The Development and Implementation of an Evidence-Based Tumescent Liposuction Protocol, Online Educational Course for Perioperative Staff, and Discharge Instructions: A Quality Improvement Project.

PURPOSE: The purpose of this quality improvement project was to improve perioperative management of patients undergoing tumescent liposuction (TL) through the development and implementation of a perioperative evidence-based protocol, educational course for perioperative staff, and patient discharge instructions. DESIGN: The TL protocol was validated using the modified Delphi process. The educational course and discharge instructions used a pre and postimplementation design. METHODS: An evidence-based protocol, an educational course for perioperative staff, and readable discharge instructions for patients undergoing TL were developed in accordance with best practice guidelines. The protocol was validated by subject matter experts at the facility and submitted for adoption. The evidence-based educational course was implemented, and the effectiveness of the course was evaluated for improving providers' knowledge and self-confidence. The evidence-based discharge instructions were implemented and evaluated for patient satisfaction and readability. FINDINGS: Three items were removed from the protocol, 2 items were modified, and 25 items were accepted with no change from modified Delphi analysis. Provider knowledge scores improved from 85.7% ± 16.18 to 97.1% ± 4.88; however, this was not statistically significant (P = .066). There was a trend toward improved confidence scores (P = .180). Overall patient satisfaction scores slightly improved postimplementation; results were not statistically significant (P > .05). CONCLUSIONS: All three phases of perioperative care in patients receiving TL were evaluated, reflecting best practice guidelines and successful adoption. There was no statistically significant improvement in provider knowledge, provider self-confidence, or patient satisfaction. A small sample size was a significant limiting factor.

Optimization of solid oral dosage form administration to patients with swallowing difficulties: An integrative review.

AIM: To appraise and synthesize research investigating optimizing the administration of solid oral dosage forms (SODFs) to adults with swallowing difficulties. DESIGN: An integrative review. METHODS: An electronic search was conducted on Medical Literature Analysis and Retrieval System Online (Public Medline interface), Elsevier SciVerse Scopus and Scientific Electronic Library Online (updated February 2023). Restriction regarding the publication date was not considered for the inclusion of records. Studies addressing risks, general aspects, recommendations about patient postural adjustments, swallowing techniques, swallowing aids and aspects of concealment of SODFs were included. RESULTS: Fifty-three records published between 2002 and 2021 were included. The main administration risks were aspiration, asphyxia and solid oral dosage form-induced oral/oesophageal mucosal lesions. The most frequent general aspect reported was administering one oral dosage form at a time. The sitting position was the most patient postural adjustment mentioned. The most frequently reported solid oral dosage form swallowing technique was the lean-forward method for capsules. Solid oral dosage form swallowing aids cited: tongue and throat lubricant and solid oral dosage form coating device, swallowing cup and swallowing straw. CONCLUSION: The literature data on administering SODFs for adults with swallowing difficulties were appraised and synthesized. Some aspects, for example, not administering SODFs simultaneously, can make swallowing safer. Postural adjustments and solid oral dosage form swallowing aids are important to avoid administration risks. Swallowing SODFs can be easier if learned by techniques. Liquid and food are helpful as vehicles, and several of these have been listed. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: By optimizing the contributing factors of administering oral pharmacotherapy, the nurse can use appropriate practices to improve patient safety. Additionally, knowing and establishing the administration aspects are reasonable steps for standardizing care for patients with swallowing oral dosage form difficulties. IMPACT: This study addressed administering SODFs to adult patients with swallowing difficulties. The administration of SODFs to adult patients with swallowing difficulties can be optimized if only one oral dosage form at a time is administrated and if patient postural adjustments, swallowing techniques and swallowing aids are used. This investigation will impact the care of patients with swallowing difficulties. REPORTING METHOD: The authors declare they adhered to the relevant EQUATOR guidelines and report following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 Statement. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Teaching How to Study Expository Texts: A Programmed Instruction / Ensinar a Estudar Textos Didáticos: Uma Programação de Ensino

Abstract The objective of this study was to develop and evaluate the application of computerized programming to teach how to study expository texts. Principles of programmed instruction were used, and different target behaviors were focused on: inspecting the text, locating and highlighting important information, paraphrasing, building schemes, and conceptual maps, and elaborating questions on the topic. The activities were designed and carried out using Google Forms, Socrative, and Wordwall applications. Nine students from the 3rd to the 6th year of elementary school, from public and private schools, participated in this study. Participation was online and remote. The results showed an improvement in the performance of the participants in seven of the ten selected objectives for evaluation. In conclusion, it is possible to teach how to study expository texts through programmed instruction based on a clear description of the objectives involved in this repertoire.

Resumo O objetivo do estudo foi avaliar a aplicação de uma programação informatizada para ensinar a estudar textos didáticos. Utilizando princípios para a elaboração do ensino programado, teve-se como foco diferentes comportamentos-alvo: inspecionar o texto, localizar e grifar informações importantes, parafrasear, construir esquemas e mapas conceituais, e elaborar questões sobre o tema. As atividades foram elaboradas e realizadas utilizando os aplicativos Google Forms, Socrative e Wordwall. Participaram desse estudo nove estudantes do 3o ao 6o ano do ensino fundamental, de escolas públicas e privadas. A participação foi online e remota. Os resultados apontaram melhora no desempenho dos participantes em sete dos dez comportamentos selecionados para avaliação. Conclui-se que é possível ensinar comportamentos de estudo de textos didáticos por meio de uma programação de ensino a partir da descrição clara dos objetivos envolvidos neste repertório.

Análise clínica da atividade de trabalho de agentes funerários no nordeste brasileiro / A clinical activity analysis of funeral agents' work in the brazilian northeast / Análisis clínico de la actividad laboral de agentes funerarios en el nordeste de Brasil

Especializados na gestão dos processos da morte e do morrer, os agentes funerários são uma categoria profissional indispensável na sociedade contemporânea. Estudar esses profissionais, marcados por alto grau de invisibilidade social, torna-se extremamente relevante, sobretudo concebendo-os como sujeitos ativos no processo de análise de sua atividade. Nesse sentido, este artigo teve como objetivo analisar a atividade de trabalho de agentes funerários a partir das contribuições teórico-metodológicas da Clínica da Atividade. Para o desenvolvimento desta pesquisa-intervenção foram realizadas 23 observações participantes no local de trabalho, 15 entrevistas individuais e seis entrevistas em grupo, mediadas pelo uso da técnica de Instruções ao Sósia, com agentes funerários que trabalham em um grande grupo funerário no interior do nordeste brasileiro. A análise da atividade de trabalho nos levou à compreensão de que o fazer desses trabalhadores é muito mais do que lidar meramente com o corpo inerte, sem vida, mas demanda deles alto grau de habilidades para lidar com suas emoções e prestar apoio às famílias enlutadas. O gênero profissional da atividade dos agentes funerários fornece importantes maneiras desses trabalhadores se portarem. Diante das imprevisibilidades e impedimentos presentes nas rotinas de trabalho, cada agente funerário age de um jeito, estiliza seu fazer, mas há aqueles modos de agir que são compartilhados, o que permite a construção do modo coletivo do agir profissional, tornando a atividade do agente funerário uma constante mescla do coletivo e do singular.(AU)

Specialized in the management of death processes, funeral agents are an indispensable professional category in contemporary society. It is extremely relevant to study these professionals who endure a high degree of social invisibility, especially by considering them as active subjects in the process of analyzing their own activities. Thus, this study aimed to analyze the work activity of funerary agents using the theoretical-methodological contributions of Clinical Activity. To develop this research-intervention, 23 participant-observations at their workplace, 15 individual interviews, and six group interviews, mediated by the use of the Instructions to the Double technique were carried out with funeral agents who work in a large funeral group in the inner Brazilian northeast. The analysis of work activity led us to understand that these workers' job prescriptions exceeds dealing with inert lifeless bodies. These workers have a high demand of socio-emotional skills, especially to cope and support grieving families. The professional genre in funeral agents' activity provide important ways for these workers to behave. As a result of the unpredictability and impediments in their work routines, funerary agents find their own way to meet the demands of work. However, their shared conducts enable them to construct the collective mode of professional action, making funerary agents' activity a constant mixture of collective and singular contributions.(AU)

Especializados en la gestión de los procesos de la muerte y del morir, los agentes funerarios son una categoría profesional indispensable en la sociedad contemporánea. Estudiar estos profesionales, caracterizados por el alto grado de invisibilidad social, se convierte en algo extremamente relevante, principalmente considerándolos como sujetos activos en el proceso de análisis de su actividad. En este sentido, este artículo tuvo como objetivo analizar la actividad laboral de agentes funerarios a partir de las contribuciones teórico-metodológicas de la Clínica de la Actividad. Para el desarrollo de esta investigación-intervención fueron realizadas 23 observaciones participantes en el local de trabajo, 15 encuestas individuales y seis grupales, mediadas por el uso de la técnica de instrucción al doble, con agentes funerarios que trabajan en un grupo funerario en el interior del Nordeste de Brasil. El análisis de la actividad laboral destaca que estos profesionales desempeñan una labor que va más allá del cuerpo inerte, sin vida, que les requiere un alto grado de habilidades para lidiar con las emociones y fornecer apoyo a las familias en duelo. El tipo profesional de la actividad de los agentes funerarios les proporciona a estos trabajadores importantes modos de portarse. Ante lo imprevisible y las dificultades en sus rutinas de trabajo, cada agente funerario actúa a su manera, pero hay modos de actuar compartidos, lo que permite la construcción del modo colectivo del actuar profesional, transformando la actividad del agente funerario en una constante mezcla entre lo colectivo y lo singular.(AU)

Unidirectional Speaker Naming in Toddlers: Effects of Multiple Exemplar Instruction Teaching / Nomeação Unidirecional de Falante em Crianças Bem Pequenas: Efeitos do Ensino por Múltiplos Exemplares / Nombramiento Unidireccional de Hablante en Niños Muy Pequeños: Efectos de la Enseñanza por Múltiples Ejemplares

Abstract: Toddlers (children aged 1 to 3 years) may have difficulties responding as a speaker to objects/events for which they have been taught to respond as a listener. This study aimed to perform a methodologically robust evaluation of the effectiveness of a Multiple Exemplar Instruction teaching (MEI) consisting only of listener (auditory-visual matching-to-sample) and speaker tasks (intraverbal tact), in inducing Unidirectional Speaker Naming in toddlers with typical development. Thus, three toddlers aged between 28 and 29 months were exposed to: listener and speaker pre-tests with auditory stimuli and two-dimensional visual stimuli; listener teaching; listener and speaker post-test 1; MEI; and listener and speaker post-test 2. In post-test 2, one toddler showed emergence of Unidirectional Speaker Naming. The findings of this study may help to refine language teaching procedures for toddlers.

Resumo: Crianças bem pequenas (1 a 3 anos de idade) podem apresentar dificuldades em responder como falante para objetos/eventos para os quais foram ensinadas a responder como ouvinte. Este estudo objetivou realizar uma avaliação metodologicamente robusta da eficácia de um Ensino por Múltiplos Exemplares (MEI, no acrônimo em inglês), constituído apenas por tarefas de ouvinte (emparelhamento ao modelo auditivo-visual) e de falante (tato intraverbal), na indução de Nomeação Unidirecional de Falante em crianças bem pequenas com desenvolvimento típico. Assim, três crianças com idades entre 28 e 29 meses foram expostas a: pré-testes de ouvinte e falante com estímulos auditivos e estímulos visuais bidimensionais; ensino de ouvinte; pós-teste 1 de ouvinte e falante; MEI; pós-teste 2 de ouvinte e falante. No pós-teste 2 uma criança apresentou emergência de Nomeação Unidirecional de Falante. Os achados deste estudo poderão contribuir para o refinamento de procedimentos de ensino de linguagem para crianças bem pequenas.

Resumen: Los niños muy pequeños (1 a 3 años) pueden tener dificultades para responder como hablantes a objetos/eventos a los que se les ha enseñado a responder como oyentes. Este estudio buscó llevar a cabo una evaluación metodológicamente robusta de la eficacia de una Enseñanza por Múltiples Ejemplares (MEI, del acrónimo en inglés), consistente únicamente en tareas de oyente (igualación a la muestra auditivo-visual) y hablante (tacto intraverbal), para inducir el Nombramiento Unidireccional de Hablante en niños muy pequeños con desarrollo típico. Así, tres niños de entre 28 y 29 meses fueron expuestos a: prepruebas de oyente y hablante con estímulos auditivos y estímulos visuales bidimensionales; enseñanza de oyente; posprueba 1 de oyente y hablante 1; MEI; posprueba 2 de oyente y hablante. En la posprueba 2, un niño mostró la aparición de la denominación unidireccional del hablante. Los hallazgos de este estudio podrían contribuir a perfeccionar los procedimientos de enseñanza del lenguaje para niños muy pequeños.

Remote vs. face-to-face activities in the teaching of renal pathophysiology in the context of social isolation during the early phase of the COVID-19 pandemic.

The advent of the COVID-19 pandemic forced medical schools around the world to adopt emergency remote learning as a resort to avoid interruption of courses. However, the effectiveness of online classes as an educational strategy has been questioned by medical educators and students. In a prospective observational study design, students enrolled in a renal physiology and pathophysiology course were exposed to either face-to-face or remote synchronous classes. Students taught online obtained significantly higher mean scores than the group who had in-person classes, both groups assessed with identical exams. Appropriate screening tests suggested that fraud is unlikely to have significantly influenced these results and that the observed differences in performance reflected increased learning by the remote group. These observations suggest that online classes can help to maintain the continuity of physiology and pathophysiology courses during periods of social isolation and may contribute to improving learning under normal conditions.NEW & NOTEWORTHY In this study, we were able to make a rare direct comparison of face-to-face and remote strategies for the teaching of undergraduate medical students in a specific area, namely, renal pathophysiology. Unexpectedly, students who attended the remote course had significantly higher grades than those who had mostly in-person classes.

Aprendizado baseado em problemas utilizando histórias em quadrinhos na Odontologia Forense / Aprendizaje basado en problemas utilizando cómics en Odontología Forense / Problem-based learning using comics in Forensic Dentistry

O objetivo desse estudo foi avaliar a percepção e aceitação dos discentes acerca da metodologia de aprendizado baseado em problemas (problem based learning-PBL) modificada para a modalidade online. Os estudantes da disciplina de Odontologia Forense foram inseridos em uma cena de crime simulada em formato de história em quadrinhos (HQ). Divididos em "equipes forenses", receberam como tarefa elaborar um laudo pericial desse local de crime com o auxílio de um tutor. Ao final do semestre, foi produzido um questionário pela plataforma Google Forms com perguntas acerca da metodologia utilizada, da disponibilização de materiais na plataforma virtual e do uso de um ambiente simulando a realidade forense. Utilizou-se questionário de modelo fechado e respostas baseadas na escala Likert. A amostra foi composta por 58 participantes, dos quais 50 (86,2%) concordaram ou concordaram totalmente que a metodologia foi estimulante e que proporcionou um aprendizadosólido e com propósito. Dentre os participantes, 49 (84,5%) concordaram ou concordaram totalmente que o uso do método PBL contribuiu para desenvolver a autonomia do aluno. Na percepção dos estudantes, a aplicação da metodologia PBL no ambiente virtual, por meio do recurso de HQ, contribuiu positivamente para o desenvolvimento da autonomia do aluno sobre o próprio aprendizado (AU).

El objetivo de este estudio fue evaluar la percepción y aceptación de los estudiantes sobre la metodología de aprendizaje basada en problemas (problem based learning-PBL) modificada para la modalidad en línea. Estudiantes de Odontología Forense fueron insertados en una escena del crimen simulada en formato de cómic. Divididos en "equipos forenses", se les encomendó la tarea de elaborar un informe pericial sobre estaescena del crimen con la ayuda de un tutor. Al final del semestre, se elaboró un cuestionario utilizando la plataforma Google Forms con preguntas sobre la metodología utilizada, la disponibilidad de materiales en la plataforma virtual y el uso de un entorno que simula la realidad forense. Se utilizó un modelo de cuestionario cerrado y respuestas basadas en la escala de Likert. La muestra estuvo conformada por 58 participantes, de los cuales 50 (86,2%) estuvieron de acuerdo o totalmente de acuerdo en que la metodología fue estimulante y proporcionó un aprendizaje sólido y propositivo. Entre los participantes, 49 (84,5%) estuvieron de acuerdo o muy de acuerdo en que el uso del método PBL contribuyó al desarrollo de la autonomía de los estudiantes. En la percepción de los estudiantes, la aplicación de la metodología PBL en el entorno virtual, a través del recurso del cómic, contribuyó positivamente al desarrollo de la autonomía del estudiante sobre su propio aprendizaje (AU).

The objective of this study was to evaluate the students' perception and acceptance of problem-based learning methodology (PBL) modified for online application. Forensic Dentistry students were inserted into a simulated crime scene in comic book format. Divided into "forensic teams", they were assigned the task of preparing an expert report on this crime scene with the help of a tutor. At completion of the semester, a questionnaire was produced using the Google Forms platform with questions about the methodology used, availability of materials on the virtual platform and the use of an environment simulating forensic reality. A closed model questionnaire was used, and responses were based on the Likert scale. The sample consisted of 58 participants, of which 50 (86.2%) agreed or completely agreed that the methodology was stimulating and that it provided solid and purposeful learning. Among the participants, 49 (84.5%) agreed or strongly agreed that the use of PBL contributed to developing student autonomy. In the students' perception, the application of PBL methodology in the virtual environment, using the comic resource, contributed positively to the development of student's autonomy in their own learning (AU).

Lectura académica: Revisión de estudios empíricos y reflexiones teóricas en contextos hispanohablantes / Academic reading: review of empirical studies and theoretical reflections in spanish-speaking contexts

La lectura en la universidad es un tema de creciente preocupación en contextos hispanohablantes. Por ello se planteó como objetivo indagar qué se ha dicho sobre la alfabetización académica y qué diagnósticos se han hecho sobre este tema. Se llevó a cabo una revisión narrativa dentro del paradigma cualitativo de investigación con técnica de análisis de contenido. Se hizo un rastreo de documentos publicados entre los años 2000 y 2020 en bases de datos de acceso abierto. Se encontraron 25 documentos sobre 21 estudios empíricos con diversidad de técnicas y población objetivo, donde se muestran las prácticas de lectura referidas por estudiantes y vistas en el aula, el abordaje de los docentes e instituciones y, evaluaciones diagnósticas de las habilidades de lectura. En cuanto a los estudios empíricos, se han realizado diferentes caracterizaciones donde se identifica que las prácticas de lectura de los estudiantes en el aula y por fuera de ella, no favorecen el desarrollo de un nivel lector experto. Además, las evaluaciones de comprensión de textos se alinean con la propuesta teórica de niveles ascendentes de lectura que sigue siendo muy usada. Como parte de las reflexiones teóricas, se encontró que desde el constructo de alfabetización académica se concibe la lectura como una habilidad que continúa desarrollándose y depende de la situación en la que se aplique

Reading in higher education is an issue of growing concern in Spanish-speaking contexts. Therefore, the aim was to find out what has been said about academic literacy and what diagnoses have been made on this subject. A narrative review was carried out within the qualitative research paradigm using the content analysis technique. A crawl of documents published between 2000 and 2020 in open access databases was carried out. Twenty-five documents were found on 21 empirical studies with a diversity of techniques and target population, showing the reading practices referred to by students and seen in the classroom, the approach of teachers and institutions, and diagnostic assessments of reading skills. As for empirical studies, different characterizations have been made where it is identified that students' reading practices in the classroom and outside it, do not favor the development of an expert reading level. In addition, text comprehension evaluations are aligned with the theoretical proposal of ascending reading levels, which is still widely used. As part of the theoretical reflections, it was found that from the academic literacy construct, reading is conceived as a skill that continues to develop and depends on the situation in which it is applied.

Trabalho, formação e política em debate na pesquisa-intervenção em uma Unidade Básica de Saúde (UBS) de Porto Alegre (RS) / Work, professional development, and politics in debate in an intervention-research in a Basic Health Unit in Porto Alegre (RS)

Este artigo coloca em debate a relação entre trabalho, formação e política a partir de uma experiência de pesquisa-intervenção realizada com trabalhadores de uma Unidade Básica de Saúde do município de Porto Alegre. Iniciamos posicionando a tríade "trabalho-formação-política" esboçando a compreensão que temos dessa relação. A seguir, apresentamos os principais operadores teórico-metodológicos utilizados na pesquisa, destacando o emprego da cartografia e o dispositivo da instrução ao sósia. Por fim, desenvolvemos trechos do material analisado por meio dos operadores conceituais e metodológicos propostos, indicando que a análise da atividade suscita a colocação de problemas aos saberes construídos no trabalho, constituindo outras maneiras de trabalhar em meio a debates que envolvem decisões relacionadas aos impactos do trabalho para os trabalhadores e o território onde atuam. Concluímos, com base na investigação feita, que a construção de saberes ao trabalhar não é somente uma tessitura de si ou de saberes, mas também, e necessariamente, da própria política, visto que viver o/no/pelo trabalho, renormatizando os processos, implica a tessitura dos modos de viver em conjunto

This article discusses the relationship between work, professional development, and politics based on an intervention-research experience conducted with workers of a Basic Health Unit in the city of Porto Alegre. We begin by positioning the "work-education-politics" triad, outlining our understanding of this relationship. Next, we present the main theoretical-methodological operators used in this research, highlighting the use of cartography and the device of the instruction to the double. Finally, we developed excerpts of the analyzed material with the proposed conceptual and methodological operators, indicating that the analysis of the activity leads to posing problems to the knowledge built at work, constituting other ways of working in the midst of debates that involve decisions related to the impacts of the work for the workers and the territory where they work. We conclude, based on the investigation carried out, that the construction of knowledge when working is not only a weaving of itself, or of knowledge, but also, and necessarily, of the policy itself, since living the/in/through work, normalizing the processes again, implies weaving the modes to live together

Parada cardiorrespiratória pediátrica: efetividade do ensino híbrido no processo ensino-aprendizagem em enfermagem / Pediatric cardiorespiratory arrest: effectiveness of blended learning in the teaching-learning process in nursing

A Parada Cardiorrespiratória (PCR) em pediatria é uma situação emergencial que exige desempenho adequado. Considerando a importância da formação de enfermeiros para atuar nessa situação, faz-se premente o ensino híbrido, que se destaca nos processos formativos de graduação. O objetivo deste estudo foi avaliar a efetividade do ensino híbrido na aprendizagem cognitiva de estudantes de enfermagem, implementados por tecnologias educacionais e simulação clínica acerca do cuidado da criança em situação de PCR por Insuficiência Respiratória (IR). Trata-se de um estudo metodológico e de intervenção quase-experimental, de abordagem transversal e quantitativa, cujo quadro teórico se pauta na Teoria da Aprendizagem Significativa e da Aprendizagem Experiencial. A primeira etapa do estudo foi constituída pela construção dos instrumentos de coleta de dados e utilização na abordagem educativa (pré-teste, pós-teste, questões guiadas ao chat e checklist do cenário de simulação), sendo todos validados pelo Índice de Validação de Conteúdo (IVC). Sequencialmente, o cenário de simulação clínica, previamente construído, também foi validado pelo índice supracitado. A segunda etapa ocorreu com a implementação da proposta educativa em duas ofertas, com estudantes de enfermagem de uma Instituição de Ensino Superior pública paulista, a partir do 4o e 5o semestre de graduação. Esta etapa contou com 43 estudantes, 15 participaram no segundo semestre de 2021 e 28 no primeiro semestre de 2022. Os estudantes foram incluídos em um Ambiente Virtual de Aprendizagem que continha as orientações da pesquisa e coleta de dados, além do questionário de caracterização, Inventário de Estilos de Aprendizagem de Kolb e objetos virtuais de aprendizagem relativos à PCR pediátrica por IR. Inicialmente, a proposta educativa demandou aos estudantes que respondessem à um pré-teste no primeiro acesso ao Ambiente Virtual de Aprendizagem e, posteriormente, disponibilização dos materiais. Em seguida, os estudantes participaram de uma sessão síncrona de chat e de uma simulação clínica presencial sobre a temática. O pós-teste foi aplicado em três momentos: após a sessão síncrona de chat, ao término da participação na simulação e 30 dias após as atividades propostas. Identificou-se prevalência de participação de estudantes do 7o semestre da graduação. Nas análises, foram utilizados teste de Friedman, teste de comparação múltiplas de Nemenyi, ANOVA e de Kruskal-Wallis. Quanto aos Estilos de Aprendizagem, a maior parte dos estudantes demonstrou se caracterizar como "convergentes". A melhor média ocorreu no pós-teste ao término da simulação e houve diferença entre as notas obtidas nos distintos momentos de aplicação dos testes, onde constatou-se aumento significativo da média das notas obtidas no pós-teste comparado com os pré-testes. Ademais, houve associação entre o tempo de execução do teste e o período em que foi realizado, havendo diferença nos tempos de execução. Por fim, coletou-se as percepções dos estudantes sobre as intervenções e estratégias de ensino utilizadas durante a coleta de dados. Os resultados demonstraram eficácia do ensino híbrido no processo de aprendizagem sobre a PCR em pediatria por IR e evidenciou o uso de uma estratégia de ensino que engloba a flexibilização e personalização das abordagens educativas para atender as individualidades e demandas dos estudantes de enfermagem.

Cardiopulmonary arrest (CPA) in pediatrics is an emergency situation that requires adequate action. Considering the importance of training nurses to act in this situation, blended learning is urgently needed, which stands out in degree training processes. The aim of this study was to evaluate the effectiveness of blended learning in the cognitive learning of nursing students, implemented by educational technologies and realistic simulation on the care of children in situations of CPA due to Respiratory Failure (RF). This is a methodological and quasi-experimental intervention study, with a cross-sectional and quantitative approach, whose theoretical framework is part of the Theory of Significant Learning and Experiential Learning. The first stage of the study consisted in the construction of instruments for data collection and application in the educational approach (pre-test, post-test, questions addressed to the chat and checklist for the simulation scenario), all of which were validated by the Content Validation Index (CVI). Sequentially, the previously constructed realistic simulation scenario was also validated by the aforementioned index. The second stage occurred with the implementation of the educational proposal in two stages, with nursing students from a public higher education institution in São Paulo, starting from the 4th and 5th semester of the degree. This stage had 43 students, 15 participated in the second semester of 2021 and 28 in the first semester of 2022. The students were included in a Virtual Learning Environment (VLE) that contained research and data collection guidelines, in addition to the characterization questionnaire, Learning Styles Inventory by Kolb and virtual learning objects related to CPA by pediatric RF. Initially, the educational proposal required that students answer a test prior to accessing the VLE for the first time and, later, making the materials available. Subsequently, the students participated in a synchronous chat session and a realistic face-to-face simulation on the subject. The post-test was applied in three moments: after the synchronous chat session, at the end of participation in the realistic simulation, and 30 days after the proposed activities. A predominance of participation of the students of the 7th semester of grade was identified. The Friedman test, the Nemenyi multiple comparison test, ANOVA and Kruskal-Wallis were used in the analyses. Regarding the Learning Styles, most of the students demonstrated that they characterized themselves as "convergent". The best average was presented in the post-test at the end of the realistic simulation and there was a difference between the scores obtained at the different moments of application of the tests, where a significant increase was observed in the average of the scores obtained in the pre-test compared to the post-tests. In addition, there was an association between the execution time of the tests and the period in which they were carried out, and differences in the execution time. Finally, students' perceptions of the interventions and teaching strategies used during data collection were collected. The results demonstrated the effectiveness of blended learning in the learning process about CPA by pediatric RF and evidenced the use of a teaching strategy that encompasses flexibility and personalization of educational approaches to meet the individualities and demands of nursing students.

Cardiopulmonary Resuscitation Training in Select Rhode Island High Schools: A Descriptive Study.

Fewer than 15% of people who have out-of-hospital cardiac arrests survive, but chances of survival can be tripled with effective bystander cardiopulmonary resuscitation (CPR). The majority of states, including Rhode Island, require high school CPR training, yet the impact of this is not well studied. A 33-question REDCap survey regarding cardiac arrest preparedness, CPR education, and barriers to CPR training was emailed to high school staff in Rhode Island. There were 62 responses; 26% reported their school taught CPR and 94% felt it was important for students to have CPR certification. Barriers included time (85%), budget (82%), and materials (79%). Over 80% felt students would not be able to perform high-quality CPR or properly use a defibrillator. Despite laws requiring CPR training and the belief by school staff of the importance of CPR training, the majority of students are not receiving CPR training. Staff report students do not have the ability to perform effective CPR or use a defibrillator.

Desarrollo del discurso narrativo en niños ecuatorianos de 6 años / The development of narrative discourse in Ecuadorian 6-year-old children

Resumen Existe consenso en la literatura acerca de la importancia del andamiaje del adulto en el desarrollo de la cognición y, particularmente, de las habilidades lingüísticas de los niños (Bruner, 1986; Nelson, 1996; Vygotsky, 1978). En este sentido, el presente trabajo tuvo por objetivo examinar la incidencia de la intervención del adulto, según su metodología de enseñanza, en el desempeño narrativo de niños de primer grado. Para ello, se evaluó el rendimiento en una tarea de recuento de relatos de dos grupos de niños que concurrían a primer grado en escuelas del distrito de Quito que sostenían una metodología diferente: mientras que una de ellas se atenía exclusivamente a los lineamientos del diseño curricular planteado por el Ministerio de Educación, en la otra se incorporaban, además, estrategias de los libros Letras y sonidos I (Jara de Torres, 2001) y Aprendo y escribo (Jara de Torres, 2003) -adaptados de la propuesta integral de la editorial Abeka- y principalmente se recurría a la lectura dialógica y a la enseñanza explícita de habilidades de producción de relatos. Se analizaron las narrativas producidas por los niños a principio y a fin de año y se comparó el desempeño de ambos grupos atendiendo tanto a la cantidad de información recuperada como al tipo de información y los recursos lingüísticos puestos en juego. Se observaron diferencias significativas en las variables mencionadas, lo cual brinda evidencia acerca de la incidencia positiva de la lectura dialógica y la enseñanza de habilidades de producción de relatos en el desarrollo narrativo.

Abstract There is a consensus in the literature about the importance of adult scaffolding in the development of children's cognition and language skills (Bruner, 1986; Nelson, 1996; Vygotsky, 1978). This document analyzes first grade children's narrative development in order to verify the incidence of adult intervention and teaching methodology. For this purpose, the performance of two groups of children enrolled in first grade of school in the district of Quito was analyzed. Two different teaching methodologies were observed: while one of them exclusively adheres to the guidelines of the curriculum design proposed by the Ministry of Education, the other one incorporates strategies from the books Letters and Sounds I (Jara de Torres, 2001) and Learn and Write I (Jara de Torres, 2003) -adapted from the proposal by editorial Abeka. The narratives performed by the children at the beginning and at the end of the school year were analyzed and each performance of both groups was compared based on the amount of information retrieved and the type of information and linguistic resources used. The stories were presented to the children in audiovisual format (steady images and recorded voice). For task administration, the children were instructed to listen and look at the story very carefully because they had to recount it to a friend or family member. The children's remarks were recorded on audio for later analysis. Descriptive and inferential statistical methods were used in order to analyze and compare the linguistic and cognitive performance in the production of stories of the two groups of children in the different evaluation. Significant differences were observed in the variables analyzed, which provides evidence about the positive incidence of dialogic reading and the teaching of story production skills in narrative development. Differences in the performance of schools, especially in first graders, cannot be attributed to maturational factors since both groups are conformed by children of the same chronological age. Neither by the socioeconomic factors, since, in fact, group A was composed of children who attend a rural school and most of them happened to have low resources. Therefore, the significant improvement in the performance of the children of group A at the end of the school year could be attributed to the intervention of their teacher's work. It is thought that this advance in retell story skills is due to an improvement in the understanding of the basic story, however there are studies that observe that the level reached in this process does not directly affect the quality of children's narrative performance (Bustos Ibarra et al., 2014). In consequence, the improvement in the children's narrative performance of group A can be linked not only to the work carried out by the teachers with texts but also to the situations of story production involved. Many investigations have observed that adult scaffolding during story reading has a positive effect on children's linguistic and discursive development (Sénechal, Le Fevre, Hudson & Lawson, 1996; Trabasso & Nickels, 1992; Wasik & Bond, 2001; West et al., 2021). In fact, as Wells (1988) points out in a pioneering study, while reading stories contributes to children's linguistic development, the parallel text generated by teachers through their interventions to explain vocabulary, make inferences explicit, relate events and post-reading reconstruction has shown a greater effect than just reading any kind of story aloud. Thereupon, the results obtained in this work show the relevance not only of the teacher's texts daily reading but, mainly, of the intervention strategies and methodologies that they use to promote comprehension and textual production in the classroom.

Ultra-Processed Foods as Ingredients of Culinary Recipes Shared on Popular Brazilian YouTube Cooking Channels.

Social media platforms are readily accessible sources of information about cooking, an activity deemed crucial for the improvement of a population's diet. Previous research focused on the healthiness of the content shared on websites and blogs, but not on social media such as YouTube®. This paper analysed the healthiness of 823 culinary recipes retrieved from 755 videos shared during a six-month period on ten popular Brazilian YouTube® cooking channels. Recipes were categorized by type of preparation. To assess recipes' healthiness, ingredients were classified according to the extension and purpose of industrial processing, in order to identify the use of ultra-processed foods. Additionally, a validated framework developed from criteria established in both editions of the Dietary Guidelines for the Brazilian Population was employed. Recipes for cakes and baked goods, puddings, snacks and homemade fast foods, which were among the most frequently posted, contained the lowest proportion of unprocessed/minimally processed ingredients and the highest proportion of ultra-processed ingredients. Recipes containing whole cereals, fruits, legumes, nuts, and seeds were scarce. Results indicate that users should be critical about the quality of recipes shared on YouTube® videos, also indicating a need for strategies aimed at informing individuals on how to choose healthier recipes or adapt them to become healthier.

O processo de trabalho de um ambulatório de oncologia em análise / The work process of an oncology outpatient clinic under analysis

O alto índice do câncer é algo preocupante em todo o mundo. A modalidade de tratamento mais utilizada em oncologia são os quimioterápicos, que, por sua vez, trazem o desconforto por seus efeitos colaterais tão temidos, como náuseas, vômitos, alopecia, entre outros. Se, por um lado, lidar com a dor e o sofrimento faz parte do trabalho em saúde, por outro, isso não pode significar que o trabalhador tenha que carregar as consequências como uma carga de sofrimento individual inerente às suas escolhas profissionais. Afinal, lidar com a dor e o sofrimento é uma necessidade e um bem social inestimável, que precisa ser reconhecido e valorizado nas instituições. Os objetivos deste estudo consistem conhecer os processos de trabalho junto da equipe de enfermagem no ambulatório de oncologia; promover o diálogo e a reflexão da atividade desenvolvida pela equipe de enfermagem no ambulatório de oncologia a partir do método de Instrução ao Sósia; analisar os processos de trabalho da equipe de enfermagem do ambulatório de oncologia por meio do método de Instrução ao Sósia; propor a implantação de supervisão/de reuniões de equipe com o intuito de produção coletiva do trabalho. O cenário foi o ambulatório de oncologia de um hospital público federal do estado do Rio de Janeiro; os participantes foram os integrantes da equipe de enfermagem que atuam na sala de terapia na qual se administram os quimioterápicos. Nos resultados: a dificuldade de instruir o outro na terceira pessoa trata da complexidade que é falar de sua atividade como algo fora de si; o reconhecimento de que o trabalho na quimioterapia é muito focado na técnica, e que, muitas vezes, o trabalhador esquece o poder que existe a cada encontro com o usuário e suas singularidades, mostrando aí que, frequentemente, o trabalhador é capturado pelo "trabalho morto" em detrimento do "trabalho vivo"; a falta de espaço para discussões diárias para trocas e reflexões da prática, trazendo a necessidade de reuniões; e a falta de atendimento psicológico aos profissionais do ambulatório de oncologia. Esta pesquisa traz à luz assuntos que, de fato, precisam ser vistos pelos gestores, líderes que atuam no setor referido: do quanto investimentos com espaços de Educação Permanente em Saúde, para reflexões e resoluções sobre a prática do cuidado em saúde, são essenciais; a atenção à saúde do trabalhador do ambulatório em oncologia deve ser vista e, assim, considerar que se um profissional é bem assistido, o paciente também o será. Cuidando de quem cuida, certamente reverberará em seu cuidado ao usuário.

The high rate of cancer is something worrisome around the world. The most used treatment modality in oncology is chemotherapy, which in turn brings discomfort due to its feared side effects such as nausea, vomiting, alopecia, among others. If, on the one hand, dealing with pain and suffering is part of health workers, on the other hand, this cannot mean that workers have to bear the consequences as a burden of individual suffering inherent to their professional choices. After all, dealing with pain and suffering is an invaluable need and social good that needs to be recognized and valued in institutions. The objectives of this study are: to know the work processes with the nursing team in the oncology outpatient clinic from the use of the method of instruction to the double and thus expand the resources for the action of their activities; to identify the challenges encountered in practice for the care of people using chemotherapy; and to promote transformations in the work processes. This is a qualitative study, which used the method of instruction to the double, promoting dialogue and reflection among workers. The scenario was the oncology outpatient clinic of a federal public hospital in the state of Rio de Janeiro, the participants were the members of the nursing team working in the therapy room where chemotherapy is administered. Results: the difficulty of instructing the other in the 3rd person addresses the difficulty that is to speak of their activity as something outside of themselves; the recognition that the work in chemotherapy is very focused on the technique, and that often the worker forgets the power that exists at each meeting with the user and its singularities, showing that the worker is often captured by "dead work" to the detriment of "living work"; the lack of space for daily discussions for exchanges and reflections of practice, bringing the need for meetings; the lack of psychological care for the professionals of the oncology outpatient clinic. Final considerations: this research brings to light issues that need to be seen by managers, leaders working in the referred sector, of how much investment with spaces of Permanent Education in Health are essential for reflections and resolutions on the practice of health care, the health care of the outpatient worker in oncology should be seen and thus it should be considered that if the professional is well-attended, the patient will be, too. Taking care of those who care will certainly reverberate in their care towards the user.

Alfabetização e Letramento: Uma Discussão sobre Gêneros Textuais Digitais / Alphabetization and Literacy: A Discussion about Digital Textual Genres / Alfabetización y Literacia: Una Discusión sobre los Géneros Textuales Digitales

Este artigo tem o objetivo de discutir contribuições do uso de gêneros textuais digitais no processo de alfabetização e letramento. Em situações vivenciadas em sala de aula é notável que as novas tecnologias trazem grande motivação aos alunos. Tal observação assinala a possibilidade de empregar ferramentas tecnológicas como recursos didáticos que potencializem os processos de alfabetização e de letramento. Diante disso, questionamos: os gêneros textuais digitais podem fomentar a aprendizagem da linguagem escrita no início do processo de escolarização? Para responder a essa questão, buscamos embasamento na Teoria Histórico-Cultural e em princípios da teoria bakhtiniana. Inicialmente, analisamos o papel do professor diante do processo de ensino e aprendizagem da linguagem escrita. Na sequência, discorremos a respeito dos processos de alfabetização e letramento. Posteriormente, apresentamos algumas reflexões a respeito da possibilidade de gêneros discursivos digitais promoverem tais processos. Esperamos que tais reflexões auxiliem o leitor a pensar a organização do ensino da linguagem escrita, buscando assegurar a todos os alunos a apropriação desse conhecimento, condição para o pleno desenvolvimento. (AU)

This article aims to discuss contributions of the use of digital textual genres in the literacy and initial reading instruction process. In situations experienced in the classroom, it is remarkable that new technologies bring great motivation to students. Such observations show the possibility of using technological tools as didactic resources that enhance the initial reading instruction and literacy process. Therefore, we question: can digital text genres promote written language learning at the beginning of the schooling process? To answer this question, we look for a basis in Historical-Cultural Theory and in Bakthin´s theory principles. Initially, we analyze the role of the teacher in the process of teaching and learning written language. Next, we discuss the processes of initial reading instruction and literacy. Later, we present some reflections on the possibility of digital discursive genres promoting such processes. We hope that such reflections will help the reader to think about the organization of written language teaching, seeking to ensure to all students the appropriation of this knowledge, a condition for full development. (AU)

Este artículo tiene como objetivo discutir las contribuciones del uso de géneros textuales digitales en el proceso de alfabetización y letramiento. En situaciones vividas en el aula es destacable que las nuevas tecnologías aporten una gran motivación a los alumnos. Esta observación indica la posibilidad de utilizar herramientas tecnológicas como recursos didácticos que potencian los procesos de alfabetización y letramiento. Por lo tanto, nos preguntamos: ¿fomentan los géneros textuales digitales el aprendizaje del lenguaje escrito al inicio del proceso escolar? Para contestar a esta pregunta, buscamos nos basar la Teoría Histórico-Cultural y en los principios de la teoría bajtiniana. Inicialmente, se analizó el papel del maestro en el proceso de enseñanza y aprendizaje de la lengua escrita. A continuación, discutimos la alfabetización y los procesos de letramiento. Posteriormente, presentamos algunas reflexiones acerca de la posibilidad de que los géneros discursivos digitales promuevan este tipo de procesos. Esperamos que tales reflexiones ayuden al lector a pensar en la organización de la enseñanza de la lengua escrita, buscando asegurar a todos los estudiantes la apropiación de este conocimiento, condición para el pleno desarrollo. (AU)

Gamifying Sexual Education for Adolescents in a Low-Tech Setting: Quasi-Experimental Design Study.

BACKGROUND: Sexual education has become increasingly important as unhealthy sexual practices and subsequent health risks become more prevalent during adolescence. Traditional sex education teaching methodologies are limiting for digital natives exposed to various digital technologies. Harnessing the power of technology applications attractive to the younger generation may be a useful approach for teaching sex education. OBJECTIVE: The aim of this study was to improve sexual health knowledge and understanding of the problems associated with unhealthy sexual practices and address sexual and reproductive health challenges experienced in a low-tech setting. METHODS: A participatory design approach was used to develop the digital gamified methodology. A sample of 120 secondary school students aged 11-15 were randomly assigned to either experimental or control group for each of the 3 teaching approaches: (1) gamified instruction (actual serious games [SG] in teaching); (2) gamification (GM; making nongames, such as game-like learning); and (3) traditional teaching (TT) methods. RESULTS: The SG and GM approaches were more effective than TT methods in teaching sexual health education. Specifically, the average scores across groups demonstrated an increase of mean scores from the pre- to posttest (25.10 [SD 5.50] versus 75.86 [SD 13.16]; t119=41.252; P<.001 [2 tailed]). Analysis of variance indicated no significant differences across groups for pretest scores (F2,117=1.048, P=.35). Significant differences across groups were evident in the posttest scores. Students in the SG and GM groups had higher average scores than the TT group (F2,117=83.98; P<.001). Students reported increased learning motivation, attitude, know-how, and participation in learning (P<.001) when using SG and GM approaches. CONCLUSIONS: Digital health technologies (particularly teaching and learning through gamified instruction and other novel approaches) may improve sexual health education. These findings may also be applied by practitioners in health care settings and by researchers wishing to further the development of sex education.

Relatedness support enhances motivation, positive affect, and motor learning in adolescents.

Social relatedness is a basic psychological need to experience satisfaction of interpersonal acceptance and closeness with others. In this experiment, the effects of social relatedness on the learning of a task (hitting a ball with a racket toward a target) were tested in adolescents. Participants were assigned to three experimental groups. After a pre-test and before practice, participants in the relatedness support (RS) condition received instructions emphasizing recognition, importance, and interest in the participant's experience. Participants in the relatedness frustration (RF) condition received instructions emphasizing disinterest in the participant as a person. Control participants did not receive specific relatedness instructions. One day later, they performed retention and transfer tests. Questionnaires measured participants' motivational and affective levels. The results showed that supporting the relatedness need enhances task learning in adolescents. Motivation and affective levels were also affected. The findings are the first to show that social relatedness affects adolescent's motor performance and learning and reveal underlying mechanisms implicated in such effects.

De Elton Mayo a Ivar Oddone: redescobrir a instrução ao sósia / From Elton Mayo to Ivar Oddone: rediscovering the instruction to the double

O presente texto foi publicado originalmente como prefácio de uma obra de Yves Clot em homenagem a Ivar Oddone. Decidimos publicá-lo no formato de artigo, com a autorização do autor, por considerarmos que traz importantes e atuais contribuições para o campo do trabalho em intercruzamento com diversas teorias: Clínica da Atividade, Ergologia, Ergonomia, Saúde do Trabalhador, dentre outras. Neste texto, Yves Clot retoma aspectos significativos da obra de Ivar Oddone e tece reflexões sobre aspectos originais dessa, nem sempre considerados pelos estudiosos da área. Assim, faz uma análise comparativa com as propostas apresentadas por Elton Mayo, as quais se sagraram como importante ferramenta para o desenvolvimento do capitalismo industrial sob a suposta égide do enaltecimento do aspecto humano nas situações de trabalho. Ao contrário das concepções e práticas de Mayo, que foram efetivamente voltadas para o aumento da produtividade das empresas e, portanto, para a exploração dos trabalhadores, Oddone buscou reconhecer e valorizar o saber dos operários, com o intuito de que esse se configurasse como um contrapoder ao ampliar o seu poder de agir na situação de trabalho, aspectos que são amplamente discutidos por Clot no texto que ora apresentamos.¹

This text was initially published as a preface written by Yves Clot in honor of Ivar Oddone. We decided to publish it as an article, authorized by the author, as we believe that it brings important and current contributions to the field of work, in interseccion with several theories: Clinic of Activity, Ergology, Ergonomics, Worker's Health, among others. In this text, Yves Clot takes up highlights of Ivar Oddone's work and produces reflections about its original aspects, not always considered by experts in the field. Thus, he makes a comparative analysis with those aspects and the proposals presented by Elton Mayo, which have become an important tool for the development of industrial capitalism under the supposed appreciation of the human sides in work situations. Contrary to Mayo's conceptions and practices, which were aimed at increasing the productivity of companies and, therefore, at the exploitation of workers, Oddone sought to recognize and value the knowledge of workers, intending that this was used as a kind of counterpower, by expanding its power to act in the work situation, points that are widely discussed by Clot in the text that we present now.

Innovación emergente para la COVID-19: taller virtual sobre el uso educativo de la plataforma Moodle / COVID-19 Emergent Innovation: Virtual Workshop about Moodle Platform Educative Use

Introducción: se requiere el desarrollo de competencias docentes para programar soluciones significativas a los problemas educativos identificados. Objetivo: analizar una innovación para la capacitación profesoral en el uso educativo de la plataforma Moodle, como estrategia emergente durante el aislamiento social por la COVID-19. Metodología: se desarrolló una investigación descriptiva, con enfoque cualitativo, aplicando la metodología de la sistematización de experiencias. Resultados: en la determinación de la situación a mejorarse se reconoció la escasa experiencia de los docentes del departamento con el uso de la plataforma Moodle; la elección de los contenidos, tecnología y actividades estuvo en función de organizar un aprendizaje gradual que contemplara el tratamiento de las esencialidades de las innovaciones educativas con las TICs, haciendo uso de recursos educativos disponibles en la plataforma Moodle. Conclusiones: la innovación desarrollada durante el aislamiento social por la COVID-19, puso de manifiesto su eficacia y transferibilidad(AU)

Introduction: it is required to develop professor's competences to program significant responses to identified educational problems. Objective: to analyze an innovation for instructing professors in the educative use of platform Moodle developed as an emergent strategy during social isolation due to the COVID-19. Methodology: it was developed a descriptive and qualitative investigation, applying the experience systematizing methodology. Results: the learning situation to activate was the departmental professor's experience with the Moodle platform use; the contents, technology and activities selection procured the use of Moodle recourses to organize a planned learning of educative innovation inner essentialities; to evaluate the innovation results there were considered its efficacy and transferability. Conclusions: the virtual methodological workshop developed during social isolation due to the COVID-19 evidenced its efficacy and transferability(AU)

Effects of an in situ instructional design based postpartum hemorrhage simulation training on patient outcomes: an uncontrolled before-and-after study.

Objective: To compare postpartum hemorrhage (PPH) patient outcomes before and after an in situ instructional design based PPH simulation attended by obstetrics and gynecology (OBGYN) residents.Methods: This uncontrolled before-and-after study was conducted in Recife, Brazil including all 1388 women delivering from June to August 2012 and all 1357 delivering from June to August 2013. The 36 OBGYN residents were divided into13 teams of two or three participants and were trained through ID based PPH simulation training with the following eight steps: (1) prior knowledge activation, (2) video demonstration, (3) dual-coding PPH protocol discussion-an image association during the training, (4) training scenario # 1, (5) debriefing, (6) training scenario # 2 with immediate feedback, (7) training scenario # 3, and (8) debriefing with self-assessment. The training scenarios had an increasing level of complexity. The main goal of the training was the adequate management of PPH and situational awareness improvement-the ability to anticipate, recognize, and intercept unfolding error chains. The primary patient outcomes rates used for the before and after comparison were therapeutic uterotonics use within 24 h of birth and blood transfusion. Secondary outcomes were therapeutic oxytocin mean dosage IU within 24 h of birth, postpartum Hb < 6 g/dL, among others. Chi-square test was used for categorical variables comparison and independent t-test for continuous variables.Results: PPH rates were 100 (7.2% of 2012 deliveries) and 80 cases (5.9% of 2013 deliveries), respectively. Comparison of primary post- and pre-simulation outcomes revealed no significant differences. However, in the comparison for therapeutic oxytocin mean dosage IU within 24 h of birth, there was an increase found after the simulation (15.98 ± 7.4 versus 25.1 ± 12.3; p < .001). For all other outcome measures, there were no statistical differences.Conclusions: In situ ID based PPH simulation leads to an increase in the mean dosage of oxytocin after training, in selected cases. This may indicate better situational awareness when managing women with PPH.