la formación profesional de enfermería, se le atribuyen variadas ventajas respecto a otras metodologías. Es importante conocer cómo esta metodología es valorada por parte de los estudiantes. Objetivo: Analizar la valoración de los estudiantes de enfermería sobre la metodología de simulación en tres universidades latinoamericanas. Métodos: Se realizó un estudio cuantitativo, descriptivo, transversal. La población correspondió a los estudiantes de la carrera de enfermería de tres universidades, una de Argentina, una de Bolivia y otra de Chile. La muestra, de carácter intencionado, incluyó a estudiantes que cursaban programas de simulación. El estudio se realizó en las ciudades de Mendoza, La Paz y Santiago. Se utilizó un instrumento validado por juicio de expertos, que evaluaba el grado de acuerdo/desacuerdo a través de 34 aseveraciones, a través de escala tipo Likert. Resultados: Participaron 221 estudiantes, 72 (32,58 por ciento) correspondieron a Argentina, 34 (15,38 por ciento) a Bolivia y 115 a Chile (52,04 por ciento). El puntaje promedio total para el instrumento fue de 4,47 ± 0,19, considerando los 3 países. Al analizar la media por país se obtiene: Argentina 4,38 ± 0,32, Bolivia 4,68 ± 0,22 y Chile 4,04 ± 0,17. La confiabilidad fue alta (0,94). Se realizó prueba de Krusbal-Vallis, no se encontró diferencia entre la muestra de los países. Conclusiones: El instrumento demostró ser válido y confiable. Los elementos con mayor valoración tuvieron relación con la capacidad de la simulación para fortalecer el desarrollo profesional; el aspecto con menor valoración correspondió al déficit de simulaciones interprofesionales(AU)

Introduction: Clinical simulation, fundamental in professional nursing education, has been attributed several advantages over other methodologies. It is important to know how this methodology is evaluated by students. Objective: To analyze nursing students' evaluation regarding the simulation methodology in three Latin-American universities. Methods: A quantitative, descriptive and cross-sectional study was carried out. The population consisted of the Nursing major students from three universities from Argentina, Bolivia and Chile. The sample, of a purposive nature, included students enrolled in simulation programs. The research was carried out in the cities of Mendoza, La Paz and Santiago. The used instrument was validated by expert judgment and evaluated the degree of agreement or disagreement through 34 statements, using a Likert-type scale. Results: A total of 221 students participated: 72 (32.58 percent) from Argentina, 34 (15.38 percent) from Bolivia and 115 from Chile (52.04 percent). The total mean score for the instrument was 4.47 ± 0.19, considering the three countries. The mean was analyzed according to each country: Argentina was 4.38 ± 0.32, Bolivia was 4.68 ± 0.22 and Chile was 4.04 ± 0.17. Reliability was high (0.94). The Kruskal-Wallis test was performed and no difference was found between the sample by countries. Conclusions: The instrument proved to be valid and reliable. The highest rated items were related to simulation's capacity to strengthen professional development. The lowest rated aspect corresponded to a deficit of interprofessional simulations(AU)

Adaptación del equipo docente del laboratorio de aprendizaje de prácticas simuladas al proceso de enseñanza aprendizaje en modalidad virtual. Relato de experiencia. / Adaptation of the teaching team of the simulated practice learning laboratory to the teaching-learning process in virtual mode. Experience report

El presente relato describe la adaptación que atravesó el equipo docente del Laboratorio de Aprendizaje de Prácticas Simuladas en una institución educativa de nivel universitario en Argentina al enfrentar el cambio en el proceso de enseñanza-aprendizaje, para ajustarse a las nuevas modalidades educativas con el fn de dar seguimiento a las actividades prácticas de simulación. En base a ello, se buscó reconocer como se logró, en dos aspectos: en primer lugar, relacionado a las tecnologías que debieron de adquirir; y en segundo, referido a las plataformas que debieron utilizar, considerándose los cambios a evaluar e implementar en la virtualidad, sirvieron como punto de partida para la creación de reglamentos y propuestas pedagógicas en simulación clínica. A modo de cierre, se arribó a conclusiones y retroalimentaciones positivas en cuanto a los objetivos planteados, pudiendo así implementar favorablemente estrategias tales como plataformas de trasmisión (streaming), recursos digitales e interrogación. (debriefng)[AU]

This report describes the adaptation that the teaching team of the Simulated Practices Learning Laboratory went through in a university-level educational institution in Argentina when facing the change in the teaching-learning process, to adjust to the new educational modalities in order to follow up on practical simulation activities. Based on this, we sought to recognize how it was achieved in two aspects; in the frst place, related to the technologies that they had to acquire; and secondly, referring to the platforms that they had to use, considering the changes to be evaluated and implemented in virtuality, which served as a starting point for the creation of regulations and pedagogical proposals in clinical simulation. By way of closing, positive conclusions and feedback were reached regarding the objectives set, thus being able to favorably implement strategies such as streaming, digital resources and debriefng[AU]

Este relatório descreve a adaptação que a equipe docente do Laboratório de Aprendizagem de Práticas Simuladas passou em uma instituição educacional de nível universitário na Argentina diante da mudança no processo de ensino-aprendizagem, para se adequar às novas modalidades educacionais para acompanhar atividades práticas de simulação. Com base nisso, buscou-se reconhecer como isso foi alcançado em dois aspectos; em primeiro lugar, relacionadas com as tecnologias que tiveram de adquirir; e em segundo lugar, referindo-se às plataformas que deveriam utilizar, considerando as mudanças a serem avaliadas e implementadas na virtualidade, que serviram de ponto de partida para a criação de normativas e propostas pedagógicas em simulação clínica. Em jeito de encerramento, chegaram-se a conclusões e feedback positivos relativamente aos objetivos traçados, podendo assim implementar de forma favorável estratégias como streaming, recursos digitais e debriefng[AU]

Clinical simulation with dramatization, a teaching-learning strategy for undergraduate students of nutrition and dietetics

At present, education in Health Sciences requires interaction with real patients, which is made more complex due to the need to ensure their health safety. For this reason, new teaching methodologies are now being implemented, which help to improve and protect safe care. Objective: This study was carried out using a quantitative approach with a non-experimental, descriptive design. Materials and Methods: The sample was non-probabilistic and consisted of 87 undergraduate students. A questionnaire was used, with 18 statements divided into 3 dimensions: dimension 1, simulation structure, with six questions reflecting aspects related to its implementation; dimension 2, learning, with seven questions related to aspects of effective communication, trust, learning and respect for diversity; dimension 3, feedback for learning, with five questions, including feedback by the teacher and the simulated patient, as well as their own views with regard to participating in another similar experience again. A five-point Likert scale was used. Results: The three dimensions studied, simulation structure, learning and feedback for learning, report a high level of positive perceptions. Conclusion: The simulation strategy is an educational tool in health-related careers that enhances the clinical competencies of the students as well as the relevant theoretical and practical skills and abilities in their learning process, promoting integration of the knowledge acquired in previous subjects(AU)

En la actualidad, la formación en Ciencias de la Salud requiere de la interacción con pacientes reales, lo que se hace más complejo por la necesidad de velar por la seguridad de su salud. Por ello, ahora se están implementando nuevas metodologías docentes que ayudan a mejorar y proteger la atención segura. Objetivo: Este estudio se llevó a cabo con un enfoque cuantitativo con un diseño no experimental, descriptivo. Materiales y métodos: La muestra fue no probabilística a conveniencia y estuvo conformada por 87 estudiantes de pregrado. Se utilizó un cuestionario, con 18 enunciados divididos en 3 dimensiones: dimensión 1, estructura de simulación, con seis preguntas que reflejan aspectos relacionados con su implementación; la dimensión 2, aprendizaje, con siete preguntas relacionadas con aspectos de comunicación efectiva, confianza, aprendizaje y respeto a la diversidad; dimensión 3, retroalimentación para el aprendizaje, con cinco preguntas, que incluye la retroalimentación del docente y del paciente simulado, así como sus propias opiniones con respecto a participar nuevamente en otra experiencia similar. Se utilizó una escala tipo Likert de cinco puntos. Resultados: Las tres dimensiones estudiadas, estructura de simulación, aprendizaje y retroalimentación para el aprendizaje, reportan un alto nivel de percepciones positivas. Conclusión: La estrategia de simulación es una herramienta educativa en carreras afines a la salud que potencia las competencias clínicas de los estudiantes, así como las destrezas y habilidades teóricas y prácticas pertinentes en su proceso de aprendizaje, favoreciendo la integración de los conocimientos adquiridos en materias anteriores(AU)

Un modelo para la evaluación de las habilidades no técnicas en anestesiología: una revisión de la literatura / A model for the assessment of non-technical skills in anesthesiology: a literature review

Resumen: Hasta 80% de los errores médicos se deben a fallas en factores humanos (mala comunicación, monitoreo inadecuado, fallas de verificación, etc.), por lo que el entrenamiento de los anestesiólogos exige el desarrollo de habilidades no técnicas en anestesiología. Las habilidades no técnicas son las habilidades cognitivas, sociales y personales que complementan las habilidades técnicas, y que contribuyen al desempeño seguro y eficiente de la tarea. En 2004 la Universidad de Aberdeen fue la primera en plantear un modelo para la definición y evaluación de estas habilidades en el ámbito médico. El modelo práctico consta de 15 elementos incluidos en cuatro categorías: manejo de la tarea, trabajo en equipo, conciencia de la situación y toma de decisiones. La herramienta es utilizada por anestesiólogos graduados para evaluar a quienes están en entrenamiento en el quirófano o mediante simulación clínica. La validez de este sistema, así como su importancia en la seguridad del paciente, ha sido demostrada por diferentes estudios.

Abstract: Close to 80% of medical errors are due to human factors (poor communication, inadequate monitoring, failure to check, etc.), which is why training for anaesthetists requires developing essential soft skills for Anaesthesiology. Soft skills are defined as specific cognitive, socio-emotional and interpersonal abilities complementing core skills which contribute to the safe and efficient carrying out of a job-specific task. In 2004, the University of Aberdeen established a first model for defining and evaluating these soft skills. The model consists of 15 elements across four categories: task management, team working, situational awareness and decision-making. The model is a tool employed by postgraduate anaesthesiologists to assess trainees in the operating theatre or through clinical simulation. The validity of this system, as well as its importance for patient safety have been demonstrated in a range of studies.

Use of clinical simulation to train healthcare teams in conflict management: A scoping review.

OBJECTIVE: To assess and analyze the impact of clinical simulation as a training tool in healthcare teams ability to resolve and manage conflicts, through an exploratory systematic review. METHODS: A structured literature review was performed with the terms [Clinical Simulation OR Patient Simulation OR Simulation Training OR High Fidelity simulation Training] AND [Conflict OR Conflict Resolution] in the following databases: MEDLINE, LILACS, Cochrane, Scielo, PubMed, CINHAL, ScienceDirect, MEDES, IBECS y DOCUMED. Articles were considered if they involved clinical simulation oriented to training of healthcare professionals or trainees in conflict management, using clinical scenarios, and excluding those studies older than 20 years. Absence of debriefing was not considered an exclusion criterion, neither the use of simulation along with other methodologies. A quantitative analysis was performed. RESULTS: 10 articles were retrieved, mostly with quasi-experimental designs, in which clinical simulation was designed as an interprofessional training and was used with multiple other methodologies like roleplay, reflexive practice and audiovisual aids, strategy that suggest an increase its effectivity. Different scenarios have been recreated, like decision-making divergences and management of medical errors, in order to apply the competences of mediation, communication, emotional skills among others, and followed by debriefing. The use of validated scales and conventional assessment methods reveal a positive impact on satisfaction, perception and learning of students, as well as transfer to clinical practice and decrease in errors. CONCLUSION: Multiple studies describe and support the use of clinical simulation for training in management and resolution of conflicts among healthcare professionals. Simulation is accepted by participants, developing transfer of skills and competences and impact at the organizational level. Nonetheless, studies are recent and limited in number, making this area a developing field that promotes future research.

Simulación in situ y "madre" simulada, nuevas estrategias pedagógicas en pediatría / Simulação in situ e simulação "mãe", novas estratégias pedagógicas em pediatria / In situ simulation and simulated "mother", new pedagogical strategies in pediatrics

El proceso de docencia-aprendizaje de las disciplinas clínicas tiene entre sus desafíos la adquisición de habilidades del estudiante con el paciente. Las oportunidades de prácticas clínicas se han reducido. La menor cantidad de consultas pediátricas en el año 2020 durante la pandemia por Coronoavirus exacerbó este hecho. Objetivo: Comunicar la experiencia de simulación in situ y madre simulada realizada por docentes del Departamento de Emergencia Pediátrica del Centro Hospitalario Pereira Rossell, dirigida al entrenamiento de estudiantes de la Unidad Curricular Pediatría (Facultad de Medicina-UdelaR), en la realización de la anamnesis de un paciente con patología respiratoria. Metodología: estudio descriptivo. Madre simulada: docentes/residentes. Simulador: lactante-tecnología intermedia. Participantes del escenario: 2 estudiantes. Lugar: DEP-CHPR. Período: setiembre-diciembre 2020. Resultados: Participaron de la simulación 327 estudiantes, 255 contestaron el censo. Utilidad de la simulación: 53,2% muy útil/excelente, poco o nada útil 24,8%, no contesta 22%. Credibilidad: aceptable 38%, muy creíble/excelente 27,5%, 12,5% poco o nada creíble, 22% no contesta. Participación grupal en el debriefing 64,5%, participación parcial 11,4%, sin debriefing 2,1%, no contesta 22%.Discusión: De los 327 estudiantes que realizaron la simulación al menos 24,% la percibió como poco o nada útil. La falta de información previa, la participación en el escenario de 2 estudiantes por grupo y la poca interacción en el debriefing en algunos grupos pudo haber influído. Conclusiones: La experiencia comunicada generó nuevas oportunidades de docencia aprendizaje. Se identificaron aspectos metodológicos que pueden mejorarse.

The teaching-learning process in clinical disciplines includes amongst its challenges the acquisition of the student's skills with the patient. Opportunities for clinical practice have diminished. A smaller number of pediatric visits in 2020 during the Coronavirus pandemic increased this fact. Objective: to communicate the experience of in situ simulation and simulated mother carried out by the faculty of the Pediatric Emergency Department of the Pereira Rossell Hospital Center, address to students in the Pediatrics Curricular Unit (School of Medicine- UdelaR), in the case of an infant patient with respiratory pathology. Methods: Descriptive study. Simulated mother: faculty members/residents. Simulator: intermediate technology infant. Participants in the scenario: 2 students. Location: DPE.PRHC. Period: September- December 2020.Results: 327 students participated in the simulation, 255 answered the census. Usefulness of the simulation: 53.2% very useful / excellent, little or not at all useful 24.8%, no answer 22%. Credibility: acceptable 38%, very credible / excellent 27.5%, 12.5% ​​little or not at all credible, 22% do not answer. Group participation in the debriefing 64.5%, partial participation 11.4%, without debriefing 2.1%, no answer 22%. Discussion: Of the 327 students who carried out the simulation at least 24,8 % perceived it as little or not useful. The lack of previous information, the participation in the scenario of 2 students per group and the little interaction in the debriefing in some groups could have influenced. Conclusions: The communicated experience generated new teaching-learning opportunities. Methodological aspects that can be improved were identified.

O processo de ensino-aprendizagem de disciplinas clínicas tem entre seus desafios a aquisição de habilidades do aluno com o paciente. As oportunidades de estágio clínico foram reduzidas. O menor número de consultas pediátricas em 2020 durante a pandemia de Coronoavirus exacerbou esse fato. Objetivo: Comunicar a experiência de simulação in situ e simulação materna realizada pela docentes do Serviço de Urgência Pediátrica do Centro Hospitalar Pereira Rossell, com alunos da Unidade Curricular Pediatria (Faculdade de Medicina-UdelaR), na anamnese de paciente com doença respiratória. Metodologia: estudo descritivo. Mãe simulada: professores / residentes. Simulador: lactente de tecnologia intermédia. Participantes do cenário: 2 alunos. Local: DEP-CHPR. Período: setembro a dezembro de 2020. Resultados: 327 alunos participaram da simulação, 255 responderam a pesquisa. Utilidade da simulação: 53,2% muito útil / excelente, pouco ou nada útil 24,8%, sem resposta 22%. Credibilidade: aceitável 38%, muito credível / excelente 27,5%, 12,5% pouco ou nada credível, 22% não respondem. Participação do grupo no debriefing 64,5%, participação parcial 11,4%, sem debriefing 2,1%, sem resposta 22%. Discussão: Dos 327 alunos que realizaram a simulação, pelo menos 24,% a perceberam como pouco ou nada útil. A falta de informação prévia, a participação no cenário de 2 alunos por grupo e a pouca interação no debriefing em alguns grupos podem ter influenciado. Conclusões: A experiência comunicada gerou novas oportunidades de ensino-aprendizagem. Aspectos metodológicos que podem ser melhorados foram identificados.

Innovative training of university students in cardiac arrest in clinical Ssimulation / Entrenamiento innovador de estudiantes universitarios en parada cardíaca en simulación clínica

Introduction: Statistics show nowadays, bystanders provided Cardiopulmonary Resuscitation (CPR) in 40-46% of all out-of-the-hospital cardiac arrests. Strategies must focus on specialized training for non-medical personnel. Engaging new generations in self-care depends on the development of new approaches to address the issue. The objective of this study was to assess the efficacy of an innovative training in CPR through the perception of the participants. Material and methods: This study considered a quantitative approach with a descriptive and correlational design. This study had a convenience sample of 103 participants from undergraduate programs in different disciplines: Engineering, Health, Law, and Design with participated voluntarily in the innovate training. To understand the efficacy of the innovative training data was collected of the participants through a self-assessment rubric. While participants were taken part in the training, an expert assessor was observing the performance and scored the procedure using a similar rubric. Both rubrics use a 5-point Likert scale to assess the level of agreement with each sentence. Results: Self-assessment results show that students excel on identifying if a patient has a pulse (mean=4.47) and if a patient is breathing (mean=4.52). The results of the expert assessment indicate a higher level of performance in hand positioning (mean=4.75) and compression-ventilation coordination (mean=4.77).Discussion: These results are encouraging as participants gained confidence on basic procedures, the main challenges are still on skills that rely deeply on practice. Therefore, this training might need to be offered periodically, as any certification offered for health professionals. This study is a first attempt to design an innovative short term and effective training that universities can replicate to prepare their students for these life-saving skills.

Introducción:Las estadísticas muestran que hoy en día los transeúntes realizan la reanimación cardiopulmonar (RCP) en el 40-46% de las paradas cardíacas extrahospitalarias. Las estrategias deben centrarse en la formación especializada del personal no médico, por lo que es importante desarrollar; nuevos enfoques para abordar el tema y comprometer a las generaciones más jóvenes en el autocuidado. El objetivo de este estudio fue evaluar la eficacia de un entrenamiento innovador en RCP a través de la percepción de los participantes.Ma-terial y métodos: Se utilizó un diseño cuantitativo para correlacionar ambas medidas de rendimiento. Este estudio consideró un enfoque cuantitativo con un diseño descriptivo y correlacional. Este estudio tuvo una muestra de conveniencia de 103 participantes de programas de pregrado en diferentes disciplinas: Ingeniería, Salud, Derecho y Diseño con participación voluntaria en el entrenamiento innovador. Para entender la eficacia de la formación innovadora se recogieron datos de los participantes a través de una rúbrica de autoevaluación. Mien-tras los participantes participaban en la formación, un evaluador experto observaba la actuación y puntuaba el procedimiento utilizando una rúbrica similar. Ambas rúbricas utilizan una escala Likert de 5 puntos para evaluar el nivel de acuerdo con cada frase.Resultados: Los resultados de la autoevaluación muestran que los estudiantes destacan en la identificación de si un paciente tiene pulso (media=4,47) y si un paciente respira (media=4,52). Los resultados de la evaluación de expertos indican un mayor nivel de rendimiento en la colocación de las manos (media=4,75) y en la coordinación compresión-ventilación (media=4,77). Discusión: Estos resultados son alentadores, ya que los participantes ganaron confianza en los procedimientos básicos; los principales retos siguen siendo las habilidades que dependen en gran medida de la práctica. Por lo tanto, es posible que esta formación deba ofrecerse periódicamente, como cualquier certificación ISSN: 0719-1855 © Dirección de Extensión y Educación Continua, Escuela de Medicina, Pontificia Universidad Católica de Chile. http://arsmedica.cl26ARS MEDICA Revista de Ciencias Médicas Volumen 46 número 3 año 2021Segura et al.ofrecida a los profesionales de la salud. Este estudio es un primer intento de diseñar una formación innovadora, eficaz y de corta duración, que las universidades pueden replicar para preparar a sus estudiantes en estas habilidades que salvan vidas.

Estructura factorial y confiabilidad de la escala de evaluación de debriefing para simulación en salud / Factorial structure and reliability of the debriefing evaluation scale for health simulation

Introducción: Las prácticas pedagógicas del docente en el debriefing son importantes para asegurar mejores resultados de aprendizaje en la educación basada en simulación clínica. Objetivo: Evaluar la estructura factorial de una versión adaptada de la escala de evaluación del debriefing para simulación en salud en estudiantes de Enfermería. Métodos: Estudio cuantitativo metodológico. Fueron elegidos 159 estudiantes de la carrera de Enfermería de una universidad privada de Concepción (Chile) mediante muestreo no probabilístico por accesibilidad. Estos respondieron la versión adaptada de la escala de evaluación del debriefing para simulación en salud más un cuestionario sociodemográfico, previo consentimiento informado. Se realizó un análisis factorial exploratorio de esta versión adaptada, se evaluó la confiabilidad del factor encontrado a través de alfa de Cronbach y luego se condujo un análisis descriptivo de estos. Resultados: Solo un factor fue identificado, el cual permite evaluar la calidad del debriefing en simulación clínica. El análisis de la confiabilidad del factor identificado mostró un alfa de Cronbach de 0,97, por lo que se clasificó como excelente, según los tramos sugeridos por George y Mallery. Conclusiones: Los resultados presentan evidencia psicométrica que apoya la validez y confiabilidad de la versión adaptada de la escala de evaluación del debriefing para simulación en salud, para emplearla en la evaluación de la calidad del debriefing en simulación clínica en la carrera de Enfermería. No obstante, se asume que su uso debe ser complementario y no excluyente, con un abordaje cualitativo de este fenómeno(AU)

Introduction: Professors' pedagogical practices in debriefing are important to ensure better learning outcomes in clinical simulation-based education. Objective: To assess the factorial structure of an adapted version of the Debriefing Evaluation Scale for health simulation in Nursing students. Methods: A methodological quantitative study was carried out with 159 Nursing students from a private university in Concepción, Chile, chosen through nonprobabilistic sampling for accessibility. They answered the adapted version of the Debriefing Evaluation Scale for health simulation and a sociodemographic questionnaire, with prior informed consent. An exploratory factor analysis of this adapted version was carried out, the reliability of the factor found was assessed using Cronbach's alpha, and then a descriptive analysis of these elements was carried out. Results: Only one factor was identified, which allows assessing the quality of debriefing in clinical simulation. The analysis of the reliability of the identified factor showed a Cronbach's alpha of 0.97, a reason why it was classified as excellent, according to the ranges suggested by George and Mallery. Conclusions: The results present psychometric evidence that supports the validity and reliability of the adapted version of the Debriefing Evaluation Scale for health simulation, to be used for assessing the quality of debriefing in clinical simulation in the Nursing major. However, it is assumed that its use must be complementary and not exclusive, with a qualitative approach to this phenomenon(AU)

Use of clinical simulation to train healthcare teams in conflict management: a scoping review. / Uso de la simulación clínica para entrenar equipos en el manejo de conflictos durante los cuidados en salud: una revisión sistemática exploratoria.

OBJECTIVE: To assess and analyze the impact of clinical simulation as a training tool in healthcare teams ability to resolve and manage conflicts, through an exploratory systematic review. METHODS: A structured literature review was performed with the terms clinical simulation OR patientsimulation OR simulation training OR high fidelity simulation training AND conflict OR conflict resolution in the following databases: MEDLINE, LILACS, Cochrane, Scielo, PubMed, CINHAL, ScienceDirect, MEDES, IBECS and DOCUMED. Articles were considered if they involved clinical simulation oriented to training of healthcare professionals or trainees in conflict management, using clinical scenarios, and excluding those studies older than 20 years. Absence of debriefing was not considered an exclusion criterion, neither the use of simulation along with other methodologies. A quantitative analysis was performed. RESULTS: 10 articles were retrieved, mostly with quasi-experimental designs, in which clinical simulation was designed as an interprofessional training and was used with multiple other methodologies like roleplay, reflexive practice and audiovisual aids, strategy that suggest an increase its effectivity. Different scenarios have been recreated, like decision-making divergences and management of medical errors, in order to apply the competences of mediation, communication, emotional skills among others, and followed by debriefing. The use of validated scales and conventional assessment methods reveal a positive impact on satisfaction, perception and learning of students, as well as transfer to clinical practice and decrease in errors. CONCLUSION: Multiple studies describe and support the use of clinical simulation for training in management and resolution of conflicts among healthcare professionals. Simulation is accepted by participants, developing transfer of skills and competences and impact at the organizational level. Nonetheless, studies are recent and limited in number, making this area a developing field that promotes future research.

Validación de un modelo simulado inanimado basado en impresión 3D de ureterorrenoscopía flexible / Validation of an inanimate simulated model based on flexible ureterorenoscopy 3D printing

Resumen Objetivo: Establecer validez aparente, de contenido y constructo, de un programa de simulación de ureterorrenoscopía flexible. Materiales y Método: Se desarrolló un modelo de simulación de silicona para ureterorrenoscopía flexible, en el cual se establecieron 8 marcas de colores en los distintos cálices. Para la validación, se reclutaron urólogos expertos y residentes de urología con experiencia variable en este procedimiento. Se separaron en 3 grupos: G1 para residentes sin experiencia en ureteroscopía, G2 para residentes con experiencia variable y G3 para urólogos expertos. Se les solicitó realizar una navegación completa del modelo, en un tiempo máximo de 600 segundos. Al finalizar, cada participante contestó una encuesta respecto a la utilidad y realismo del modelo. Además, se midió tiempo total, número de puntos encontrados y cantidad de veces de reingreso a los cálices para validación de constructo. Resultados: 15 personas participaron en la evaluación. Se obtuvo una mediana de 8,6 puntos para la utilidad del modelo y 6,75 puntos para el realismo de este. Los tiempos totales de navegación fueron 504, 293 y 133 segundos para G1, G2 y G3 respectivamente (p = 0,02). De las 8 marcas, se encontraron en promedio 5,1, 6,6 y 7,3 (p = 0,18), presentando un promedio de 9,5, 3,8 y 1,3 reintentos de exploración de los cálices en los respectivos grupos (p = 0,11). Conclusiones: Se establece validez aparente y contenido para un modelo de ureterorrenoscopía flexible. El programa de simulación de ureterorrenoscopía flexible establecido, permite diferenciar novatos de expertos en cuanto a reducción en los tiempos de navegación.

Aim: To establish the face, content, and construction validity of a flexible ureterorenoscopy simulation program. Materials and Method: A simulation model for flexible ureterorenoscopy was developed using silicone on which eight colored marks were marked on the calyxes. For validation, expert urologists and residents with varying amounts of experience in this procedure were recruited. They were separated into three groups: 1) G1 for residents without experience in ureteroscopy; 2) G2 for residents with variable experience; and 3) G3 for expert urologists. They were asked to perform a full navigation of the model in a maximum time of 600 sec. At the end, each participant answered a survey regarding the usefulness and realistic nature of the model. In addition, total time, number of marks found, and times of re-entry to the calyxes were measured. Results: A median of 8.6 points was obtained for the utility of the model and 6.75 points for its realistic nature. The total navigation times were 504, 293, and 133 seconds for G1, G2, and G3, respectively (p = 0.02). Of the eight marks, an average of 5.1, 6.6, and 7.3, (p = 0.18) were found with an average of 9.5, 3.8, and 1.3 exploration reattempts at the chalices in the corresponding groups (p = 0.11). Conclusions: Face and content validity was established for this simulation model of flexible ureterorenoscopy. This flexible ureterorenoscopy simulation program allowed us to differentiate the level of expertise in terms of reduction in navigation time.

Tecnologías en la enseñanza en enfermería, innovación y uso de TICs: revisión integrativa / Innovation and use of information and communication technologies in nursing teaching: An integrative review / Tecnologias no ensino em enfermagem, inovação e uso de TICs: revisão integrativa

Resumen Introducción: La utilización de los recursos digitales modernos para la enseñanza constituye una estrategia para atender las nuevas necesidades de aprendizaje. En el ámbito de enfermería puede facilitar la inserción de los estudiantes en la práctica clínica en modo virtual para que desarrollen sus habilidades y competencias. Objetivo: Analizar las evidencias sobre la utilización de tecnologías en la enseñanza de enfermería. Métodos: Revisión integrativa realizada en el portal de revistas SciELO y en las bases de datos IBECS, LILACS, BDENF, Web of Science, PubMed y CINAHL. Resultados: Se realizó la identificación inicial de 62 artículos, se aplicaron los criterios de exclusión hasta el establecimiento de la muestra de 26 artículos. Después de la lectura y análisis de los estudios, se constató que las tecnologías son más utilizadas junto con las clases teóricas en las aulas, o como plataformas online de enseñanza, o también como herramientas auxiliares para la práctica de simulaciones realísticas. Discusión: El uso de internet fue predominante en los estudios, pues favorece la actualización, la comunicación y la cualificación académica. En cuanto a las plataformas digitales de enseñanza, el espacio virtual permite reunir e integrar diversos medios con finalidades diferentes posibilitando la creación de actividades variadas. Para la enseñanza a través de simulaciones se presentaron diversos beneficios de inmersión a un ambiente profesional desde la universidad. Conclusiones: El estudio presenta una visión general de las tecnologías educativas utilizadas para la enseñanza de enfermería y provee conocimiento de nuevas metodologías, lo que beneficia a profesores y estudiantes.

Abstract Introduction: The utilization of modern digital resources in teaching constitutes a strategy to address the new learning needs. In the area of nursing, the use of digital resources can facilitate the insertion of students into the clinical practice by providing a virtual environment in which students can develop their skills and competencies. Objective: To analyze the evidence regarding the utilization of technologies in nursing teaching. Methods: This is an integrative review based on the SciELO publications and IBECS, LILACS, BDENF, Web of Science, PubMed and CINAHL databases. Results: 62 relevant articles were identified. After considering the exclusion criteria, a final sample with 26 articles was constituted. The studies were read and analyzed, and it was found that the diverse technologies are more frequently utilized in conjunction with theory classes in classrooms, as online teaching platforms, or as auxiliary tools to support realistic simulations. Discussion: The use of the Internet was prevalent in the analyzed studies. Regarding some teaching digital platforms, virtual spaces showed being useful to create diverse teaching-learning activities; with simulations being helpful to prepare students to enter the professional practice. Conclusions: This study presents a general view of the educational technologies utilized in nursing teaching, while displaying some specific methodologies which can be of benefit for both students and teachers.

Resumo Introdução: A utilização de recursos digitais modernos para o ensino constitui uma estratégia para atender as novas necessidades de aprendizagem. No âmbito de enfermagem pode facilitar a inserção dos estudantes na prática clínica em modalidade virtual para que desenvolvam suas habilidades e competências. Objetivo: Analisar as evidências sobre a utilização de tecnologias no ensino de enfermagem. Métodos: Revisão integrativa realizada no portal de periódicos SciELO e nas bases de dados IBECS, LILACS, BDENF, Web of Science, PubMed e CINAHL. Resultados: Foi realizada a identificação inicial de 62 artigos, aplicaram-se os critérios de exclusão até o estabelecimento da amostra de 26 artigos. Após a leitura e a análi-se dos estudos, foi constatado que as tecnologias são mais utilizadas em conjunto com as aulas teóricas nas salas de aula, ou como plataformas de ensino online, ou também como ferramentas auxiliares para a prática de simulações realísticas. Discussão: O uso da internet foi predominante nos estudos, dado que favorece a atualização, a comunicação e a qualificação acadêmica. Sobre as plataformas digitais de ensino, o espa-ço virtual permite reunir e integrar diversos médios com finalidades diferentes possibilitando a criação de atividades variadas. Apresentaram-se diversos benefícios de imersão para o ensino através de simulações em um ambiente profissional desde a universidade. Conclusões: O estudo apresenta uma visão geral das tecnologias educacionais utilizadas no ensino de enfermagem e provê conhecimento de novas metodologias, o qual beneficia professores e estudantes.

Clinical judgment and diagnostic reasoning of nursing students in clinical simulation / Juicio clínico y razonamiento diagnóstico de estudiantes de enfermería en simulación clínica / Julgamento clínico e raciocínio diagnóstico de estudantes de enfermagem em simulação clínica

ABSTRACT Objectives: to determine the degree of association between clinical judgment and diagnostic reasoning of nursing students in clinical simulation. Methods: this is a correlational research design using a quantitative approach. The sample consisted of 41 nursing students who assisted a patient with vaso-occlusive crisis in a high-fidelity clinical simulation setting. The instruments used included the Lasater Clinical Judgment Rubric - Brazilian Version and the Diagnostic Thinking Inventory. Results: clinical judgment was associated with diagnostic reasoning (r=0.313; p=0.046), as well as the "noticing" aspect of clinical judgment with diagnostic reasoning (r=0.312; p=0.047). Conclusions: the results show that skills to interpret patient data are associated with diagnostic reasoning skills. Teaching clinical judgment skills is necessary to develop the diagnostic reasoning of nursing students.

RESUMEN Objetivos: conocer el grado de asociación entre el juicio clínico y el razonamiento diagnóstico de estudiantes de enfermería en simulación clínica. Métodos: estudio correlacional con enfoque cuantitativo. La muestra consistió en 41 estudiantes de enfermería, que atendieron a pacientes en una crisis vasooclusiva, en un escenario de simulación clínica de alta fidelidad. Los instrumentos utilizados incluyeron la rúbrica Lasater Clinical Judgment Rubric - Brazilian Version y el Inventario de Razonamiento Diagnóstico. Resultados: el juicio clínico se asoció con el razonamiento diagnóstico (r=0.313; p=0.046), así como el aspecto de "reconocimiento del juicio clínico" con el razonamiento diagnóstico (r=0.312; p=0.047). Conclusiones: los resultados muestran que las habilidades para interpretar los datos del paciente están asociadas con las habilidades de razonamiento diagnóstico. La enseñanza de habilidades de juicio clínico es necesaria para el desarrollo del razonamiento diagnóstico de los estudiantes de enfermería.

RESUMO Objetivos: conhecer o grau de associação entre o julgamento clínico e o raciocínio diagnóstico de estudantes de enfermagem em simulação clínica. Métodos: estudo correlacional de abordagem quantitativa. A amostra foi composta por 41 estudantes de enfermagem, que realizaram atendimento a paciente em crise vaso-oclusiva, em cenário de simulação clínica de alta fidelidade. Os instrumentos utilizados compreenderam o Lasater Clinical Judgment Rubric - Brazilian Version e o Inventário de Raciocínio Diagnóstico. Resultados: o julgamento clínico apresentou associação com o raciocínio diagnóstico (r=0,313; p=0,046), bem como o aspecto "reconhecimento do julgamento clínico" com o raciocínio diagnóstico (r=0,312; p=0,047). Conclusões: os resultados evidenciam que as habilidades para interpretar os dados do paciente estão associadas às habilidades de raciocínio diagnóstico. O ensino das habilidades de julgamento clínico é necessário para o desenvolvimento do raciocínio diagnóstico dos estudantes de enfermagem.

La simulación clínica en la adquisición de conocimientos en estudiantes de la Licenciatura de Enfermería / Clinical simulation in acquisition of knowledge among undergraduate nursing students / A simulação clínica na aquisição de conhecimentos em estudantes da Licenciatura de Enfermagem

Resumen Introducción: La simulación clínica es una herramienta educativa que permite a los estudiantes de enfermería experimentar la representación de un hecho real, para practicar, aprender y adquirir los conocimientos necesarios para el desempeño de su profesión. En Oaxaca, la Universidad de la Sierra Sur (UNSIS), tiene una clínica robotizada, que apoya a los estudiantes en el desarrollo de su práctica clínica, pero aún no cuenta con una metodología específica para llevar a cabo simulación clínica. Objetivo: Comparar la adquisición de conocimientos en estudiantes de enfermería con el método tradicional y otro basado en simulación clínica. Metodología: Estudio de pre y postest para evaluar conocimiento del tema trabajo de parto en alumnos de 4° semestre; se compararon dos metodologías, la tradicional utilizada en la universidad y otra basada en simulación clínica; la primera consistió en dar la clase teórica en aula y replicarla con un simulador; la segunda consistió en clase teórica, escenario de simulación clínica, caso clínico y debriefing. Resultados: Hubo diferencia estadísticamente significativa (p <.001) entre pretest y postest en ambas metodologías, pero quienes recibieron la metodología basada en simulación clínica obtuvieron mayores puntajes (p=0.004). Discusión: El uso de una metodología basada en simulación clínica permitió que los alumnos obtuvieran mayores conocimientos en el tema trabajo de parto, respecto a la metodología tradicional que se utiliza en la universidad. La UNSIS empieza a generar evidencia sobre el uso de la simulación clínica adaptada a su modelo educativo. Conclusiones: Utilizar la simulación clínica logró que los estudiantes obtuvieran mayores conocimientos.

Abstract Introduction: Clinical simulation is an educational tool which allows nursing students to experience representations of real events in order to practice, learn, and acquire the necessary knowledge to perform in their profession. In Oaxaca, Mexico, the Universidad de la Sierra Sur (UNSIS), has a robotic clinic which helps nursing students in their clinical learning; however, a specific clinical simulation methodology needs to be developed. Objective: To contrast the acquisition of knowledge among nursing students as a result of using the traditional method in comparison to using a method based on clinical simulation. Methodology: This is pre and post-test study to assess the knowledge development related to labor among nursing students from the 4th semester. Two teaching methodologies were compared: the traditional one, which included classroom classes and a replication using a simulator, and the clinical simulation based one, which included classroom classes, a clinical simulation scenario, a clinical case, and a debriefing session. Results: Statistically significant differences (p <.001) were found between the pre and post test knowledge status with both teaching methodologies; but the improvement of those who learned through the clinical simulation based methodology was higher (p=0.004). Discussion: The use of the methodology based on clinical simulation allowed the students to acquire more knowledge on labor among in comparison to the use of the traditional methodology. The UNSIS is now collecting evidence on the use of clinical simulation in order to adapt this methodology to its educational model. Conclusion: The use of clinical simulation resulted in the acquisition of more knowledge by the nursing students.

Resumo Introdução: A simulação clínica é uma ferramenta educativa que permite aos estudantes de enfermagem experimentar a representação de um fato real, para praticar, aprender e adquirir os conhecimentos necessários para o desempenho de sua profissão. Em Oaxaca, a Universidad de la Sierra Sur (UNSIS), tem uma clínica robotizada, que apoia aos estudantes no desenvolvimento de sua prática clínica, mas ainda não conta com uma metodologia específica para levar a cabo simulação clínica. Objetivo: Comparar a aquisição de conhecimentos em estudantes de enfermagem com o método tradicional e outro baseado na simulação clínica. Metodologia: Estudo de pre e postest para avaliar conhecimento do tema trabalho de parto nos alunos de 4° semestre; compararam-se duas metodologias, a tradicional utilizada na universidade e outra baseada em simulação clínica; a primeira consistiu em dar a aula teórica na sala e replicá-la com um simulador; a segunda consistiu na aula teórica, cenário de simulação clínica, caso clínico e debriefing. Resultados: Houve diferença estatisticamente significativa (p <.001) entre pretest e postest em ambas as metodologias, mas aqueles que receberam a metodologia baseada em simulação clínica obtiveram maiores pontuações (p=0.004). Discussão: O uso de uma metodologia baseada em simulação clínica permitiu que os alunos obtivessem maiores conhecimentos no tema trabalho de parto, ao respeito da metodologia tradicional que se utiliza na universidade. A UNSIS começa a gerar evidência sobre o uso da simulação clínica adaptada a seu modelo educativo. Conclusões: Utilizar a simulação clínica conseguiu que os estudantes obtivessem maiores conhecimentos.