RESUMEN
BACKGROUND: Latin American clinical simulation has had an important development; there are no studies that characterize simulation centers and programs in the entire region. The aims of this work are to characterize the current state of simulation-based education in the health sciences, to determine the structure of Latin American simulation centers in terms of teaching, research, and continuing medical education (CME), as well as to determine the perception of quality based on international standards of simulation practices for the directors of Latin American centers. METHODS: A quantitative, descriptive, cross-sectional study with a demographic questionnaire and a Likert-type survey was conducted to the directors of the simulation centers found in Latin America. RESULTS: Four hundred eight simulation centers were documented, the survey was answered by 240 directors, and the data from 149 were complete responses on the 42 quality self-perception scale and considered valid on further analyses related to the quality of the programs. Most of the centers that responded correspond to Chile, Brazil, and Mexico (37.5%, 18.1%, 12.7%). 84% of the centers are university-based, and 71% of the centers are medium-sized, with less than 10 instructors (54%). The directors are mostly women (61.7%), medical doctors (50%), and nurses (40%), with clinical specialization (37%), master's degree (53%), and doctorate (13%). 75% have completed a simulation instructor course, and 6% have developed a fellowship. Most consider the maintenance of international quality standards to be relevant in their centers, mainly in reflective training techniques, ethical aspects, and adequate learning environments. CONCLUSIONS: Simulation-based education in health sciences has had an increasing development in Latin America, within a university environment, in an important academic specialization process that seeks to adhere to high-quality standards to improve training and development of clinical skills, human factors, and critical thinking. We recommend starting accreditation processes in Latin America and studies that measure the quality of simulation-based education in our region, based on objective observations more than in self-reporting.
RESUMEN
This was an action research study conducted during an undergraduate nursing course. The objective was to propose and implement experiential learning for nursing consultation education using clinical simulation with actors. The 4 steps of action research were followed: planning, action, observation and reflection. Three nursing undergraduate students participated in the study. Data were collected in May and July 2013 via participant comments and interviews and were analyzed in accordance with the operative proposal for qualitative data analysis. Planning included constructing and validating the clinical guides, selecting and training the actors, organizing and preparing the scenario and the issuing invitations to the participants. The action was carried out according to Kolb's (1984) 4 stages of learning cycles: Concrete Experience, Reflective Observation, Abstract Conceptualization and Active Experimentation. Clinical simulation involves different subjects' participation in all stages, and action research is a method that enables the clinical stimulation to be implemented. It must be guided by clear learning objectives and by a critical pedagogy that encourages critical thinking in students. Using actors and a real scenario facilitated psychological fidelity, and debriefing was the key moment of the reflective process that facilitated the integral training of students through experiential learning.
