Diseño de una plantilla de escenarios de simulación clínica. Una propuesta para la formación en Obstetricia y Puericultura / Design of a clinical simulation scenario template. A proposal for training in Obstetrics and Child Care

Objetivo: Elaborar un esquema de diseño de escenarios de simulación clínica apoyados en un modelo de plantilla aplicable a la formación del grado de Obstetricia y Puericultura en universidades chilenas. Material y métodos: Se revisaron las mallas curriculares de 19 universidades que imparten el grado de Obstetricia y Puericultura en Chile, y se analizaron detalladamente seis planes de estudio de ellas. Se detectaron 26 competencias susceptibles de enseñarse con metodología de simulación. Se delimitaron los campos necesarios para ejecutar una sesión o actividad basada en simulación clínica de acuerdo con las recomendaciones de diseño identificadas en la bibliografía, la experiencia del Centro de Innovación en Simulación CISARC de la Universitat de Vic-Universitat Central de Catalunya, Campus Manresa, y la propia experiencia de las autoras. El proceso de diseño incluyó una validación de las plantillas en varias competencias y pruebas piloto. Resultados: Se diseñaron cuatro plantillas: dos fueron plantillas didácticas para la enseñanza de dos niveles de complejidad de la competencia de patología mamaria y otras dos fueron plantillas de evaluación del desempeño durante la simulación. Estas plantillas fueron validadas aplicándolas a tres competencias técnicas y no técnicas, para finalmente elaborar nuestro propio esquema de plantilla que guiará los diseños de la formación con simulación para estudiantes del grado de Obstetricia y Puericultura. Conclusiones: Las plantillas de simulación propuestas son aplicables a las competencias del grado de Obstetricia y Puericultura, y facilitarán la aplicación correcta de la simulación a los docentes.(AU)

Aim: To elaborate a model for the design of clinical simulation scenarios supported by a template applicable to Obstetrics and Puericulture (Obstetricia y Puericultura) degree training in Chilean universities. Material and methods: The curricula of 19 universities that offer the degree of Obstetrics and Puericulture. in Chile were reviewed and six curricula of these universities were analyzed in detail. Twenty-six competencies susceptible to be taught with simulation methodology were detected. The necessary fields to execute a session or activity based on clinical simulation were delimited according to design recommendations identified in the literature, the experience of the Center for Innovation in Simulation CISARC of the Universitat de Vic-Universitat Central de Catalunya Manresa Campus and the authors' own experience. The design process included a validation of the templates in several competencies and pilot tests. Results: Four templates were designed, two were teaching template for teaching two levels of complexity of the competence breast diseases and other two were assessment templates for the performance during the simulation. These templates were validated by applying them to three technical and non-technical competences, to finally elaborate our own scheme of template that will guide the designs of the training with simulation for students of the degree of Obstetrics and Puericulture. Conclusions: The proposed simulation templates are applicable to the competencies of the Obstetrics and Puericulture degree and will facilitate the correct application of simulation to teachers.(AU)

Construction and Evaluation of a Realistic Low-Cost Model for Training in Chest-Tube Insertion.

INTRODUCTION: Emergency thoracostomy is applied in life-threatening situations. Simulation plays a pivotal role in training in invasive techniques used mainly in stressful situations. Currently available commercial simulation models for thoracostomy have various drawbacks. METHODS: We designed a thoracostomy phantom from discarded hospital materials and pigskin with underlying flesh. The phantom can be used alone for developing technical skills or mounted on an actor in simulation scenarios. Medical students, intensive care unit (ICU) and emergency department teams, and thoracostomy experts evaluated its technical fidelity and usefulness for achieving learning objectives in workshops. RESULTS: The materials used to construct the phantom cost €47. A total of 12 experts in chest-tube placement and 73 workshop participants (12 ICU physicians and nurses, 20 emergency physicians and nurses, and 41 fourth-year medical students) evaluated the model. All groups rated the model's usefulness and the sensation of perforating the pleura highly. Experts rated the air release after pleura perforation lower than other groups. Lung reexpansion was the lowest rated item in all groups. Ratings of the appearance and feel of the model correlated strongly among all groups and experts. The ICU professionals rated the resistance encountered in introducing the chest drain lower than the other groups. CONCLUSIONS: This low-cost, reusable, transportable, and highly realistic model is an attractive alternative to commercial models for training in chest-tube insertion skills.

Numerical Assessment Tool to Measure Realism in Clinical Simulation.

Realism is indispensable in clinical simulation learning, and the objective of this work is to present to the scientific community the methodology behind a novel numerical and digital tool to objectively measure realism in clinical simulation. Indicators measuring accuracy and naturality constitute ProRealSim v.1.0 (Universidad Europea, Madrid, Spain) which allows the assessing of attained realism for three dimensions: simulated participant, scenography, and simulator. Twelve experts in simulation-based learning (SBL) analyzed the conceptual relevance of 73 initial qualitative indicators that were then reduced to 53 final indicators after a screening study evaluating eight medical clinical simulation scenarios. Inter- and intra-observer concordance, correlation, and internal consistency were calculated, and an exploratory factorial analysis was conducted. Realism units were weighted based on variability and its mathematical contribution to global and dimensional realism. A statistical significance of p < 0.05 was applied and internal consistency was significant in all cases (raw_alpha ≥ 0.9698094). ProRealSim v.1.0 is integrated into a bilingual, free, and open access digital platform, and the intention is to foster a culture of interpretation of realism for its better study and didactic use.

Seguridad del paciente a través del cine-educación y simulación. Evaluación del aprendizaje a largo plazo / Patient safety through cinemeducation and simulation. Long-term learning assessment

Introducción: El aprendizaje a largo plazo es uno de los objetivos de la educación médica. Combinar cine-educación y simulación ha demostrado ser eficaz para enseñar seguridad del paciente a estudiantes de medicina. Este artículo describe la evaluación de la retención de conocimientos sobre seguridad del paciente al cabo de un año aplicados a un nuevo contexto clínico.Sujetos y métodos.En un escenario de simulación de error transfusional, se evalúan los comentarios sobre seguridad del paciente de 59 estudiantes de tercer curso de medicina que el año anterior habían participado en una sesión de seguridad del paciente con cine-educación y simulación. El análisis de los datos se realiza desde un enfoque cualicuantitativo, agrupando y cuantificando los comentarios de los estudiantes en función de cinco de los 11 dominios de seguridad del paciente, según la Organización Mundial de la Salud (OMS).Resultados.La mayoría de los estudiantes recuerda el escenario audiovisual y es capaz de aplicar en el nuevo escenario conceptos complejos de seguridad del paciente y las actuaciones recomendadas por la OMS aprendidos un año atrás.Conclusión.La combinación de cine-educación y simulación permite la retención y transferencia de conceptos complejos de seguridad del paciente a otro contexto al cabo de un año. Esto puede vincularse con la buena recepción que las series de televisión médicas tienen entre los estudiantes de medicina. Éstas sustituyen el componente experiencial de la simulación, el cual proporciona los componentes de briefing, debriefing y transferencia que le son propios. (AU)

Introduction: Long-term learning is one of the goals of medical education. Combining cinemeducation and simulation was proven effective to teach patient safety (PS) to medical students. This paper describes the evaluation of PS knowledge retention after one year applied to a new clinical context.Subjects and methods.In a transfusion error simulation scenario, the comments of 59 3rd year medical students who had participated in PS session with cinemeducation and simulation the previous year were evaluated. Data analysis was performed from a qualitative-quantitative approach, grouping and quantifying student feedback based on 5 of the 11 PS topics according to WHO.Results.Most of the students remember the audiovisual scenario and are able to applied complex PS concepts and the actions recommended by the WHO learned a year ago in the new setting.Conclusion.The combination of cinemeducation and simulation has allowed the retention and transfer of complex PS concepts to another context after one year. This can be linked to the good reception that medical TV series have among medical students. These can replace the experiential component of the simulation, which in turn provides its own briefing, debriefing and transfer components. (AU)

Collaborative clinical simulation in cardiologic emergency scenarios for medical students. An exploratory study on model applicability and assessment instruments.

Aims: This paper evaluates the feasibility of piloting the collaborative clinical simulation (CCS) model and its assessment instruments applicability for measuring interpersonal, collaborative, and clinical competencies in cardiologic emergency scenarios for medical students. The CCS model is a structured learning model for the acquisition and assessment of clinical competencies through small groups working collaboratively to design and perform in simulated environments supported by technology. Methods: Fifty-five students were allocated in five sessions (one weekly session) conducted with the CCS model within the course Cardiovascular Diseases. The applied practice aimed at the diagnosis and treatment of tachyarrhythmias in a simulated emergency department. In addition to the theoretical classes four weeks before the simulation sessions, students were sent a study guide that summarized the Guide to the European Society of Cardiology. For each simulation session, one clinical simulation instructor, one cardiologist teacher, and the principal investigator participated. Students were divided into three groups (3-5 students) for each-session. They designed, performed, role-played, and debriefed three different diagnoses. Three instruments to assess each group's performance were applied: peer assessment used by groups, performance assessment, created and applied by the cardiologist teacher, and individual satisfaction questionnaire for students. Results: The applicability of the CCS model was satisfactory for both students and teachers. The assessment instruments' internal reliability was good, as was internal consistency with a Cronbach Alpha of 0.7, 0.4, and 0.8 for each section (Interpersonal, Clinical, and Collaborative competencies, respectively). The performance group's evaluation was 0.8 for the two competencies assessed (Tachyarrhythmia and Electrical Cardioversion) and 0.8 for the satisfaction questionnaire's reliability. Conclusions: The CCS model for teaching emergency tachyarrhythmias to medical students was applicable and well accepted. The internal reliability of the assessment instruments was considered satisfactory by measuring satisfaction and performance in the exploratory study.

A Web Platform (MOSAICO) to Design, Perform, and Assess Collaborative Clinical Scenarios for Medical Students: Viewpoint.

BACKGROUND: The collaborative clinical simulation (CCS) model is a structured method for the development and assessment of clinical competencies through small groups working collaboratively in simulated environments. From 2016 onward, the CCS model has been applied successfully among undergraduate and graduate medical students from the Universidad de Talca, Chile; the Universität de Barcelona, Spain; and the Universidad de Vic-Manresa, Spain. All the templates for building the clinical cases and the assessment instruments with CCS were printed on paper. Considering the large number of CCS sessions and the number of participating students that are required throughout the medical degree curriculum, it is impossible to keep an organized record when the instruments are printed on paper. Moreover, with the COVID-19 pandemic, web platforms have become important as safe training environments for students and medical faculties; this new educational environment should include the consolidation and adaptation of didactic sessions that create and use available virtual cases and use different web platforms. OBJECTIVE: The goal of this study is to describe the design and development of a web platform that was created to strengthen the CCS model. METHODS: The design of the web platform aimed to support each phase of the CCS by incorporating functional requirements (ie, features that the web platform will be able to perform) and nonfunctional requirements (ie, how the web platform should behave) that are needed to run collaborative sessions. The software was developed under the Model-View-Controller architecture to separate the views from the data model and the business logic. RESULTS: MOSAICO is a web platform used to design, perform, and assess collaborative clinical scenarios for medical students. MOSAICO has four modules: educational design, students' collaborative design, collaborative simulation, and collaborative debriefing. The web platform has three different user profiles: academic simulation unit, teacher, and student. These users interact under different roles in collaborative simulations. MOSAICO enables a collaborative environment, which is connected via the internet, to design clinical scenarios guided by the teacher and enables the use of all data generated to be discussed in the debriefing session with the teacher as a guide. The web platform is running at the Universidad de Talca in Chile and is supporting collaborative simulation activities via the internet for two medical courses: (1) Semiology for third-year students (70 students in total) and (2) Medical Genetics for fifth-year students (30 students in total). CONCLUSIONS: MOSAICO is applicable within the CCS model and is used frequently in different simulation sessions at the Universidad de Talca, where medical students can work collaboratively via the internet. MOSAICO simplifies the application and reuse of clinical simulation scenarios, allowing its use in multiple simulation centers. Moreover, its applications in different courses (ie, a large part of the medical curriculum) support the automatic tracking of simulation activities and their assessment.

Repercusiones de la COVID-19 en la educación de los médicos: la formación de grado (II) / Impact of COVID-19 on medical education: undergraduate training (II)

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Formación en habilidades de comunicación en estudiantes de medicina de la Facultad de Medicina y Ciencias de la Salud de la Universitat de Barcelona / No disponible

No disponible

Situación actual de la formación en comunicación en la Facultad de Medicina y Ciencias de la Salud de la Universitat de Barcelona / Current situation of education in communication abilities in the Faculty of Medicine and Health Sciences of the Barcelona University

Introducción: La comunicación es una competencia fundamental en la formación de los futuros médicos. Objetivos: Conocer la percepción de la comunidad universitaria e identificar la situación actual de la formación en habilidades de comunicación en el Grado de Medicina de la Facultad de Medicina y Ciencias de la Salud de la Universitat de Barcelona. Sujetos y métodos: Análisis descriptivo de las respuestas a tres encuestas diseñadas por método Delphi, dirigidas a profesorado y estudiantes de cuarto y sexto curso durante el período académico 2017-2018. Resultados: La encuesta de profesorado fue respondida por 43 docentes; la de cuarto curso, por 87 alumnos, y la de sexto curso, por 79 alumnos. Los alumnos que respondieron suponían un tercio de los matriculados en esos cursos. Había acuerdo entre los encuestados respecto a la alta importancia de la comunicación y del feedback clínico. Los profesores daban más valor formativo a las clases teóricas que los alumnos, quienes otorgaban más valor a las herramientas con participación activa. Los mini-CEX y el feedback clínico fueron las herramientas consideradas más útiles. La falta de feedback en las evaluaciones clínicas objetivas estructuradas limitaba su utilidad. Los alumnos de cuarto curso utilizaban más herramientas de formación activa que los de sexto. Conclusión: Se detecta una mejora progresiva en la formación en habilidades de comunicación y en la utilización de herramientas docentes activas, pero se identifican áreas y medidas de mejora en la formación de competencias de comunicación de fácil implementación en el grado

Introduction: Communication is a fundamental competence for the university education of the future doctors. Aims: To know the university community perception and to identify the current situation of education regarding communication abilities in the Medicine Bachelor of the Faculty of Medicine and Health Sciences of Barcelona University. Subjects and methods: Descriptive analysis of the obtained answers to three surveys designed by Delphi method, addressed to three subgroups of the university population: professors and students in their fourth and sixth years of the academic year 2017-2018. Results: The survey was answered by 43 professors, 87 fourth-year students and 79 sixth-year students. Around a third of the enrolled students participated. The three populations commonly scored high the importance of communication and feedback of the clinical performance. The professors gave more value to theoretical classes than students did, who scored higher the active teaching tools. Mini-CEX and feedback were the more useful considered tools. The lack of feedback after the objective structured clinical examination limits its use. Fourth-grade students used more active training tools than the sixth-grade students. Conclusion: Evidence shows a progressive improvement in the education in communication abilities and suggests areas of improvement of easy implementation in the education of these skills

Nueva plantilla para diseñar escenarios de simulación: interrelación de elementos en un vistazo / New template for simulation scenario design: interrelation of the elements at a single glance

Idealmente, la simulación clínica debería ser aplicada a todos los ámbitos para la formación de los profesionales antes de proceder sobre el paciente, pero su uso se ve limitado porque muchas de las herramientas didácticas disponibles precisan simuladores sofisticados y experiencia previa, ya que se centran en aspectos específicos del diseño de escenarios pero no muestran una visión global del proceso. Por este motivo es acuciante simplificarlas, especialmente pensando en instructores noveles. Presentamos una plantilla que durante toda la fase de diseño mantiene a la vista los elementos esenciales en un único plano, lo que permite comprender fácilmente las relaciones entre ellos y, consecuentemente, las bases conceptuales del diseño de escenarios. En nuestra experiencia, esta plantilla mejora la comprensión de la metodología de diseño, especialmente en instructores noveles. Además, creemos que es útil para preparar simulaciones clínicas puesto que su estructura permite detectar incoherencias precozmente, aumenta el realismo y mejora el enfoque del escenario hacia los objetivos del debriefing. Por último, es exportable a cualquier nivel tecnológico por no requerir simuladores complejos. No se pretende aportar nuevos conceptos en simulación, sino ofrecer una herramienta que facilite la comprensión de la metodología de diseño de escenarios, especialmente para instructores no expertos

Ideally, simulation should be applied in all clinical settings for training professionals before proceeding on the patient, but its use is still limited because many available teaching tools need prior experience and sophisticated simulators. Thus, it is mandatory to simplify them, especially if we focus on novel instructors. We present a template that provides an integrative and simultaneous vision during the design phase of the key simulation design components. This allows the designer to revise them easily at a glance and consequently understand the relationship between these elements. In our practical experience, this template has improved the novel instructors' understanding about the scenario design. Moreover, we believe it can be useful to get better clinical simulations since its structure allows detecting internal inconsistencies at an early stage, increases realism and improves the focus of the scenario towards the objectives of debriefing. It is exportable to all technological levels, since it does not require complex simulators. The template does not contain new concepts in simulation but offers a tool that facilitates a better understanding of the scenario design methodology since it integrates all the elements in a unique plane, especially for non-expert instructors

[Collaborative clinical simulation to train medical students]. / Simulación clínica colaborativa para el desarrollo de competencias de trabajo en equipo en estudiantes de medicina.

In health sciences and medicine, collaborative learning has an important role in the development of competences to solve clinical situations. Adequate cooperation, coordination and communication skills have a direct effect on patient safety. Computer Supported Collaborative Learning (CSCL) and Clinical Simulation (CS), separately, are effective and efficient educational methods to develop competences in undergraduate medical students. To our knowledge, educational models that combine both teaching methods, including a personalized attention of the student, educational infrastructure, materials, teaching techniques and assessment competencies, have not been proposed previously. This article describes the application of a combined model of CSCL and CS for teaching clinical competences to medical students. Since 2015, the collaborative clinical simulation model is part of the training agenda of the Universidad de Talca Medical School in Chile. During 2016 and 2017 it was also applied on students of the Universidad de Barcelona Faculty of Medicine in Spain. According to the experience acquired, implementation of this method is feasible with commonly used resources, although its real efficacy remains to be evaluated.

Simulación clínica colaborativa para el desarrollo de competencias de trabajo en equipo en estudiantes de medicina / Collaborative clinical simulation to train medical students

In health sciences and medicine, collaborative learning has an important role in the development of competences to solve clinical situations. Adequate cooperation, coordination and communication skills have a direct effect on patient safety. Computer Supported Collaborative Learning (CSCL) and Clinical Simulation (CS), separately, are effective and efficient educational methods to develop competences in undergraduate medical students. To our knowledge, educational models that combine both teaching methods, including a personalized attention of the student, educational infrastructure, materials, teaching techniques and assessment competencies, have not been proposed previously. This article describes the application of a combined model of CSCL and CS for teaching clinical competences to medical students. Since 2015, the collaborative clinical simulation model is part of the training agenda of the Universidad de Talca Medical School in Chile. During 2016 and 2017 it was also applied on students of the Universidad de Barcelona Faculty of Medicine in Spain. According to the experience acquired, implementation of this method is feasible with commonly used resources, although its real efficacy remains to be evaluated.

Simulación para formar en la competencia de valoración preanestésica: diseño común para residentes de primer año de anestesiología y enfermeras de anestesia / Simulation for training the competence pre-anesthetic assessment: a common design for first year anesthesia residents and anesthesia nurses

Introducción. La valoración preanestésica (VP) es una competencia compleja que debe adquirir el residente de anestesia tempranamente. La incorporación de enfermería especializada en la VP ha demostrado ser segura y eficaz. No existen recomendaciones para el entrenamiento en VP. La simulación puede ser una metodología apropiada para acortar el tiempo de adquisición de la competencia. Objetivo. Describir detalladamente el diseño y aplicación de un taller de simulación para formar residentes de anestesiología y enfermeras posgraduadas en la competencia VP. Sujetos y métodos. Taller de dos horas de duración con casos clínicos en formato video y ejecutados mediante técnica de role-playing. Los componentes fueron dos videos de grabación propia (el primero, de una VP con errores, y el otro, con una VP correctamente realizada), una plantilla para que cada alumno valorara en los videos los componentes técnicos y no técnicos de las competencias de la VP y una encuesta de satisfacción para alumnos e instructores. En el grupo de residentes se añadieron tres escenarios de VP de pacientes complejos. Resultados. Se analizaron las encuestas de los 10 residentes de dos promociones y de 60 enfermeras. La satisfacción de los dos tipos de alumnos y de los instructores sobre el aprendizaje fue muy alta. En el caso de las enfermeras, más del 85% de las alumnas de las promociones que recibieron el taller superaron la estación VP de la evaluación clínica objetiva estructurada (ECOE) frente a sólo el 20% de la promoción anterior. Conclusiones. El taller de VP con formato video y role-playing permite entrenar la competencia VP a residentes de anestesia y enfermeras posgraduadas, mejorando el rendimiento de éstas en la ECOE

Introduction. Preoperative anesthetic assessment (PA) is a complex competence that anesthesia residents should acquire early in their training. Participation of specialized nurses in the PA is increasing since it is safe and efficacious. There is not an established curriculum in PA. Simulation may be an adequate methodology to train PA. Aim. To describe in detail the design and application of a simulation workshop for training residents and postgraduate nurses in the competence PA. Subjects and methods. Workshop of 2 hours duration, with clinical cases combining videotapes and role-playing. Workshop components were two homemade videos, one with a PA with errors and the other one with a correct PA, a checklist in which each participant assesses technical and non-technical components of the PA and a satisfaction survey for students and instructors. Three simulation scenarios of PA in complex patients were added for residents. Results. 10 residents and 60 nurses participating in the workshop were surveyed. Satisfaction with the methodology applied was high for students and instructors. The percentage of passing the PA station of the final objective structured clinical examination (OSCE) of two promotions of nurses that had participated in the workshop was over 85% compared with only 20% of the previous promotion. Conclusions. A simulation workshop based on videos and role-playing allows to train the competence PA in anesthesia residents and postgraduate nurses, improving the performance of the latter in the OSC

Perioperative ultrasound applied to diagnosis and decision making in anesthesia.

INTRODUCTION: Ultrasound is a portable and safe technology that is increasingly used to assist anesthetic procedures and has been integrated into the routine practice of a wide range of invasive procedures. As a complementary diagnostic tool, publications related to perioperative support other than vascular access and nerve blocks are currently lacking. EVIDENCE ACQUISITION: Given the growing interest of anesthesiologists in acquisition of knowledge and skills of ultrasound, we propose a systematic review of the diagnosis, decision making or change in perioperative management of non-cardiac surgical patients derived from ultrasound practice. Of 1112 references found in electronic databases, 62 studies resulted from the screening process. EVIDENCE SYNTHESIS: A complete critical reading of 19 full-text publications was carried out with quantitative analysis of 1825 ultrasound examinations including echocardiography, neck and laryngeal ultrasound, pulmonary ultrasound and abdominal ultrasound, all of them performed by anesthesiologists. Diagnosis applied ultrasound and decision making during perioperative period resulted in change in the management of 31% with 95% CI of 21.06 to 42.04 and odds ratio of 2.68 (1.77 to 4.06) related to hemodynamic, airway and respiratory perioperative management. CONCLUSIONS: Since most of the articles included in this review are observational studies with inherent design concerns, there is an urgent requirement for randomized controlled trials in this area. As anesthesiologists become more comfortable and knowledgeable in ultrasound applied to the perioperative support, emergence of protocols with multidisciplinary ultrasound exploration is expected to allow an improvement in perioperative safety.

A collaborative clinical simulation model for the development of competencies by medical students.

Herein, we present a new collaborative clinical simulation (CCS) model for the development of medical competencies by medical students. The model is a comprehensive compendium of published considerations and recommendations on clinical simulation (CS) and computer-supported collaborative learning (CSCL). Currently, there are no educational models combining CS and CSCL. The CCS model was designed for the acquisition and assessment of clinical competencies; working collaboratively and supported by technology, small groups of medical students independently design and perform simulated cases. The model includes four phases in which the learning objectives, short case scenarios, materials, indices, and the clinical simulation are designed, monitored, rated and debriefed.

La utilización del Mini Clinical Evaluation Exercise (mini-CEX) en estudiantes de medicina Josep / No disponible

En los últimos años se recomienda el uso de instrumentos que evalúen la adquisición de habilidades clínicas en el contexto de la práctica clínica. Entre los instrumentos más recomendados se encuentra el Mini Clinical Evaluation Exercise (mini-CEX), desarrollado inicialmente para la evaluación de médicos residentes, y que ha demostrado una buena fiabilidad y validez. Aunque se ha utilizado en estudiantes de medicina, no se dispone de un análisis completo de la experiencia acumulada. Para la presente revisión se realizó en septiembre de 2014 la búsqueda de los artículos indizados en Medline, Embase, Biosis Previews y Current Contents. Se seleccionaron aquellos artículos que incluían los términos ‘mini clinical evaluation exercise’, ‘mini-CEX’ o ‘mcex’. Tras la eliminación de los duplicados se obtuvo un total de 168 artículos. Se revisaron los que se referían al uso del mini-CEX en estudiantes de medicina (n = 34) y se analizaron a fondo aquellos que contenían datos empíricos (n = 21). Los estudios llevados a cabo en estudiantes de medicina confirman que el miniCEX es un instrumento útil y factible para evaluar las habilidades clínicas de los estudiantes de medicina y que posee propiedades psicométricas adecuadas en términos de validez y fiabilidad. Asimismo, es bien aceptado por estudiantes y tutores y puede ser usado tanto con finalidades formativas como sumativas. La importancia de dar un feedback adecuado y la concordancia de las puntuaciones de los tutores son los puntos más críticos en la implementación del mini-CEX en estudiantes de grado

In recent years the use of work-based assessments has been increasingly recommended to evaluate clinical skills, as they allow for the evaluation of performance in the context of clinical practice. Among these tools, one of the most recommended is the Mini Clinical Evaluation Exercise (mini-CEX). This method was developed to be used in physicians-in-training and has good reliability and validity properties. Even when mini-CEX has also been used in medical students, a review of its value in undergraduates is lacking. This review is mainly based on a search of the articles indexed in Medline, Embase, Biosis Previews or Current Contents databases in September 2014. References were selected for articles which included the following terms: ‘mini clinical evaluation exercise’, ‘mini-CEX’ or ‘mcex’. Duplicates between databases were eliminated; as a result, a total of 168 articles were retrieved. Articles that dealt with the use of mini-CEX in medical students were reviewed (n = 34) and those that included empirical data were further analysed (n = 21). These studies confirm that this tool is useful and feasible to assess medical students and has adequate psychometric properties in different domains of validity and reliability. It is also well-accepted by students and tutors and may be used both in formative and summative evaluations. The present review shows that mini-CEX is also a good tool to assess clinical skills of medical students. The importance of giving adequate feedback and the alignment in the scores of tutors are the most critical points to be considered in the implementation of mini-CEX in undergraduate students

El mini-CEX como instrumento de evaluación de la competencia clínica. Estudio piloto en estudiantes de medicina / No disponible

Introducción: La evaluación de la competencia clínica constituye un importante elemento de la formación médica. En el presente artículo se presentan los resultados de un estudio piloto para evaluar la factibilidad del empleo del Mini-Clinical Evaluation Exercise (mini-CEX) en estudiantes de grado de medicina. Sujetos y métodos: Se utilizó el mini-CEX en estudiantes de tercer, cuarto y quinto cursos de la Facultad de Medicina de la Universitat de Barcelona durante las prácticas clínicas de semiología y propedéutica, neumología/cirugía torácica y nefrología/urología en el curso académico 2013-2014. Los estudiantes completaron al menos una evaluación y participaron diversos profesores de los departamentos correspondientes. Resultados: Participaron 13 tutores y 27 estudiantes, con un total de 64 observaciones y una media de 2,4 observaciones por estudiante. El tiempo medio empleado en cada una de ellas fue de 14 min (rango: 4-60 min) y en el período de feedback, de 8,4 min (rango: 3-30 min). La satisfacción media de los estudiantes (9,2; rango: 6-10) fue superior a la de los tutores (8,8; rango: 7-10). Conclusiones: El estudio demostró la factibilidad del empleo del mini-CEX en estudiantes de medicina en cuanto al tiempo empleado para realizarlo y en la satisfacción de los participantes

Introduction: The evaluation of clinical skills is an important part of the medical training. The present article describes the results of a pilot study that was carried out to analyze the feasibility of the implementation of the Mini-Clinical Evaluation Exercise (mini-CEX) in medical students. Subjects and methods: Mini-CEX was used in students from third, fourth and fifth year of Medical School of the University of Barcelona during their clerkship in Internal Medicine, Pneumology/Thoracic surgery, Nephrology/Urology in the academic year 2013-2014. Students completed at least one encounter and several tutors from different departments participated in the study. Results: Thirteen tutors and 27 students participated, with 64 encounters and a mean of 2.4 encounters by student. The mean time of the encounters was 8.4 min (range: 4-60 min) and of the feedback period of 8.4 min (range: 3-30 min). The mean score of students’ satisfaction (9.2; range: 6-10) was higher than of the tutors (8.8; range: 7-10). Conclusions: The study showed the feasibility of mini-CEX in medical students regarding the time needed to perform it and the satisfaction of tutors and students with the experience