Future directions for simulation in healthcare: A critical review.

There was a widespread discontinuation of simulation programs during and after the COVID-19 pandemic. The objective is to explore how to facilitate greater integration of simulation in healthcare organizations. A literature review was conducted in PubMed, MEDES, IBECS and DOCUMED databases. Twenty-three articles published after the pandemic were selected, categorized in seven themes and critically reviewed. In order to consistently and fully integrate simulation into the organizational culture it is recommended to prioritize the development of new strategies that enhance the efficiency and safety of healthcare delivery. And also strategies that enhance the satisfaction and well-being of all stakeholders.

Validity and reliability of a depression, anxiety and stress scale in Cuban dental students during the COVID-19

Introduction: An indisputable consequence has to do with the psychological impact of the COVID-19 on health professionals and students. In Cuba, these psychological manifestations have scarcely been investigated, and there are no reports in the dental undergraduate program. Objective: To analyze the evidences of validity and reliability of a depression, anxiety and stress scale in Cuban dental students in the context of COVID-19. Methods: An instrumental and cross-sectional study was carried out, which included students of all years and Cuban universities. A documentary measurement instrument was validated, using its main psychometric evidence. Convergent validity was analyzed and reliability was estimated using Cronbach's alpha coefficient. Results: 301 students were included, of which 74.09 % were women and whose ages ranged from 17 to 30 years. The asymmetry and kurtosis values of all items were adequate. The confirmatory factorial analysis showed that the factorial structure of 21 items distributed in 3 factors is satisfactory. The goodness of fit indices was equally satisfactory. The scale factors are directly and significantly related with the Generalized Anxiety Disorder-2 (p<0.01) and the Patient Health Questionnaire-2 (p<0.01); the scale shows evidences of convergent validity. With Cronbach's α coefficient, the scale scores were estimated to be reliable. Conclusions: The depression, anxiety and stress scale (DASS-21) in Cuban dental students in the context of COVID-19 turned out to be valid and reliable, in addition to allowing the evaluation of the dimensions of these three factors in this sector of the society.

Introducción: La COVID-19 produce un innegable impacto psicológico en estudiantes y profesionales de la salud. En Cuba, estas manifestaciones psicológicas apenas se han estudiado, y no existen informes al respecto en el programa de pregrado que corresponde a estomatología. Objetivo: Analizar las evidencias sobre validez y confiablidad de una escala para medir depresión, ansiedad y estrés en estudiantes de estomatología cubanos en el contexto de la COVID-19. Métodos: Se realizó un estudio instrumental y trasversal con estudiantes de todos los cursos y universidades cubanas. Se validó un instrumento de medición de tipo documental mediante su principal evidencia psicométrica. Se analizó la validez convergente y se estimó la confiabilidad mediante el coeficiente alfa de Cronbach. Resultados: Se incluyeron 301 estudiantes, el 74,09 % de los cuales son mujeres y cuyas edades oscilan de diecisiete a treinta años. Los valores de la asimetría y la curtosis de todos los ítems fueron adecuados. El análisis factorial confirmatorio mostró que la estructura factorial de los 21 ítems distribuidos en tres factores es satisfactoria. La bondad de los índices de ajuste también fue satisfactoria. Los factores de la escala están directa y significativamente relacionados con la escala para medir el trastorno de ansiedad gefneralizas-2 (p<0,01) y con el cuestionario sobre salud del paciente-2. La escala muestra evidencias de validez convergente. El coeficiente alfa de Cronbach permitió estimar la confiablidad de las puntuaciones del instrumento. Conclusiones: La escala para medir depresión, ansiedad y estrés (DASS-21) aplicada a estudiantes de estomatología cubanos en el contexto de la COVID-19 resulto ser válida y confiable, además de permitir la evaluación de las dimensiones de estos tres factores en este sector de la sociedad.

Occurrence of Leishmania infantum in Wild Mammals Admitted to Recovery Centers in Spain.

Zoonotic leishmaniasis caused by Leishmania infantum is distributed worldwide and affects humans and domestic and wild mammals. In Europe, specifically in the Mediterranean basin, leishmaniasis is endemic due to the concurrence of the phlebotomine vectors and reservoir mammals, including carnivorous wildlife species and other less studied wild species. In this article, spleen, skin, and eye or oral swabs taken from 134 wild mammals admitted to five wildlife recovery centers in Spain were used. PCR employing fragments of the Repeat region, ITS1, and SSUrRNA were used for detection, and positive samples were processed for sequencing. L. infantum was detected in three out of the nine species analyzed, including European hedgehog, European badger, and red squirrel, with percentages ranging from 11.53 to 35.71%, depending on the species. Most of the species showed higher percentages of positivity in spleen samples than in skin samples. A small number of animals from the remaining six species tested negative, including Algerian hedgehog, stone marten, least weasel, garden dormouse, western polecat, and Egyptian mongoose. Hedgehogs and badgers are good candidates for consideration as epidemiological sentinels and pose a higher risk as potential reservoirs of leishmaniasis based on their percentage of infection and wide distribution.

Prevalence of Oestrus ovis in small ruminants from the eastern Iberian Peninsula. A long-term study.

Oestrus ovis is an obligate parasite that causes myiasis in domestic ruminants, being commonly found in the Mediterranean area. From 2009 to 2019 a total of 3476 heads of culling sheep and goats from the Mediterranean coast of Spain were examined for the presence of O. ovis. The total prevalence was 56.3%, significantly higher in sheep than in goats (61.2% and 43%, respectively). Differences were found in the mean annual prevalence, with the highest value being registered in 2018 (61.7%) and the lowest in 2012 (50.3%). Autumn, for sheep, and winter, for goats, were the seasons with the highest number of infested specimens. Temperature, but not rainfall, was found to be associated with prevalence (p < 0.05). Most L1 were found in the anatomic region I (septum, meatus, and ventral conchae), while L2 and L3 were mainly located in regions II (nasopharynx, ethmoid labyrinth, and dorsal conchae), and III (sinuses). The overall intensity was 12.8 larvae per head, significantly higher in sheep (13.3) than in goats (3.5). Our results confirm the high prevalence of O. ovis in sheep and goats in this geographic area over the last decade, with the trend increasing in recent years in association with higher mean temperatures.

Captive Breeding and Trichomonas gallinae Alter the Oral Microbiome of Bonelli's Eagle Chicks.

Bonelli's eagle (Aquila fasciata) is an endangered raptor species in Europe, and trichomonosis is one of the menaces affecting chicks at nest. In this paper, we attempt to describe the oral microbiome of Bonelli's eagle nestlings and evaluate the influence of several factors, such as captivity breeding, Trichomonas gallinae infection, and the presence of lesions at the oropharynx. The core oral microbiome of Bonelli's eagle is composed of Firmicutes, Bacteroidota, Fusobacteria and Proteobacteria as the most abundant phyla, and Megamonas and Bacteroides as the most abundant genera. None of the factors analysed showed a significant influence on alfa diversity, but beta diversity was affected for some of them. Captivity breeding exerted a high influence on the composition of the oral microbiome, with significant differences in the four most abundant phyla, with a relative increase of Proteobacteria and a decrease of the other three phyla in comparison with chicks bred at nest. Some genera were more abundant in captivity bred chicks, such as Escherichia-Shigella, Enterococcus, Lactobacillus, Corynebacterium, Clostridium and Staphylococcus, while Bacteroides, Oceanivirga, Peptostreptococcus, Gemella, Veillonella, Mycoplasma, Suttonella, Alloscardovia, Varibaculum and Campylobacter were more abundant in nest raised chicks. T. gallinae infection slightly influenced the composition of the microbiome, but chicks displaying trichomonosis lesions had a higher relative abundance of Bacteroides and Gemella, being the last one an opportunistic pathogen of abscess complications in humans. Raptor's microbiomes are scarcely studied. This is the first study on the factors that influence the oral microbiome of Bonelli's eagle.

Factores asociados a la publicación científica de estudiantes de Estomatología de siete universidades cubanas / Scientific production on Orthodontics published in biomedical journals belonging to Cuban medical universities

La publicación científica es la etapa final del ciclo investigativo, por lo que se deben estudiar los factores que se relacionan con su realización en el pregrado. El objetivo del estudio fue determinar los factores asociados a la publicación científica de estudiantes de Estomatología de siete universidades cubanas. Se diseñó un estudio multicéntrico, observacional y transversal con análisis de datos secundarios. Se investigó acerca del logro de las publicaciones científicas, otras variables socioeducativas y de participación en temas científicos. Se obtuvieron las razones de prevalencias ajustadas, los intervalos de confianza a 95 por ciento (IC 95 por ciento) y los valores p, mediante modelos lineales generalizados. De los 738 alumnos encuestados, el 9,3 por ciento declaró haber publicado, al menos, un artículo científico. El promedio de publicaciones fue de 9 por ciento entre todas las universidades; el porcentaje más elevado fue el de la Universidad de Ciencias Médicas de Camagüey (19 por ciento) y el más bajo el de la Universidad de Ciencias Médicas de Granma (4 por ciento) hubo una mayor frecuencia de publicación científica entre los que habían participado en proyectos (RPa: 1,85; IC 95 por ciento: 1,18-2,88; p =0,007) y habían obtenido premios en eventos científicos (RPa: 5,66; IC 95 por ciento: 2,16-14,85; p < 0,001), ajustando por cuatro variables. Se concluye que existió un bajo porcentaje de alumnos que publicaron, lo cual se asoció con la participación en proyectos y la obtención de premios en eventos científicos(AU)

Scientific publication is the final stage of the investigative cycle, so the factors that are related to its elaboration in the undergraduate should be studied. The objective of the study was to determine the associated factors with the scientific publication of Dentistry students from seven Cuban universities. A multicenter, observational, cross-sectional study with secondary data analysis was designed. The achievement of scientific publications, other socio-educational variables and participation in scientific matters were investigated. Adjusted prevalence ratios, 95percent confidence intervals (95percent CI) and p-values were obtained using generalized linear models. Seven hundred thirty-eight (738) students were surveyed; 9.3percent of them declared having published at least one scientific article. The average number of publications was 9percent among all universities; the highest percentage was that of Universidad de Ciencias Médicas de Camagüey (19%) and the lowest that of Universidad de Ciencias Médicas de Granma (4percent). There was a higher frequency of scientific publication among those who had participated in projects (RPa: 1.85; 95percent CI: 1.18-2.88; p =0.007) and had obtained prizes in scientific events (RPa: 5.66 95percent CI: 2.16-14.85, p < 0.001). It is concluded that there was low percentage of students who published, which was associated with participation in projects and obtaining prizes in scientific events(AU)

[Validity and Reliability of the Wong-Law Emotional Intelligence Scale (WLEIS) in Cuban Dental Students in COVID-19 Times]. / Validez y confiabilidad de la Wong-Law Emotional Intelligence Scale (WLEIS) en estudiantes cubanos de Estomatología en tiempos de COVID-19.

Introduction: The pandemic produced by SARS-CoV-2 impacted on educative systems, which justifies the necessity of research about the emotional capacities of the university students to face the challenges that COVID-19 imposes. Objective: To analyze the evidences of validity and reliability of the Wong-Law Emotional Intelligence Scale (WLEIS) in Cuban dental students. Materials and methods: Cross-sectional study with instrumental design. The scale was administered through a virtual questionnaire and later distributed by means of social networks to 307 students (81 male and 226 female). A confirmatory factorial analysis was performed and the intern consistency and the relation between the scale and other variables were evaluated. Results: Through the confirmatory factorial analysis, the model of four correlationated factors was evaluated and an adequate adjust was found, χ2(98) = 303.1, P < .001, CFI = 0.948, TLI = 0.937, RMSEA = 0.083 and SRMR = 0.064. The results of the Omega intern consistency are ωSEA = 0.84, ωOEA = 0.77, ωUOE = 0.83 and ωUROE = 0.91. With respect to the relation of WLEIS with other variables, we had correlations ranging from 0.22 and 0.51 with general well-being, and inverse correlations ranging from -1 and -0.29 of three of its dimensions with depression, showing evidences of convergent and discriminant validity. Conclusion: The WLEIS in Cuban dental students in COVID-19 times resulted be valid and reliable.

Avian Oropharyngeal Trichomonosis: Treatment, Failures and Alternatives, a Systematic Review.

Oropharyngeal avian trichomonosis is a potentially lethal parasitic disease that affects several avian orders. This review is focused on the disease treatments since prophylactic treatment is prohibited in most countries and resistant strains are circulating. A systematic review following the PRISMA procedure was conducted and included 60 articles. Successful and non-toxic treatments of avian oropharyngeal trichomonosis started with enheptin, a drug replaced by dimetridazole, metronidazole, ornidazole, carnidazole and ronidazole. Administration in drinking water was the most employed and recommended method, although hierarchy of the avian flocks and palatability of the medicated water can interfere with the treatments. Besides pigeons, treatments with nitroimidazoles were reported in budgerigars, canaries, finches, bald eagles, a cinereous vulture and several falcon species, but resistant strains were reported mainly in domestic pigeons and budgerigars. Novel treatments include new delivery systems proved with traditional drugs and some plant extracts and its main components. Ethanolic extracts from ginger, curry leaf tree and Dennettia tripetala, alkaloid extracts of Peganum harmala and essential oils of Pelargonium roseum and some Lamiaceae were highly active. Pure active compounds from the above extracts displayed good anti-trichomonal activity, although most studies lack a cytotoxicity or in vivo test.

Conceptos para la identificación y abordaje dela gangrena de Fournier / Concepts for the identification and approach of Fournier's gangrene

Introducción. La gangrena de Fournier es una fasciitis necrosante fulminante y progresiva, de origen infeccioso sinérgico polimicrobiano, que afecta las regiones perianal, perineal, genital y abdominal. Su incidencia es mayor en hombres, la edad promedio de presentación reportada está en los 54,7 ± 15,6 años, su mortalidad es del 3-67 %, aunque hay estudios que informan una mortalidad en hombres del 7,5 % y en las mujeres del 12,8 %. Métodos. Se hizo una revisión de la literatura en las bases de datos y fuentes de información PubMed, Scielo y Google Scholar, publicados entre 1950 y 2018, utilizando términos como "fournier gangrene", "fasciitis, necrotizing", "wound infection", "therapy"[subheading] y "GRADE approach". Se realizó una segunda revisión para artículos latinoamericanos en español hasta 2020 usando las mismas fuentes y palabras claves. Resultados. Se seleccionaron artículos que reportaron definiciones, datos históricos, actualizaciones en diagnóstico y terapéutica para hacer una revisión actualizada. Para el uso de las imágenes se solicitó consentimiento informado. Conclusión. La gangrena de Fournier continúa siendo una emergencia quirúrgica potencialmente letal. Gracias a las investigaciones realizadas se ha avanzado en su tratamiento, mejorando los resultados. Es importante analizar los factores de riesgo en cada paciente y su etiología para establecer el tratamiento más adecuado.

Introduction. Fournier's gangrene is a fulminant and progressive necrotizing fasciitis of synergistic polymicrobial infectious origin that affects the perianal, perineal, genital and abdominal regions. Its incidence is greater in men, the average age of reported presentation is 54.7 ± 15.6 years; its mortality is 3-67%, although there are studies that report a mortality of 7.5% in men and 12.8% in women. Methodology. A review of the literature was carried out in the databases and information sources: PubMed, Scielo, and Google Scholar, published between 1950 and 2018 using terms such as "Fournier Gangrene", "Fasciitis, Necrotizing", Wound Infection, "therapy"[Subheading] and "GRADE Approach". A second review was performed for articles in Latin American Spanish up to 2020 using the same sources and keywords. Results. Articles that reported definitions, historical data, diagnostic and therapeutic updates were selected, performing an updated review. Informed consent was requested for the use of images.Conclusion. Fournier's gangrene continues to be a potentially lethal surgical emergency, thanks to the research carried out, progress has been made in its treatment, improving results. It is important to analyze the risk factors for each patient and its etiology to establish the most appropriate treatment

Factores asociados a la procrastinación académica en estudiantes de Estomatología de siete universidades cubanas / Factors associated to academic procrastination in dental students from seven Cuban universities

RESUMEN Introducción: La procrastinación, que es la acción de posponer determinadas actividades, impacta negativamente en el ámbito académico, de ahí la necesidad de investigar sobre el tema. Objetivo: Determinar algunos factores asociados a la procrastinación académica en estudiantes cubanos de Estomatología. Métodos: Estudio multicéntrico, observacional, analítico y transversal, realizado en 7 universidades cubanas. Se investigó la procrastinación con una escala validada y se obtuvieron razones de prevalencias ajustadas (RPa), intervalos de confianza al 95 % (IC 95 %) y valores p mediante modelos lineales generalizados. Resultados: De los 738 estudiantes, el 17 % y el 14% postergan los trabajos y las lecturas de los cursos que no le gustan; respectivamente. En el modelo multivariado, se encontró que estuvo asociado a una mayor frecuencia de procrastinación el tener más edad (RPa: 1,16; IC 95 %: 1,05-1,29; p= 0,003) y contar con el apoyo de un tutor (RPa: 1,81; IC 95 %: 1,24-2,64; p= 0,002). Por el contrario, hubo menos procrastinación entre los que habían publicado al menos un artículo científico (RPa: 0,62; IC 95 %: 0,40-0,97; p= 0,036); ajustado por 3 variables. Conclusiones: La edad, el tener un tutor y la publicación de artículos científicos son factores asociados a la procrastinación académica en estudiantes cubanos de Estomatología.

ABSTRACT Introduction: Procrastination, which is the action of postponing certain activities, has a negative impact on the academic field, hence the need to investigate the subject. Objective: To determine some factors associated with academic procrastination in Cuban dental students. Methods: Multicenter, observational, analytical and cross-sectional study, performed in 7 Cuban universities. Procrastination was investigated with a validated scale and adjusted prevalence ratios (aPR), 95 % confidence intervals (95 % CI), and p-values ​​were obtained using generalized linear models. Results: Of the 738 students, 17 % and 14 % put off course work and reading that they don't like; respectively. In the multivariate model, it was found that being older (aPR: 1,16; 95 % CI: 1,05-1,29; p= 0,003) and having the support of a tutor (aPR: 1,81; 95 % CI: 1,24-2,64; p= 0,002) were factors associated with a higher frequency of procrastination. On the contrary, there was less procrastination among those who had published at least one scientific article (aPR: 0,62; 95 % CI: 0,40-0,97; p= 0,036); adjusted for 3 variables. Conclusions: Age, having a tutor and the publication of scientific articles were factors associated with academic procrastination in Cuban dental students.

Prevalence of Toxocara Eggs in Public Parks in the City of Valencia (Eastern Spain).

Toxocara spp. is one of the most common zoonotic geohelminths in the world. Its infections are associated with the accidental ingestion of contaminated soil and affecting, especially children. In this study, feces, and soil samples from 14 public parks in the city of Valencia were analyzed. The Telemann method and a modified version of a sieving technique were used to process feces and soil, respectively. None of the fecal samples and 10.9% of soil samples from five parks (35.7%) tested positive for the presence of Toxocara eggs. The most contaminated areas were the canine sanitary parks (30.8% of the samples), followed by socialization areas for dogs (9.7%); no positive samples were found at children's playgrounds. Our results suggest that most pets in Valencia are periodically dewormed, although additional preventive measures should be applied, since the risk of infection exists probably due to the presence of stray dogs and feral cats.

Depresión, ansiedad y estrés en estudiantes cubanos de Estomatología durante el rebrote de la COVID-19

RESUMEN Introducción: La pandemia de la COVID-19 ha incidido negativamente en la salud mental de los estudiantes y es necesario evaluar dichas manifestaciones psicológicas. Objetivo: Identificar los niveles de depresión, ansiedad y estrés en estudiantes cubanos de Estomatología durante el rebrote de la COVID-19. Métodos: Estudio observacional, descriptivo y transversal. Se utilizó la escala Depression, Anxiety and Stress, validada para el pregrado de Estomatología en Cuba. La escala estuvo disponible en un formulario de Google. Se utilizaron las redes sociales Facebook, Telegram y WhatsApp para invitar a los estudiantes. Se categorizó a la depresión, ansiedad y el estrés según puntos de corte y se obtuvieron estadísticos descriptivos. Resultados: De los 329 encuestados de 16 universidades, el 74,16 % padecieron de depresión, ansiedad 63,22 % y estrés 68,69 %. De manera general, el 55,62 % padecieron de depresión, ansiedad y estrés. Conclusiones: Se identificaron síntomas de depresión, ansiedad y estrés y las categorías severas son las de mayor prevalencia en el estudiantado de Estomatología.

ABSTRACT Introduction: The COVID-19 pandemic has had a negative impact on the mental health of students and is necessary to evaluate these psychological manifestations. Objective: To identify the levels of depression, anxiety and stress in Cuban Stomatology students during the outbreak of COVID-19. Methods: Observational, descriptive and cross-sectional study. The Depression, Anxiety and Stress scale, validated for the undergraduate of Dentistry in Cuba was used. The scale was available in a Google form. Facebook, Telegram and WhatsApp social networks were used to invite the students. Depression, anxiety and stress were categorized according to cut-off points and descriptive statistics were obtained. Results: Of the 329 surveyed from 16 universities, 74,16 % suffered from depression, anxiety 63,22 % and stress 68,69 %. In general, 55,62 % suffered from depression, anxiety and stress. Conclusions: Symptoms of depression, anxiety and stress were identified, being the severe categories the most prevalent in the students of Dentistry.

Evidencias de validez y confiabilidad de una escala de burnout en estudiantes cubanos de Estomatología

RESUMEN Introducción: En Cuba, el síndrome de burnout ha sido muy poco investigado, de ahí la necesidad de contar con instrumentos válidos y confiables para su estudio. Objetivo: Analizar las evidencias de validez y confiabilidad del Maslach Burnout Inventory-Students Survey en estudiantes cubanos de Estomatología. Métodos: Estudio instrumental, transversal y multicéntrico, que incluyó estudiantes de 7 universidades cubanas. A partir de un instrumento en español validado en estudiantes colombianos, se realizó un análisis factorial confirmatorio; se utilizó el modelamiento de ecuaciones estructurales y se calculó la consistencia interna con el coeficiente α de Cronbach. Resultados: Se incluyó a 738 participantes, de los cuales el 63,69 % fueron mujeres y la media de la edad fue 21,67 ± 1,70 años. De la escala inicial de 15 ítems distribuidos en 3 factores, el análisis factorial sugirió eliminar los ítems 2, 4, 5 y 10. El modelo final quedó conformado por 11 ítems, 2 para el factor 1 (Agotamiento emocional), 4 para el factor 2 (Despersonalización) y 5 para el factor 3 (Falta de realización personal). Se obtuvo un coeficiente α de Cronbach de 0,81 (IC 95 % = 0,78-0,83), lo cual indica que la consistencia interna del instrumento es buena. Conclusiones: Se validó una escala de burnout académico de 11 ítems, la cual posee evidencias de validez y confiabilidad adecuadas para evaluar el síndrome de burnout en estudiantes cubanos de Estomatología.

ABSTRACT Introduction: In Cuba, the burnout syndrome has been scarcely investigated, hence the need for valid and reliable instruments for its study. Objective: To analyze the evidence of validity and reliability of the Maslach Burnout Inventory-Students Survey in Cuban dental students. Methods: Instrumental, cross-sectional and multicenter study, which included students from seven Cuban universities. Using an instrument in Spanish validated in Colombian students, a confirmatory factor analysis was performed, structural equation modeling was used, and internal consistency was calculated with Cronbach's α coefficient. Results: 738 participants were included, of which 63,69 % were women and the mean age was 21,67 ± 1,70 years. From the initial scale of 15 items distributed in three factors, the factor analysis suggested eliminating items 2, 4, 5 y 10. The final model was made up of 11 items, two for factor 1 (Emotional exhaustion), four for factor 2 (Depersonalization) and five for factor 3 (Lack of personal accomplishment). A Cronbach's α coefficient of 0,81 (95 % CI = 0,78-0,83) was obtained, which indicates that the internal consistency of the instrument is good. Conclusions: An 11-item academic burnout scale was validated, which has evidence of validity and adequate reliability to evaluate the burnout syndrome in Cuban dental students.

Validity and reliability of an academic procrastination scale in Cuban dental students / Validez y confiabilidad de una escala de procrastinación académica en estudiantes cubanos de Estomatología

Introduction: Academic procrastination can have a negative impact on student education and professional performance, hence the need for valid and reliable instruments for its study. Objective: To analyze the evidence of validity and reliability of an academic procrastination scale in Cuban dental students. Methods: Instrumental, cross-sectional and multicenter study, which included students from seven Cuban universities. Using an instrument in Spanish validated in Peruvian students, a confirmatory factor analysis was performed, structural equation modeling was used, and internal consistency was calculated with Cronbach's α coefficient. Results: 684 participants were included, of which 63,45 % were women and the mean age was 22,0 ± 1,71 years. From the initial scale of 12 items distributed in 2 factors, the factor analysis suggested eliminating item 5. The final model was made up of 11 items, 8 for factor 1 (Academic self-regulation) and 3 for factor 2 (Postponement of activities). A Cronbach's α coefficient of 0,786 (95 % CI = 0,75 ­ 0,81) was obtained, which indicates that the internal consistency of the instrument is good. Conclusions: An 11-item academic procrastination scale was validated (EPA-11-Odonto), which has evidence of validity and adequate reliability to evaluate the construct in Cuban dental students.

Introducción: La procrastinación académica puede repercutir negativamente en la formación estudiantil y el desempeño profesional, de allí la necesidad de contar con instrumentos válidos y confiables para su estudio. Objetivo: Analizar las evidencias de validez y confiabilidad de una escala de procrastinación académica en estudiantes cubanos de Estomatología. Métodos: Estudio instrumental, transversal y multicéntrico, que incluyó estudiantes de siete universidades cubanas. A partir de un instrumento en español validado en estudiantes peruanos, se realizó un análisis factorial confirmatorio, se utilizó el modelamiento de ecuaciones estructurales y se calculó la consistencia interna con el coeficiente α de Cronbach. Resultados: Se incluyó a 684 participantes, de los cuales el 63,45 % fueron mujeres y la media de la edad fue 22,0 ± 1,71 años. De la escala inicial de 12 ítems distribuidos en 2 factores, el análisis factorial sugirió eliminar el ítem 5. El modelo final quedó conformado por 11 ítems, 8 para el factor 1 (Autorregulación académica) y 3 para el factor 2 (Postergación de actividades). Se obtuvo un coeficiente α de Cronbach de 0,786 (IC 95 % = 0,75 ­ 0,81), lo cual indica que la consistencia interna del instrumento es buena. Conclusiones: Se validó una escala de procrastinación académica de 11 ítems (EPA-11-Odonto), la cual posee evidencias de validez y confiabilidad adecuadas para evaluar el constructo en estudiantes cubanos de Estomatología.

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

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

La docencia médica cubana en tiempos de COVID-19

RESUMEN La situación epidemiológica generada por la aparición del nuevo coronavirus SARS-CoV-2 ha desatado una emergencia de salud pública mundial y la búsqueda de estrategias en las cuestiones relacionadas con la educación médica en esta etapa. El objetivo fue delimitar las particularidades de la educación médica superiora cubana en los tiempos de COVID-19. El método fue un enfoque cualitativo sustentado en una concepción teórica que permitió identificar las estrategias trazadas por la docencia médica cubana en el período de la pandemia por el virus SARS-CoV-2. Se concluyó que la suspensión de actividades presenciales, la docencia a través de procesos de virtualización, la modificación del currículo y las actividades de los estudiantes fueron las estrategias fundamentales de la enseñanza y que la participación del estudiantado en la pesquisa activa constituyó la esencia en la prevención de la COVID-19 en Cuba.

ABSTRACT The epidemiological situation generated by the appearance of the new SARS-CoV-2 coronavirus has unleashed a global public health emergency and the search for strategies in matters related to medical education at this stage. The objective was to delimit the particularities of Cuban higher medical education in the times of COVID-19. The method was a qualitative approach based on a theoretical conception that allowed identifying the strategies outlined by Cuban medical teaching in the period of the SARS-CoV-2 virus pandemic. It was concluded that the suspension of face-to-face activities, teaching through virtualization processes, the modification of the curriculum and the activities of the students were the fundamental strategies of teaching and that the participation of the student body in the active research constituted the essence in the prevention of COVID-19 in Cuba.

RESUMO A situação epidemiológica gerada pelo surgimento do novo coronavírus SARS-CoV-2 desencadeou uma emergência global de saúde pública e a busca por estratégias em assuntos relacionados à educação médica nesta fase. O objetivo foi delimitar as particularidades da educação médica superior cubana em tempos de COVID-19. O método foi uma abordagem qualitativa baseada em uma concepção teórica que permitiu identificar as estratégias delineadas pelo ensino médico cubano no período da pandemia do vírus SARS-CoV-2. Concluiu-se que a suspensão das atividades presenciais, o ensino por meio de processos de virtualização, a modificação do currículo e das atividades dos alunos foram as estratégias fundamentais de ensino e que a participação do corpo discente na pesquisa ativa constituiu o essência na prevenção do COVID-19 em Cuba.

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

Objetivo:Explorar y analizar el uso de la simulación clínica para la formación y/o capacitación de equipos clínicos en el manejo y resolución de conflictos en salud, mediante una revisión sistemática exploratoria.Método:Se realizó una búsqueda con los términos: clinical simulation OR patientsimulation OR simulation training OR high fidelity simulation training AND conflict OR conflict resolution en las bases de datos MEDLINE, LILACS, Cochrane, Scielo, PubMed, CINHAL, ScienceDirect, MEDES, IBECS y DOCUMED. Los límites fueron el uso de la simulación clínica orientado a la formación en el manejo de conflictos en estudiantes o profesionales de la salud, con uso de escenarios clínicos, excluyendo aquellos con más de 20 años. No se consideró excluyente el uso o no de debriefing, ni el uso de simulación junto a otras metodologías. Se realizó un análisis cualitativo.Resultados:Se obtuvieron diez artículos, mayoritariamente cuasi-experimentales, en los cuales la simulación clínica se utiliza prioritariamente de forma interprofesional para la capacitación en manejo de conflictos clínicos, en conjunto con otras metodologías tales como role play, práctica reflexiva y uso de recursos audiovisuales, lo cual sugiere aumentar su efectividad. Se han recreado situaciones como discrepancia en la toma de decisiones y manejo de errores médicos, buscando aplicar competencias de mediación, comunicación y habilidades emocionales, entre otras, seguidas de debriefing. La aplicación de escalas validadas y métodos convencionales revelan un impacto positivo en la satisfacción, percepción y aprendizaje de los participantes, así como en la transferencia y disminución de errores atribuidos a la atención.

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

[Interprofessional team training with in situ simulation to improve the quality of cardiopulmonary resuscitation]. / Entrenamiento de equipos interprofesionales con simulación in situ para mejorar la calidad de la reanimación cardiopulmonar.

INTRODUCTION: In situ simulation facilitates training in clinical settings under similar emotional pressure that occurs in real life situations. The objective of the present study was to assess the feasibility, implementation, facilitators self-confidence and teaching challenges of a training program of cardiopulmonary resuscitation through an in situ simulation plan. METHOD: A training program was designed for the facilitators. The number of professionals trained and in situ simulations performed were recorded, as well as the logistical challenges. An ad hoc survey was designed to assess facilitators self-confidence and educational challenge which were classified using the debriefing assessment for simulation in healthcare©. RESULTS: During a period of 3 years, 95 trained facilitators implemented 378 in situ simulations that allowed to train 1281 nursing professionals working at inpatient units. Integration of in situ simulations with daily activities and availability of facilitators were the main logistical challenges. Stablishing and maintaining a stimulating learning environment and structuring the debriefing in an organized way were the main educational challenges. CONCLUSIONS: In situ simulation helps to train the coordination of nursing teams taking care of patients in cardiorespiratory arrest and to identify the risks that may affect patient safety. Identifying the educational challenges during the implementation of in situ simulation facilitates the design of specific educational and monitoring strategies.

La docencia médica cubana en tiempos de COVID-19 / Cuban medical teaching in times of COVID-19

La situación epidemiológica generada por la aparición del nuevo coronavirus SARS-CoV-2 ha desatado una emergencia de salud pública mundial y la búsqueda de estrategias en las cuestiones relacionadas con la educación médica en esta etapa. El objetivo fue de limitar las particularidades de la educación médica superior cubana en los tiempos de COVID-19. El método fue un enfoque cualitativo sustentado en una concepción teórica que permitió identificar las estrategias trazadas por la docencia médica cubana en el período de la pandemia por el virus SARS-CoV-2. Se concluyó que la suspensión de actividades presenciales, la docencia a través de procesos de virtualización, la modificación del currículo y las actividades de los estudiantes fueron las estrategias fundamentales de la enseñanza y que la participación del estudiantado en la pesquisa activa constituyó la esencia en la prevención de la COVID-19 en Cuba(AU)

The epidemiological situation generated by the appearance of the new SARS-CoV-2 coronavirus has unleashed a global public health emergency and the search for strategies in matters related to medical education at this stage. The objective was to delimit the particularities of Cuban higher medical education in the times of COVID-19. The method was a qualitative approach based on a theoretical conception that allowed identifying the strategies outlined by Cuban medical teaching in the period of the SARS-CoV-2 virus pandemic. It was conclud ed that the suspension of face-to-face activities, teaching through virtualization processes, the modification of the curriculum and the activities of the students were the fundamental strategies of teaching and that the participation of the student body in the active research constituted the essence in the prevention of COVID-19 in Cuba(EU)