Assessment of the evolution of psychomotor skills in the robotic surgery simulation process.

Robotic surgery is a rapidly expanding field, given the wide variety of new robotic platforms emerging. Looking at the training of surgeons in robotic surgery is of extreme necessity and urgency, considering the ongoing technological advancements. In this research, the performance during the virtual reality simulation phase of training for robotic surgery was analyzed. It was observed that, in addition to the lack of consensus among societies regarding the required simulation hours, there is no guidance on the best curriculum to be adopted. From the data in this study, it can be inferred that the more advanced skills have fewer proficient individuals, meaning that fewer surgeons in training have reached proficiency in all skill exercises. Even with differences in the number of exercises performed proficiently between groups that underwent varying amounts of simulation time, there is no statistically significant difference in the proportion between them.

Curricular and pedagogical approaches for physical activity prescription training: a mixed-methods study of the "Exercise is Medicine" workshops in Colombia.

BACKGROUND: The physical activity (PA) prescription workshop for physicians, through the global health initiative "Exercise is Medicine" (EIM), has trained more than 4000 health care professionals (HCPs) in Latin America. It has shown to be effective in increasing PA prescription knowledge and awareness among HCPs. The purpose of this paper is to evaluate the curricular and pedagogical approach used by EIM Colombia at the PA prescription workshops implemented between 2014 and 2015. METHODS: A mixed methods study, with a sequential explanatory design was implemented among a convenience sample of HCPs attending twenty-six PA prescription workshops. HCPs health status, PA personal habits, and medical practices were collected using a questionnaire at baseline among 795 participants (pre-test measurement), and subsequently quantitatively analyzed. A workshop satisfaction survey was administered after the completion of the workshop among 602 HCPs. The curricular and pedagogical approach of the workshop, the designers' and students' contextual factors, and perceptions about the workshop were measured using qualitative methods (analysis of the procedures manual, two workshop observations, three semi-structured interviews, and one focus group including 8 HCPs). RESULTS: The workshop is student-centered and guided by an expert with an academic and clinical background. Learning was achieved with theoretical and practical components using authentic performance and collaborative learning. An active teaching and learning approach was used with strategies such as interactive lectures, hands-on elements, and role-playing (patient-counselor). The workshop emphasized an individual approach when prescribing PA integrating in clinical practice not only health benefits but also patient´s beliefs, motivations, needs, and barriers. CONCLUSIONS: Evidence-based practices and authentic performance were the most salient pedagogical elements used by EIM Colombia at the PA prescription workshop. A knowledge assessment that includes the practical aspect is suggested for future workshops. The curricular and pedagogical approach of the PA prescription workshop implemented in Colombia is well received by the medical community and a useful continuing medical education intervention with a potential contribution to current, and future health promotion needs.

One Step Closer to Safer: Counseling Outcomes from American Academy of Pediatrics Firearm Safe Storage Education Training.

OBJECTIVE: To assess pre and postself-reported counseling outcomes for Safer: Storing Firearms Prevents Harm, an American Academy of Pediatrics universal firearm safe storage counseling training for pediatric clinicians providing health maintenance in outpatient settings. STUDY DESIGN: Safer was developed by a national multidisciplinary committee of firearm injury prevention experts with input from firearm-owning families and launched in June 2021. Pediatric clinicians completed baseline and 1-month posttraining surveys after signing up for the Pedialink course from February through June 2022. Primary outcomes included self-reported measures of counseling self-efficacy and frequency. Wilcoxon matched-pairs signed-rank tests compared outcome distributions at baseline and follow-up. Two adjusted, multilevel mixed-effects regression models were conducted. RESULTS: Of 230 clinicians who completed baseline surveys, 146 (64%) completed 1-month postsurveys. Regional representation included Southeast = 67 (46%), Northeast = 24 (16%), Midwest = 21 (14%), Pacific = 15 (10%), Southwest = 11 (8%), and Rocky Mountain = 8 (5%). At follow-up, there was significant improvement in both the distribution of self-efficacy (median [first Quartile-third Quartile = 50 [20-70] at baseline and 80 [60-85] at follow-up; P < .001) and self-reported counseling frequency (median [first Quartile-third Quartile] = 10 [0-50] at baseline and 50 [10-80] at follow-up; P < .001). Adjusted regression model results suggested that self-efficacy significantly improved from baseline to follow-up (time coefficient 25.3; 95% CI = [21.0, 29.5]; P < .001) as did counseling frequency (time coefficient 13.6; 95% CI = [9.2, 18.0]; P < .001). CONCLUSIONS: Significant improvement in self-reported counseling self-efficacy and frequency was demonstrated 1 month following Safer training.

Caracterización de estilos de aprendizaje, satisfacción y acceso a residencia médica en participantes de un programa de educación médica continuada bimodal/virtual en Medellín, Colombia, 2017 / Characterization of Learning Styles, Satisfaction, and Access to Medical Residency in Participants of a Bimodal/Virtual Continuing Medical Education Program in Medellín, Colombia, 2017

Introducción: los estilos de aprendizaje son rasgos del estudiante que pueden ayudar a la planificación curricular en educación médica. No se conoce con certeza si algún estilo de aprendizaje específico se relaciona con la satisfacción en educación médica continuada o si aumenta las probabilidades de acceder a una residencia médica. Objetivo: este trabajo buscó categorizar los estilos de aprendizaje en una cohorte de médicos, describir su satisfacción según cada estilo de aprendizaje y el acceso a una residencia médica. Materiales y métodos: estudio de corte transversal en médicos cursando un diplomado de actualización médica. Se categorizaron estilos de aprendizaje y sus combinaciones (activo, reflexivo, teórico y pragmático). Se calculó la diferencia de medias de satisfacción del curso. Posteriormente, se evaluó la asociación entre el estilo de aprendizaje y el acceso a un cupo de residencia médica. Resultados: trescientos once médicos (n=311) aceptaron participar. El 75 % tenían entre uno y dos estilos dominantes, siendo el más frecuente el reflexivo/teórico (n=108; 34,7%). No se encontró una mayor satisfacción global asociada a un estilo en particular. Conclusión: el estilo de aprendizaje dominante es el reflexivo/teórico. La satisfacción global es mayor en la modalidad bimodal. No se encontró asociación con ningún estilo de aprendizaje y el acceso a residencia médica.

Introduction: learning styles are student traits that can aid in curriculum planning in medical education. It is not known for certain if any specific learning style is related to satisfaction in continuing medical education or if it increases the chances of accessing a medical residency. Objective: the learning styles are student traits that can aid in curriculum planning in medical education. This study aimed to categorize learning styles within a cohort of physicians, describe their satisfaction according to each learning style, and assess access to a medical residency program. Methods: a cross-sectional study was conducted with physicians attending a diploma in clinical and surgical areas. Learning styles were categorized according to the CAMEA40 questionnaire. The median differences of course satisfaction was calculated. Subsequently, the association between each learning styles and access to a medical residency post was evaluated. Results: three hundred eleven (n = 311) agreed to participate. A total of 75 % had between one and two dominant learning style, the most frequent being the reflective/theoretical (n = 108; 34,7 %). No greater overall satisfaction associated with a particular learning style was found. Conclusion: one-third of the doctors had a reflective/theoretical profile. The overall satisfaction and access to a medical residency were no associated with any learning style.

A cross-sectional survey of prospective healthcare professionals' knowledge, attitudes and perceptions of medical Cannabis.

Background: Compounds isolated from Cannabis possess many beneficial effects creating a renewed worldwide interest in its therapeutic potential. With increased legalization for medicinal use globally, healthcare professionals must be familiar with the drug's uses and potential adverse effects. Objective: To determine prospective healthcare providers' knowledge, attitude and perception to medical Cannabis. Method: A self-administered online questionnaire comprising 21 questions to assess the knowledge, attitude and perception of medical Cannabis was distributed via google forms among students at the Faculty of Medical Sciences, the University of the West Indies, St Augustine Campus. Chi-square analysis was used to detect significant associations between demographics and measured variables. A p-value <0.05 was considered significant. Results: Popular perceived therapeutic benefits of Cannabis were chronic pain (91.2%), anxiety (84.2%) and seizures (71.1%), and identification of the risks associated with the use of Cannabis was low. Users of Cannabis were able to identify indications and symptoms that can be treated with Cannabis but were less aware of the adverse effects of the drug than non-users (p < 0.001). More than three-quarters (87.3%) believed they could identify therapeutic uses and adverse effects but only 14.2% were ready to answer queries from patients. The main source of Cannabis information was the internet and information was lacking in the medical school curriculum. Conclusion: The majority of students could not identify the drug's indications and adverse effects. There is a need to improve training for all prospective medical personnel to cater for the change in legislation status.

Bringing the Pediatric Endocrine Spanish Speaking Community Together: First Virtual Pediatric Endocrine Meeting in Low- and Middle-Income Countries in Central and South America.

BACKGROUND: Pediatric endocrinology is a specialty that is struggling worldwide to maintain adequately trained professionals. Pediatric endocrine care in Central America and Caribbean countries is often performed by pediatricians or adult endocrinologists due to the limited number of pediatric endocrinologists. These health care providers are seldom members of endocrine societies and frequently lack formal training in the field. OBJECTIVE: In this study, we describe the scope of a virtual conference in pediatric endocrinology and diabetes targeted to low- and middle-income countries to provide equal opportunities for access to medical education for health care professionals. METHODS: The virtual conference was sponsored by the Pediatric Endocrine Society (North America), Asociación Costarricense de Endocrinología (previously, Asociación Nacional Pro Estudio de la Diabetes, Endocrinología y Metabolismo), and Asociacion Centroamericana y del Caribe de Endocrinologia Pediátrica. The conference was free to participants and comprised 23 sessions that were either synchronous with ability for real-time interactive sessions or asynchronous sessions, where content was available online to access at their convenience. Topics included idiopathic short stature, polycystic ovarian syndrome, diabetes mellitus, telemedicine, Turner syndrome, congenital adrenal hyperplasia, obesity, central precocious puberty, and subclinical hypothyroidism. The participants were asked to evaluate the conference after its completion with a questionnaire. RESULTS: A total of 8 speakers from Spain, Canada, Costa Rica, and the United States delivered the virtual event to 668 health care professionals from Guatemala, Venezuela, Dominican Republic, Costa Rica, Ecuador, Peru, Uruguay, Mexico, Honduras, Argentina, the United States, Bolivia, Chile, Panama, El Salvador, Nicaragua, Paraguay, Belize, Spain, and Colombia. Name, profession, and country were fully disclosed by 410 (61.4%) of the 668 health care professionals. The profession or level of training of participants were as follows: pediatric endocrinologists (n=129, 19.3%), pediatricians (n=116, 17.4%), general practitioners (n=77, 11.5%), adult endocrinologists (n=34, 5.1%), medical students (n=23, 3.4%), residents in various specialties (n=14, 2.1%), and others (n=17, 2.6%). A total of 23 sessions were offered, most of which were bilingual (Spanish and English). Feedback from the evaluation questionnaire indicated that the content of the conference was very relevant to the participants' professional practice. Additionally, the participants reported that they were very satisfied with the organization, the web-based platform, and the sessions of the conference. CONCLUSIONS: Lack of accessibility to the latest and cutting-edge medical education in pediatric endocrinology and diabetes for medical professionals from low- and middle-income countries can be overcome with a virtual conference. Online availability, low cost, and easy-to-use technology were well received from the participants, who were overall very satisfied by the quality and the relevance of the sessions to their professional practice.

Códigos QR en Educación Médica - Parte 3. Una Innovación en el Proceso de Enseñanza - Aprendizaje / QR Codes in Medical Education - Part 3. An Innovation in the Teaching-Learning Process

En esta tercera y última parte de la serie Códigos QR en Educación Médica analizaremos una nueva forma de Código QR con complementos de función y los distintos contextos educativos en los que se pueden emplear como una herramienta tecnológica innovadora durante el proceso de enseñanza ­ aprendizaje. Nuestro objetivo es lograr que los educadores se familiaricen con esta tecnología y puedan incorporarla al material educativo utilizado tanto en el aula tradicional como en los cursos virtuales.

In this third and last section of the series QR Codes in Medical Education we will analyze a new form of QR Code with complements of function and the different educational contexts in which they can be used as an innovative technological tool during the teaching-learning process. The final purpose is to ensure that all educators feel familiar with this technology and can incorporate it into the educational material used both in the traditional classroom and in virtual courses.

Valor añadido de las interconsultas con otras especialidades médicas en el peritaje médico legal / The added value of interconsultations with other medical specialties in forensic expertise

Resumen La pericia médico legal es compleja y su resultado debe estar fundamentado considerando el análisis de varios elementos de juicio, como: la historia médico legal, el examen físico, el análisis de los expedientes médicos, estudios de laboratorio e imágenes radiológicas y en algunos casos, inclusive una interconsulta realizada a otros especialistas. El perito médico forense utiliza la interconsulta a especialistas para solventar la brecha que existe entre el conocimiento profesional y específico que posee una especialidad y una interrogante médico legal, por lo que difiere en gran manera en el objetivo, formulación y resultado de una interconsulta médica hospitalaria. Por esta razón, esta reflexión pretende contextualizar la importancia del recurso de interconsulta médica dentro del análisis pericial forense, que es un tema poco conocido en la medicina asistencial, y justificar la relevancia de la educación médica continua para los médicos especialistas que realizan las interconsultas y para quienes las solicitan.

Abstract The medical-legal report is complex and its result must be based on the análisis of various elements of judgment, such as: the legal medical history, the physical examination, the analysis of the medical records, laboratory and radiological images and in some cases, even an interconsultation with other specialists. The forensic medical expert uses the interconsultation with specialists to solve the gap that exists between the professional and specific knowledge that a specialty has and a legal medical question, for which it differs greatly in the objective, formulation and result of a hospital medical interconsultation. For this reason, this reflection aims to contextualize the importance of the resource of medical interconsultation within the forensic expert analysis, which is a little-known topic in healthcare medicine, and to justify the relevance of continuing medical education for medical specialists who perform interconsultations and for those who request them.

Tromboprofilaxis en pacientes hospitalizados: implementación de un programa multifacético / Thromboprophylaxis in hospitalized patients: implementation of a multifacetical program

Resumen La enfermedad tromboembólica venosa es la causa prevenible más frecuente de muerte hospitalaria. A pesar de contar con evidencia y recomendaciones sobre la utilidad de la tromboprofilaxis, la adherencia por parte de los médicos a las mismas es muy variable, y frecuentemente subóptima. El objetivo de este estudio fue evaluar un programa institucional con estrategias multifacéticas dirigido a médicos, sobre tromboprofilaxis en internación y estimar el cambio en la adecuación de la tromboprofilaxis antes y después de la intervención. La intervención se mantuvo durante 6 años, fue múltiple, utilizando acciones pasivas como car telería, y activas, como educación médica continua, confección y adopción de una guía institucional de práctica clínica y un sistema de soporte informático para la decisión clínica. La adecuación basal de la tromboprofilaxis mejoró de 59% a 82% después de la intervención y se mantuvo en el tiempo. La mejora en la adecuación se asoció a una reducción de los sangrados mayores, en particular en pacientes intervenidos quirúrgicamente.

Abstract Venous thromboembolic disease is the most common preventable cause of hospital death. Despite the existence of evidence of the usefulness of thromboprophylaxis and recommendations, adherence by physicians to them is highly variable, and frequently suboptimal. The objective was to evaluate the change in the adequacy of thromboprophylaxis before and after an intervention on thromboprophylaxis with multifaceted strategies for physicians. The intervention was a 6 years institutional program with multiple strategies: passive actions such as posters and active actions as continuous medical education, adaptation of an institutional clinical practice guide and a computerized clinical decision support system. The baseline adequacy of thromboprophylaxis improved from 59% to 82% and was maintained over time. The improvement in fitness was associated with a reduction in major bleeding, particularly in patients undergoing surgery.

[Thromboprophylaxis in hospitalized patients: implementation of a multifacetical program]. / Tromboprofilaxis en pacientes hospitalizados: implementación de un programa multifacético.

Venous thromboembolic disease is the most common preventable cause of hospital death. Despite the existence of evidence of the usefulness of thromboprophylaxis and recommendations, adherence by physicians to them is highly variable, and frequently suboptimal. The objective was to evaluate the change in the adequacy of thromboprophylaxis before and after an intervention on thromboprophylaxis with multifaceted strategies for physicians. The intervention was a 6 years institutional program with multiple strategies: passive actions such as posters and active actions as continuous medical education, adaptation of an institutional clinical practice guide and a computerized clinical decision support system. The baseline adequacy of thromboprophylaxis improved from 59% to 82% and was maintained over time. The improvement in fitness was associated with a reduction in major bleeding, particularly in patients undergoing surgery.

La enfermedad tromboembólica venosa es la causa prevenible más frecuente de muerte hospitalaria. A pesar de contar con evidencia y recomendaciones sobre la utilidad de la tromboprofilaxis, la adherencia por parte de los médicos a las mismas es muy variable, y frecuentemente subóptima. El objetivo de este estudio fue evaluar un programa institucional con estrategias multifacéticas dirigido a médicos, sobre tromboprofilaxis en internación y estimar el cambio en la adecuación de la tromboprofilaxis antes y después de la intervención. La intervención se mantuvo durante 6 años, fue múltiple, utilizando acciones pasivas como cartelería, y activas, como educación médica continua, confección y adopción de una guía institucional de práctica clínica y un sistema de soporte informático para la decisión clínica. La adecuación basal de la tromboprofilaxis mejoró de 59% a 82% después de la intervención y se mantuvo en el tiempo. La mejora en la adecuación se asoció a una reducción de los sangrados mayores, en particular en pacientes intervenidos quirúrgicamente.

Problems related to sexuality are relevant but not addressed in rheumatology practice: results from a cross-sectional survey.

Sexual issues have a high prevalence in people with rheumatic diseases, but they are not commonly discussed in clinical practice, so we aim to determine the relevance and frequency of addressing problems related to sexuality in Rheumatology clinical practice in Mexico. We obtained data from an electronic survey applied to Mexican physicians involved in Rheumatology practice. The questionnaire was adapted from a previous study. The responses were analyzed and presented with descriptive statistics. We received 75 responses, 52% were from women, with an average age of 35.5 years. Sixty-two (82.6%) participants considered problems related to sexuality as quite relevant to Rheumatology practice, but a lower proportion (10, 13.3%) approach them to the same extent. The main barriers to the management of sexual issues that we recognized were the patient's embarrassment, patient´s age, and time. Most of our participants (62.7%) considered the rheumatologist as responsible for initiating the dialogue about sexual issues. Mexican rheumatologists consider sexual issues as relevant. Further training in sexuality is warranted for health care professionals attending people with rheumatic diseases.

Curriculum integration in the formative assessment of distance continuing medical education: the use of integrative activities / Integração curricular na avaliação formativa em educação médica continuada a distância: uso de atividades integradoras

Abstract Introduction: The article describes the development and implementation of integrative activities as a formative evaluation of a distance-learning course of preceptorship specialization in Family and Community Medicine and discusses how the use of this activity is capable of integrating and assessing different knowledges, practices and performance of students in this modality of education. The course curriculum involves units with modules in three areas: family and community medicine, preceptorship and clinical practice, allowing the approach of essential topics for the practice of the specialty preceptor, which go beyond the study of pedagogical aspects. Experience report: The student was encouraged to carry out a textual production based on contextualized problems in the Primary Health Care preceptorship, guided by the tutor, aiming to critically reflect on the contents of each teaching unit. Illustrated situations were used in the activity statement, shown in comic strip format, which qualified the interpretation of the context addressed in the activity and promoted greater approximation with the reality experienced by the student. The contextualization of the activity and the exercise of putting oneself in the preceptor's place were considered positive points by the tutors. Discussion: The student-tutor interaction is a fundamental part of the activity, as it allows the construction of knowledge from an interactionist perspective of education, which is the basis of the pedagogical proposal of the course. The activity allowed the identification of gaps and potentialities in the students' learning and the implementation of particular pedagogical interventions. Conclusions: This type of activity ensures important dimensions of evaluative work in long-term courses: the procedural and interdisciplinary features. The integrative activity model can be used in distance courses with different disciplines, aiming at integrating them, providing a more in-depth approach and bringing the educational contents closer to the student's reality.

Resumo: Introdução: O artigo descreve o desenvolvimento e a implementação de atividades integradoras como avaliação formativa de um curso a distância de especialização de preceptoria em medicina de família e comunidade (MFC) e discute como a utilização dessa atividade é capaz de integrar e avaliar diferentes conhecimentos, práticas e o desempenho dos alunos nessa modalidade de ensino. O currículo do curso envolve unidades com módulos em três áreas: MFC, preceptoria e clínica, permitindo que se abordem os temas essenciais para a prática do preceptor da especialidade, que vão além do estudo dos aspectos pedagógicos. Relato da experiência: O aluno era instigado a realizar uma produção textual baseada em problemas contextualizados na preceptoria na atenção primária à saúde, orientada pelo tutor, de forma a refletir criticamente sobre os conteúdos de cada unidade de ensino. Foram utilizadas situações ilustradas no enunciado da atividade, na forma de história em quadrinhos, o que qualificava a interpretação do contexto abordado na atividade e promovia maior aproximação com a realidade vivenciada pelo aluno. A contextualização da atividade e o exercício de se colocar no lugar do preceptor foram considerados pontos positivos pelos tutores. Discussão: A interação aluno-tutor é parte fundamental da atividade, pois permite a construção do conhecimento a partir de uma perspectiva interacionista da educação, que é a base da proposta pedagógica do curso. A atividade permitiu a identificação de lacunas e potencialidades na aprendizagem dos alunos e a realização de intervenções pedagógicas singulares. Conclusão: Esse tipo de atividade garante dimensões importantes do trabalho avaliativo em cursos de longa duração: o caráter processual e interdisciplinar. O modelo de atividade integradora pode ser utilizado em cursos a distância com diferentes disciplinas, com o objetivo de integrá-las, proporcionando uma abordagem mais aprofundada e aproximando os conteúdos educacionais da realidade do aluno.

Códigos QR en Educación Médica - Parte 2. Una Cooperación de Tecnología Analógica - Digital / QR Codes in Medical Education - part 2. An Analog - Digital Technology Cooperation

En esta segunda parte de la serie Códigos QR en Educación Médica describiremos los principales aspectos relacionados con los distintos tipos de códigos bidimensionales, las herramientas y aplicaciones necesarias para generar y decodificar un código QR, y los problemas de seguridad que pueden surgir durante su utilización. Nuestro objetivo es lograr que los educadores se familiaricen con esta tecnología y puedan incorporarla al material educativo utilizado en el proceso de enseñanzaaprendizaje, tanto en el aula tradicional como en los cursos virtuales. Con la finalidad de facilitar una correcta comprensión del artículo, en la última sección se proporciona un glosario alfabético con los términos y conceptos introducidos en el mismo. En la tercera y última parte de esta serie de artículos describiremos los aspectos relacionados con la personalización de los símbolos y su uso diferentes contextos educativos tanto analógicos como digitales

In this second section of the series QR Codes in Medical Education we will describe the main aspects related to the tools and applications necessary to generate and decode a QR code and how to customize them. The different types of based on their function and how to generate mixed function codes to be applied in Augmented Reality educational contexts will be analyzed. The final purpose is to ensure that all educators feel familiar with this technology and can incorporate it into the educational material used in the teaching-learning process, both in the traditional classroom and in virtual courses. In order to facilitate a correct understanding of the article, the last section provides an alphabetical glossary with the terms and concepts introduced in it. In the third and last part of this series of articles we will describe aspects related to the personalization of symbols and their use in different educational contexts, both analog and digital

Evaluación del conocimiento en donación de órganos y tejidos de los profesionales de salud asociados con servicios de cuidado crítico y urgencias / Assessment of Organ and Tissue Procurement Knowledge in Health Care Workers Associated to Critical and Emergency Care Units

RESUMEN Objetivo: Evaluar el nivel de conocimiento de profesionales en salud frente a la donación de órganos y tejidos en Barranquilla. Metodología: Estudio de corte transversal con encuesta semiestructurada sobre el conocimiento de la donación de órganos y tejidos en el personal de salud entre junio hasta diciembre de 2019. Se incluyen 232 profesionales de la salud en los servicios de Unidad de Cuidado Intensivo (UCI) adultos o pediátrica y Urgencias en seis Instituciones Prestadoras de Salud (IPS) de Barranquilla. Resultados: El 75 % de nuestros encuestados fueron mujeres. Se incluyó auxiliares de enfermería (43,5 %), profesionales en enfermería (25,4 %), médicos (22,8 %) y fisioterapeutas (8,2 %). El 84,5 % de los evaluados definió correctamente la muerte encefálica (ME); 50,4 % tiene conocimiento adecuado sobre la presunción en donación; el 52,4 % identifica apropiadamente la legislación, y el 78,9% conoce la activación de alerta en donación. No se encontraron resultados estadísticamente significativos en nivel de conocimiento comparado entre IPS (p=0.42), aunque se encontró una diferencia entre el concepto de presunción legal de la donación entre los servicios UCI adulto, pediátrica y Urgencias (p=0.000) y la definición de ME entre los profesionales asociados (p=0.001). Conclusión: Este diagnóstico del nivel de conocimiento en donación y trasplantes identificó una contundente necesidad de educación y entrenamiento continuo que podría ser gestionada con esfuerzos regionales en pro del mejoramiento del proceso y la tasa de donación de órganos y tejidos.

ABSTRACT Objective: To assess the knowledge level of organ donation and transplantation in health care workers at Barranquilla city in Colombia. Methodology: We performed a cross-sectional study from June to December 2019. Data were collected with the use of a semi-structured questionnaire regarding organ and tissue donation for transplant. This questionnaire was applied to 232 health care professionals associated with six health institutions located at Barranquilla. The main medical areas were adult and pediatric critical care units and emergency departments. Results: 75% of the participants were female. The study included nursing assistants (43,5%), nurses (25,4%), physicians (22,8%) and physiotherapists (8,2%). 84,5% of the participants had a correct definition of Brain Death (BD) and 50,4% had adequate knowledge about presumption consent in organ donation, 52,4% knew organ donation laws correctly, and 78,9% knew how to activate an organ donation alert. here was no significant difference in organ and tissue donation knowledge comparing the six health institutions (p=0.42). However, we found a significant difference in presumption consent in organ donation regarding medical areas (p=0.000), and ME definition distinguish between health care staff (p=0.001). Conclusion: We identified a need for education and training regarding organ and tissue donation in health care staff. Regional efforts should focus on improving the level of knowledge in these areas to increase the organ donor pool and strengthen transplant programs.

Implementation and Impact Evaluation of a Virtual Orthopaedic Continuing Medical Education Conference in a Low-Resource Country.

OBJECTIVE: The Haitian Annual Assembly of Orthopaedic Trauma (HAAOT) is an annual continuing medical education (CME) conference for Haitian orthopedists and trainees converted to a pilot virtual format in 2020 due to the COVID-19 pandemic. We evaluated this virtual format's effectiveness at teaching, facilitating bilingual discussion, and encouraging cross-cultural exchange of experiences - all aimed at improving orthopedic knowledge in a low-resource country like Haiti. DESIGN: Planned collaboratively between North American and Haitian colleagues, the conference involved 4 bilingual weekly Zoom meetings comprised of 4 to 6 prerecorded presentations and live-translated discussion. Pre- and postmeeting knowledge assessments in French (Haitian language of medical instruction) were administered weekly with results compared via 2-sample t-tests. An online postconference survey evaluated attendee satisfaction with the virtual format. SETTING: Virtual. PARTICIPANTS: Weekly attendance involved approximately 50 Haitian orthopedists and trainees, with 20 to 25 completing pre- and postmeeting assessments. RESULTS: Statistically significant increases between pre/post scores were seen during 3 of 4 sessions. Session-wide significant score increases occurred for residents and attending surgeons with <10 years of experience. 85.7% of attendees reported the virtual platform exceeded expectations and 100% indicated likely or extremely likely participation in further virtual events. CONCLUSIONS: The pilot virtual HAAOT was extremely well received with high desire for future sessions. Beyond short-term knowledge retention among attendees, nonmeasurable benefits included collaboration between orthopedists and trainees in the United States, Canada, United Kingdom, Haiti, and Burkina Faso. As COVID-19 spurs online learning in high-income nations, the successful low-resource context adjustments and local partnership underlying this model attest that travel restrictions need not impede delivery of virtual CME conferences in lower-income nations. Attendee learning and the decreased cost and travel requirements allude to this platform's sustainability and reproducibility in facilitating future international education and capacity building. Further studies will assess long-term retention of presented material.

Developing a Web-Based Congress: The 2020 International Web-Based Neurosurgery Congress Method.

BACKGROUND: Continuing medical education and continuing professional development have been affected by the ongoing 2019 novel coronavirus disease (COVID-19) pandemic. Therefore, we developed the 2020 International Web-Based Neurosurgery Congress (2020 IWBNC), which became the first successful virtual neurosurgical congress. The aim of this article was to describe the experience designing and organizing a web congress by the 2020 IWBNC method. METHODS: The 2020 IWBNC was organized by the Center for Research and Training in Neurosurgery (Centro de Investigación y Entrenamiento en Neurocirugía [CIEN]) in a record time of 4 weeks. Eight committees were created and assigned a specific task. The event followed a strict protocol based on the double-room method, which consisted of 2 virtual rooms (A and B) hosted from 4 different physical locations to avoid lecture overlapping and connection drops. Quality and impact were measured by a videoconferencing platform and social media parameters as well as an audience perception survey. RESULTS: High quality was achieved in academic standards, worldwide assistance, schedule adherence, and security. The 2020 IWBNC hosted 25 internationally renowned speakers and offered 30 top-of-the-line multidisciplinary conferences. There were 3096 participants from 125 countries, and 22,266 live-stream views were registered. No technical or cybersecurity-related issues occurred. CONCLUSIONS: Web-based academic meetings will continue to be a helpful educational tool for continuing medical education and continuing professional development. The 2020 IWBNC double-room method represents an alternative design that may be replicated by the academic community planning web congresses and similar events.

Recertificación médica en Uruguay: múltiples miradas de una obligación impostergable / Medical recertification in Uruguay: multiple perspectives of an imperative need / Recertificação médica no Uruguai: múltiplas visões de uma obrigação urgente

Resumen: La recertificación es el resultado de un acto por el que una entidad legalmente acreditada, asegura que el profesional médico (previamente certificado) mantiene actualizados sus conocimientos y destrezas, y que ha desarrollado su actividad dentro del marco ético y científico adecuado al progreso del "saber" y del "hacer" propio de su especialidad. A pesar de un largo camino recorrido, en Uruguay no se ha podido establecer un proceso de recertificación universal. Múltiples actores (usuarios del sistema, médicos, Facultad de Medicina, programas de Desarrollo Profesional Médico Continuo) consideran que es una necesidad, sin embargo es necesario vencer algunas barreras para que se establezca un programa de recertificación. Se recorren algunos de estos aspectos en este documento, desarrollados en el contexto de un grupo de trabajo para el Congreso por los 100 años del Sindicato Médico del Uruguay.

Abstract: Recertification is the result of an act by which a legally accredited entity ensures that medical professionals (previously certified) keep their knowledge and skills up to date, and that they have practiced their profession within the ethical and scientific framework that regulates the process that evolves from "knowing" to "knowing how" in their areas of specialization. Despite a long journey in Uruguay, it has not been possible to establish a universal recertification process. Multiple actors (system users, doctors, the School of Medicine, Continuing Medical Professional Development programs) regard it as a need, although some barriers must be overcome in order to define a recertification program. This document covers a few of these aspects and is the result of a working group created for the Congress held in commemoration of the 100 years of the Uruguayan Medical Association.

Resumo: A recertificação é o resultado de um ato pelo qual uma entidade legalmente credenciada garante que o profissional médico (previamente certificado) mantém os seus conhecimentos e competências atualizados, e que desenvolveu a sua atividade dentro do quadro ético e científico adequado ao progresso do "conhecimento" e o "fazer" da sua especialidade. Apesar do longo caminho percorrido no Uruguai, ainda não foi possível estabelecer um processo de recertificação universal. Múltiplos atores (usuários do sistema, médicos, Faculdade de Medicina, programas de Desenvolvimento Continuado do Profissional Médico) consideram isso uma necessidade, porém é necessário superar algumas barreiras para que um programa de recertificação seja estabelecido. Alguns desses aspectos são abordados neste documento, desenvolvido no contexto de um grupo de trabalho para o Congresso pelos 100 anos do Sindicato Médico del Uruguay.

Códigos QR en Educación Médica - Parte 1 Un puente Analógico ­ Digital / QR Codes in Medical Education - Part 1 An Analog-Digital Bridge

Con el rápido desarrollo de las tecnologías de la información y comunicación, el uso generalizado de Internet y los teléfonos inteligentes, los códigos QR (códigos de respuesta rápida) se están convirtiendo en una herramienta prometedora para conectar servicios en línea y fuera de línea. Este es el primero de una serie de dos artículos que tienen como objetivo contextualizar el uso de los códigos QR en la educación para la salud y permitir a los educadores desarrollar las habilidades necesarias para su creación y uso en la educación médica. La implementación exitosa del Código QR en educación requiere el conocimiento de cierta información básica tanto sobre el Código QR en sí, como así también de los requisitos necesarios para el uso de este tipo de simbología. Este primer artículo presenta una visión general del estado actual del arte de los códigos QR y se discute brevemente la estructura, simbología, versiones, propiedades y los requisitos para su uso. En la segunda parte de esta serie describiremos los principales aspectos relacionados con la personalización de los símbolos, los códigos estáticos y dinámicos, y las diferentes herramientas y aplicaciones necesarias para generar y decodificar un código QR, como así también cómo aplicarlo en diferentes contextos educativos de Realidad Aumentada. El propósito final de estos dos artículos es lograr que todos los educadores se sientan familiarizados con esta tecnología y puedan incorporarla al material educativo utilizado en el proceso de enseñanza-aprendizaje, tanto en el aula tradicional como en los cursos virtuales.

With the rapid development of Information and communication technologies and the widespread use of the Internet and smartphones, the QR codes (stands for quick response code) are becoming a promising tool for connecting offline and online services. This article is the first in a series of two articles that aim to contextualize the use of QR codes in health education. This will allow the educators to develop the skills necessary for its creation and use in medical education. Successful implementation of the QR Code in health education requires a knowledge of certain basic information about both the QR Code itself and the necessary requirements for the use of this type of symbology. This first article presents an overview of the current state of the art of the QR codes and discusses in brief the structure, symbology, versions, properties and the requirements for the use of this type of symbology. In the second part of this series we will describe the main aspects related to: custom QR Code with Logo, static and dynamic codes, and the different tools and applications necessary to generate and decode a QR code as well as how to apply it in different educational contexts of Augmented Reality. The final purpose of these two articles is to ensure that all educators feel familiar with this technology and can incorporate it into the educational material used in the teaching-learning process, both traditional classroom and online courses.

Clinical simulation strategies for knowledge integration relating to initial critical recognition and management of COVID-19 for use within continuing education and health-related academia in Brazil: a descriptive study

ABSTRACT BACKGROUND: The COVID-19 pandemic has led to an immense need to develop training on case recognition and management, with a focus on patients' and health professionals' safety at several levels of healthcare settings in Brazil. Different simulation strategies can be included in the diverse clinical care phases for these patients. OBJECTIVE: To suggest a complete simulation-based training program for Brazilian hospitals and/or academic institutions at this moment of the pandemic. DESIGN AND SETTING: Descriptive analysis on possible simulated clinical cases using different methodologies, thereby supporting suspected or confirmed COVID-19 patients. METHODS: This was a reflective theoretical descriptive study on an educational program based on clinical simulation, with four practical phases at different performance and complexity levels. Wearing, handling and adequately disposing of personal protective equipment, along with specific respiratory procedures in different healthcare settings up to intensive care for seriously infected patients were addressed. RESULTS: This program was designed for application at different Brazilian healthcare levels through different clinical simulation strategies. Summaries of expected performance were suggested in order to standardize technical capacity within these simulation settings, so as to serve these levels. CONCLUSIONS: Developing training programs for situations such as the current COVID-19 pandemic promotes safety not only for patients but also for healthcare workers. In the present context, clear definition of which patients need hospital outpatient or inpatient care will avoid collapse of the Brazilian healthcare system. Institutions that do not have simulated environments can, through the examples described, adopt procedures to promote didactic information in order to help healthcare professionals during this time.

Development and assessment of competency-based neurotrauma course curriculum for international neurosurgery residents and neurosurgeons.

OBJECTIVE: Traumatic brain injuries (TBIs) are a significant disease burden worldwide. It is imperative to improve neurosurgeons' training during and after their medical residency with appropriate neurotrauma competencies. Unfortunately, the development of these competencies during neurosurgeons' careers and in daily practice is very heterogeneous. This article aimed to describe the development and evaluation of a competency-based international course curriculum designed to address a broad spectrum of needs for taking care of patients with neurotrauma with basic and advanced interventions in different scenarios around the world. METHODS: A committee of 5 academic neurosurgeons was involved in the task of building this course curriculum. The process started with the identification of the problems to be addressed and the subsequent performance needed. After this, competencies were defined. In the final phase, educational activities were designed to achieve the intended learning outcomes. In the end, the entire process resulted in competency and outcomes-based education strategy, including a definition of all learning activities and learning outcomes (curriculum), that can be integrated with a faculty development process, including training. Further development was completed by 4 additional academic neurosurgeons supported by a curriculum developer specialist and a project manager. After the development of the course curriculum, template programs were developed with core and optional content defined for implementation and evaluation. RESULTS: The content of the course curriculum is divided into essentials and advanced concepts and interventions in neurotrauma care. A mixed sample of 1583 neurosurgeons and neurosurgery residents attending 36 continuing medical education activities in 30 different cities around the world evaluated the course. The average satisfaction was 97%. The average usefulness score was 4.2, according to the Likert scale. CONCLUSIONS: An international competency-based course curriculum is an option for creating a well-accepted neurotrauma educational process designed to address a broad spectrum of needs that a neurotrauma practitioner faces during the basic and advanced care of patients in different regions of the world. This process may also be applied to other areas of the neurosurgical knowledge spectrum. Moreover, this process allows worldwide standardization of knowledge requirements and competencies, such that training may be better benchmarked between countries regardless of their income level.