A Novel Standardized Morbidity and Mortality Process to Promote Discourse, Improve Education, and Facilitate Practice Change: The M-PROVE Model.

INTRODUCTION: The morbidity and mortality conference is essential to medical education and quality improvement. Ideally, the conference is inclusive, judgment-free, and focused on practice improvement. In reality, it may not meet these goals. We reimagined the process by standardizing presentations and creating an oversight committee to improve the perceived value of the conference and identify opportunities for improvement. This study evaluates the subjective impact of the redesigned process at our institution and provides a blueprint for our reproducible model. METHODS: We created a faculty and resident committee to review all submitted cases, implemented a standardized presentation template and moderating structure, and tracked quality improvement measures from proposed improvement initiatives. Attitudes toward the conference, including perceived quality/relevance, identification of potential systems changes, inclusiveness, and educational value, were assessed among faculty and trainees using pre- and postintervention Likert-style surveys. RESULTS: Of 45 eligible department members, 41 (91%) completed the preintervention and 36 (80%) completed the postintervention survey. We found a statistically significant improvement in all questions between pre- and postintervention surveys except on the question about the conference environment being nonthreatening, which also improved but was not statistically significant. The overall average answer improved on the postintervention survey compared to the preintervention survey (3.36 vs 4.20, P < .001). These trends were similar regardless of attendee role and gender. CONCLUSIONS: Redesigning and standardizing the morbidity and mortality conference with greater attention to education, inclusion, systems change, and quality improvement improves the attitudes of conference attendees and increases the perceived value of the conference.

Teaching strategies to develop skills to address social inequalities in nursing education: A scoping review.

OBJECTIVES: to identify teaching strategies for developing skills to address social inequalities in nursing education. DESIGN: Following the Joanna Briggs Institute and PRISMA-ScR guidelines, a scoping review was performed to answer the following research question: "What are the teaching strategies employed to develop nurses' skills to address social inequalities?" DATA SOURCES: Bibliographical search was conducted seven electronic databases until December 29, 2020, and updated on March 25, 2022. Papers published in Portuguese, English, and Spanish on competence and professional practice, social inequality, education/training, and nursing were included. REVIEW METHODS: Seven reviewers screened the articles by reading titles and abstracts. Studies on teaching strategies used to develop nurses' skills to address social inequalities were included. Of the 1137 articles found, 61 were selected by the first screening, and 23 were included in the final sample. Data were analyzed and summarized as a narrative. RESULTS: The included papers were published between 2000 and 2020, predominantly in the United States. Curricular and learning strategies, including service, experience, and interactive, were the most common, followed by university programs and civil society initiatives. Courses, classes, debates, and practical activities predominated as teaching activities. Teaching techniques focus on resources such as posters, videos, workshops, and seminars. CONCLUSIONS: This review identified teaching strategies used to develop nurses' skills to address social inequalities. Curricular initiatives, learning strategies, university programs and civil society initiatives can expand students' understanding of social inequalities and be used to develop skills.

Simulação virtual sobre amamentação e lesões mamilo-areolares: desenvolvimento e validação de protótipo / Simulación virtual sobre lactancia y lesiones en el pezón y areola: elaboración y validación de prototipo / Virtual simulation on breastfeeding and nipple-areolar lesions: prototype development and validation

Resumo Objetivo Construir e validar conteúdo e aparência do protótipo do Serious game "AleitaGame" sobre amamentação e lesões mamilo-areolares. Métodos Trata-se de um estudo realizado em três etapas, sendo elas: seleção do conteúdo através de uma Scoping Review, desenvolvimento de software educativo embasado no método de Benitti, Seara e Schlindwen, e um estudo metodológico para a validação de conteúdo, aspectos técnicos e pedagógicos, realizada com seis juízes especialistas na temática. A análise descritiva foi utilizada nesse estudo, bem como o Índice de Validade de Conteúdo para o instrumento de avaliação do conteúdo. Resultados O conteúdo dos casos clínicos e dos cenários simulados foi construído a partir de 115 estudos e foi validado por seis juízes em relação ao conteúdo e os aspectos técnico-pedagógicos, sendo esses os únicos que apresentaram sugestões no design e feedback do game. A versão final do serious game contém diferentes recursos de mídia e gamificação para uma interação com o tema que trata da técnica de amamentação como causa de lesão mamilo-areolar em lactantes. Conclusão O protótipo do "AleitaGame" foi validado por juízes especialistas e está adequado para a etapa final de desenvolvimento do software educativo.

Resumen Objetivo Elaborar y validar el contenido y la apariencia del prototipo del serious game "AleitaGame" sobre lactancia y lesiones en el pezón y areola. Métodos Se trata de un estudio realizado en tres etapas, a saber: selección de contenido a través de una Scoping Review, desarrollo del software educativo basado en el método de Benitti, Seara y Schlindwen, y un estudio metodológico para la validación del contenido, aspectos técnicos y pedagógicos, realizada con seis jueces especialistas en el tema. En este estudio se utilizó el análisis descriptivo, así como también el Índice de Validez de Contenido para el instrumento de evaluación de contenido. Resultados El contenido de los casos clínicos y de los escenarios simulados fue elaborado a partir de 115 estudios y validado por seis jueces con relación al contenido y a los aspectos técnico-pedagógicos, que fueron los únicos que presentaron sugerencias sobre el diseño y feedback del juego. La versión final del serious game contiene diferentes recursos multimedia y de gamificación para interactuar con el tema que trata sobre la técnica de lactancia como causa de lesiones en el pezón y areola en lactantes. Conclusión El prototipo de "AleitaGame" fue validado por jueces especialistas y está preparado para la etapa final de desarrollo del software educativo.

Abstract Objective To develop and validate the content and appearance of the prototype of the Serious game "AleitaGame" on breastfeeding and nipple-areolar lesions. Methods This is a study carried out in three stages, namely: content selection through a Scoping Review, development of educational software based on the Benitti, Seara and Schlindwen approach, and a methodological study for content validation, technical and pedagogical aspects, carried out with six expert judges on the subject. Descriptive analysis was used in this study, as well as the Content Validity Index for the content assessment instrument. Results The content of the clinical cases and the simulated scenarios was built from a total of 115 studies and was validated by six judges in relation to the content and the technical-pedagogical aspects, the only ones who presented suggestions in the design and feedback of the game. The final version of the serious game contains different media and gamification resources for an interaction with the theme that deals with the breastfeeding technique as a cause of nipple-areolar lesion in lactating women. Conclusion The "AleitaGame" prototype was validated by expert judges and is suitable for the final stage of educational software development.

Evaluation of therapeutic communication education for nursing students based on constructivist learning environments: A systematic review.

OBJECTIVES: Education on therapeutic communication has been emphasized in nursing education. However, few studies have used an educational framework to develop educational interventions, such as the instructional design model for Jonassen's Constructivist Learning Environments. Based on the model of Constructivist Learning Environments, this study aimed to analyze educational interventions on therapeutic communication for nursing students and propose a model for therapeutic communication education for nurse educators. DESIGN: A systematic review. DATA SOURCES: The terms "nursing," "students," "therapeutic," and "communication" were used to search for studies in English conducted between 2000 and 2022 in four databases (PubMed, Embase, Cumulative Index of Nursing and Allied Health Plus with Full Text, and Cochrane Library CENTRAL). REVIEW METHODS: Two researchers independently screened the titles and abstracts of the original studies, followed by the full texts. The Cochrane Risk of Bias Tool 2.0 for randomized controlled trials and Risk of Bias Assessment Tool for Non-Randomized Studies for quasi-experimental studies were used to evaluate the eligible studies. This review adopted the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS: Twelve studies were included in this review. Among the six instructional components of the model for Constructivist Learning Environments, the most commonly used were question/case/problem, cognitive tool, and conversational/collaboration tool. Among the three instructional methods of the model, coaching was the most frequently used. Therefore, an instructional design model for effective therapeutic communication education for nursing students was proposed based on Constructivist Learning Environments. CONCLUSIONS: Employing an instructional design, such as Constructivist Learning Environments, can effectively promote the therapeutic communication education of nursing students.

Supervisors' experiences of undergraduate nursing students' learning in clinical practice when applying caring and learning as parallel processes in a caritative caring conceptual learning model (Part 2).

The Model for Improvements in Learning Outcomes (MILO) is theoretically grounded and designed to intertwine didactics, pathophysiology and medicine with specific concepts important for learning. The aim was to describe supervisors' experiences of undergraduate nursing students' learning during clinical practice when using MILO. A qualitative and explorative design was used. Seventeen supervisors, thirteen women and four men from different departments at three hospitals in southern Sweden participated. After using the model, data were collected through four focus group interviews with open unstructured interview questions and analysed using inductive latent content analysis. Twelve subcategories, four generic subcategories and one main category emerged. The students developed a questioning approach and were more reflective, open and compliant. Twosomes enhanced learning. Specific documents generated structure and feelings of participation. The supervisors felt that taking the students' pre-understanding into account and a caring approach in the learning environment were valuable for enhanced learning. The students established a caring relationship with the patients and the patients' perspective became emphasized. Using MILO, intertwining between the natural and the professional became possible; enhanced learning in nursing skills together with a more caritative caring approach towards the patient was revealed. The need of compassion is discussed.

Osteopathic Models Integration Radar Plot: A Proposed Framework for Osteopathic Diagnostic Clinical Reasoning.

OBJECTIVE: The purpose of this article is to propose a tool to assist with clinical reasoning to select and integrate different osteopathic models and evidence-based actions into clinical practice. DISCUSSION: The authors adopted the guidelines for writing a commentary as a reporting framework for the present article. The proposed Osteopathic Models Integration Radar Plot has potential for integration into clinical practice and the educational environment. This framework may enable clinicians to manage complex clinical phenomena, such as musculoskeletal disorders related to allostatic load. CONCLUSION: This proposed framework may be helpful to communicate the outcome of osteopathic evaluations to other healthcare professionals. This proposed model will need to be tested to determine feasibility.

Students' tactical understanding during a hybrid sport education/step-game approach model volleyball teaching unit / O conhecimento tático dos alunos durante uma unidade híbrida do modelo de educação desportiva e do modelo de abordagem progressiva ao jogo no voleibol / El conocimiento táctico de los alumnos durante una unidad de híbrida del modelo de educación deportiva y del modelo de aproximación progresiva al juego en el voleibol

Abstract: Model-based research has been enhancing the positive effectiveness of both Sport Education and Step-Game Approach on students' technical, tactical and game-play improvements. Nevertheless, the analysis of students' declarative understanding on the game in this area was scarce. This study examined their declarative understanding on the game during their participation in a hybrid Sport Education/Step-Game Approach teaching unit. Ninety-six students with no previous experience in either model participated in a 24-lesson volleyball season. A video-based test was developed to assess students' declarative game understanding and applied before and after the teaching unit. Results showed that they improved in all tactical content taught during the unit. These results can find explanation on Sport Education features such as cooperative team practices and the possibility for being in roles other than players. Beyond that, instructional procedures considered by the Step-Game-Approach stimulated the development of students' tactical awareness.

Resumo: A investigação nos modelos instrucionais tem enaltecido o impacto positivo do Modelo de Educação Desportiva e do Modelo de Abordagem Progressiva ao Jogo no desenvolvimento técnico e tático dos alunos, assim como no desempenho geral no jogo. Todavia, a análise do conhecimento tático dos alunos neste âmbito tem sido escassa. O presente estudo tem como propósito analisar o conhecimento tático declarativo dos alunos durante uma unidade híbrida desses dois modelos na modalidade de voleibol. Noventa e seis alunos sem experiência prévia nos dois modelos participaram numa época desportiva com 24 aulas. Foi desenvolvido um teste de vídeo para analisar o desenvolvimento do conhecimento tático declarativo dos alunos, o qual foi aplicado antes e depois da unidade. Todos os alunos melhoraram nos conteúdos táticos ensinados, o que pode encontrar explicação no trabalho colaborativo em equipas, na possibilidade dos alunos participarem noutros papéis para além de jogadores e nos processos instrucionais, características dos dois modelos.

Resumen: La investigación en los modelos de instrucción ha enaltecido el impacto positivo del Modelo de Educación Deportiva y del Modelo de Aproximación Progresiva al Juego en el desarrollo técnico y táctico de los alumnos, así como también en el desempeño general en el juego. Sin embargo, el análisis del conocimiento táctico de los alumnos en este ámbito ha sido escaso. El presente estudio tiene como propósito analizar el conocimiento táctico declarado de los alumnos durante una unidad híbrida de estos dos modelos en la modalidad de Voleibol. 96 alumnos sin experiencia previa en los dos modelos participaron en una temporada deportiva con 24 clases. Se desarrolló un test de vídeo para analizar el desarrollo del conocimiento táctico declarado de los alumnos, que se aplicó antes y después de la unidad. Todos los alumnos mejoraron en los contenidos tácticos enseñados, lo que puede encontrar explicación en el trabajo colaborativo en equipos, en la posibilidad de que los alumnos participen en otros papeles además de como jugadores y en los procesos de instrucción, características de los dos modelos.

Construção e validação de um cenário de simulação sobre sepse: estudo metodológico / Construcción y validación de un escenario de simulación sobre la sepsis: estudio metodológico / Construction and validation of a sepsis simulation scenario: a methodological study

RESUMO Objetivo Construir, validar e testar um cenário de simulação clínica de alta fidelidade para o manejo da sepse. Método Estudo metodológico desenvolvido em três fases: construção do cenário de simulação utilizando o framework Modelo de Simulação de Ensino em Enfermagem e os protocolos instituídos pelo Instituto Latino Americano de Sepse; validação do conteúdo por nove juízes; e o teste do cenário por dois enfermeiros de uma instituição hospitalar. A análise dos dados se deu pelo Índice de Validade de Conteúdo, considerando-se adequado um valor > 0,90 entre os juízes. Resultados O cenário de simulação mostrou-se apropriado, obtendo valor geral > 0,90. No entanto, foram feitos alguns ajustes no cenário e no teste no que tange à clareza da redação, às funcionalidades e à pertinência de protocolos, conforme sugestão dos juízes. Conclusão Espera-se que o cenário de simulação validado seja um instrumento facilitador para docentes e profissionais de núcleos de educação permanente/continuada de instituições de ensino e saúde.

RESUMEN Objetivo Construir, validar y probar un escenario de simulación clínica de alta fidelidad para el manejo de la sepsis. Método Estudio metodológico desarrollado en tres fases: construcción del escenario de simulación utilizando el framework del Modelo de Simulación de Enseñanza de Enfermería y los protocolos instituidos por el Instituto Latinoamericano de Sepsis; validación del contenido por nueve jueces; y prueba del escenario por dos enfermeras de una institución hospitalaria. Los datos fueron analizados por el Índice de Validez de Contenido, considerando un valor > 0,90 entre los jueces. Resultados El escenario de la simulación fue apropiado, obteniendo un valor global > 0,90. Sin embargo, se hicieron algunos ajustes en el escenario y la prueba en cuanto a la claridad de la redacción, la funcionalidad y la pertinencia de los protocolos, como sugirieron los jueces. Conclusión Se espera que el escenario de simulación validado sea una herramienta facilitadora para los profesores y profesionales de los centros de educación permanente/continuada de las instituciones de educación y salud.

ABSTRACT Objective To build, validate and test a high-fidelity clinical simulation scenario for sepsis management. Method Methodological study developed in three phases: construction of a simulation scenario using the framework Model of Nursing Training Simulation and protocols established by the Latin-American Sepsis Institute, content validation by nine judges, and scenario testing by two nurses from a hospital institution. Data analysis was carried out through Content Validity Index, with values > 0.90 among the judges being considered satisfactory. Results The simulation scenario was observed to be appropriate and obtained an overall value > 0.90. However, some adjustments to the scenario and the test were performed concerning textual clarity, functionality, and the protocol's pertinence, following the judges' suggestions. Conclusion The validated simulation scenario is expected to be a facilitator instrument for educators and professionals in the permanent/continued education nuclei of teaching and health institutions.

A 9-Step Theory- and Evidence-Based Postgraduate Medical Digital Education Development Model: Empirical Development and Validation.

BACKGROUND: Digital education tools (e-learning, technology-enhanced learning) can be defined as any educational intervention that is electronically mediated. Decveloping and applying such tools and interventions for postgraduate medical professionals who work and learn after graduation can be called postgraduate medical digital education (PGMDE), which is increasingly being used and evaluated. However, evaluation has focused mainly on reaching the learning goals and little on the design. Design models for digital education (instructional design models) help educators create a digital education curriculum, but none have been aimed at PGMDE. Studies show the need for efficient, motivating, useful, and satisfactory digital education. OBJECTIVE: Our objective was (1) to create an empirical instructional design model for PGMDE founded in evidence and theory, with postgraduate medical professionals who work and learn after graduation as the target audience, and (2) to compare our model with existing models used to evaluate and create PGMDE. METHODS: Previously we performed an integrative literature review, focus group discussions, and a Delphi procedure to determine which building blocks for such a model would be relevant according to experts and users. This resulted in 37 relevant items. We then used those 37 items and arranged them into chronological steps. After we created the initial 9-step plan, we compared these steps with other models reported in the literature. RESULTS: The final 9 steps were (1) describe who, why, what, (2) select educational strategies, (3) translate to the real world, (4) choose the technology, (5) complete the team, (6) plan the budget, (7) plan the timing and timeline, (8) implement the project, and (9) evaluate continuously. On comparing this 9-step model with other models, we found that no other was as complete, nor were any of the other models aimed at PGMDE. CONCLUSIONS: Our 9-step model is the first, to our knowledge, to be based on evidence and theory building blocks aimed at PGMDE. We have described a complete set of evidence-based steps, expanding a 3-domain model (motivate, learn, and apply) to an instructional design model that can help every educator in creating efficient, motivating, useful, and satisfactory PGMDE. Although certain steps are more robust and have a deeper theoretical background in current research (such as education), others (such as budget) have been barely touched upon and should be investigated more thoroughly in order that proper guidelines may also be provided for them.

[Evaluation of The Medical Board Exam in Portugal]. / Avaliação do Exame Final do Internato Médico em Portugal.

INTRODUCTION: There is a high heterogeneity in the structure of postgraduate medical training evaluation worldwide. However, in contrast to other countries, there have been no scientific studies of the final medical board examination, in Portugal. The present study aimed to evaluate the adequacy of the medical board examination including its validity as measured by its association with medical school grade average and national seriation examination. MATERIAL AND METHODS: Cross-sectional, observational study. We analyzed the final results on the medical board examination of 2439 physicians, across 47 specialties, who completed their training in 2016 and 2017, using measures of central tendency and variability. We assessed the association between these grades and the national exam to initiate residency, and the grade average in Medical School. RESULTS: Measures of central tendency and variability, and consequent shape measures, revealed that the distribution of the scores of the final medical board exam is extremely negatively asymmetric and leptokurtic. A positive association was also found between the results in this exam and the score on national exam to initiate residency, and the grade average in Medical School. CONCLUSION: Although the medical board examination was, in general, positively associated with scores on the national exam to initiate residency, and the mean final Medical School grades, thus indicating its potential validity, our results demonstrate that this exam presents no satisfactory discriminative capacity. Therefore, there is room to improve the actual postgraduate medical examination model, including changes in its classification system and potentially consider other assessment models.

Introdução: Existe uma elevada heterogeneidade na estrutura da avaliação da formação médica pós-graduada a nível mundial. No entanto, contrastando com outros países, não existem estudos científicos em Portugal que tenham avaliado o modelo da avaliação final da especialidade. O presente estudo pretendeu avaliar a adequação do exame do final da especialidade aos seus propósitos; aí incluída a sua validade enquanto consubstanciada na relação com a prova nacional de seriação e média final de curso de medicina. Material e Métodos: Estudo transversal, observacional. Foram analisadas com recurso a medidas de tendência central e variabilidade, as notas na avaliação final da especialidade de 2439 médicos, de 47 especialidades, que terminaram a sua formação em 2016 e 2017. Tendo em vista a sua validação cruzada, foram também avaliadas as correlações com a média final de curso e a nota na prova nacional de seriação. Resultados: Das medidas de tendência central e variabilidade, e consequentes medidas de formato, resulta que a distribuição das pontuações do exame final de especialidade se apresenta com uma forma manifestamente assimétrica negativa e leptocúrtica. No geral, verificou-se a existência de uma associação positiva entre a avaliação final da especialidade e a média de curso e a prova nacional de seriação. Conclusão: Apesar de positivamente associado, no geral, com a média de curso e a prova nacional de seriação, o que indica a sua potencial validade, os resultados demonstram que a avaliação final de especialidade não apresenta uma capacidade discriminativa satisfatória. Deste modo, existe oportunidade para melhoria do modelo atual, nomeadamente através da alteração ao seu sistema de classificação e considerando outros modelos de exame.

The sport education model in elementary and secondary education: a systematic review / O modelo de sport education na educação primária e secundária: revisão sistemática / El modelo de sport education en la educación primaria y secundaria: revisión sistemática

This study is an updated review of the most recent implementations of the Sport Education Model (SEM) from 1st to 12th grades (ages 6-18), including the newest research trends for future studies. A systematic review conducted from 2013 to 2017 used the main reference databases and original articles including information about instances of SEM implementation in any school grade. Results showed that SEM implementation has expanded enormously over the last five years to include all learning domains: physical, social, cognitive, and affective. However, such implementation is not easy and it demands specific teacher training. SEM seems to be a proper pedagogical approach for sports practice while developing motor skills, tactical-technical knowledge, and values

Este estudo consistiu em oferecer uma revisão atualizada das implementações mais recentes do Modelo de Sport Education (SEM) do primeiro ao 12º ano (6-18 anos), incluindo as mais novas tendências de pesquisa para estudos futuros. Uma revisão sistemática de 2013 a 2017 foi realizada utilizando os bancos de dados de maior referência e os artigos originais que incluíam informações sobre as implementações do SEM em qualquer grau escolar. A implementação do SEM expandiu-se enormemente nos últimos cinco anos para incluir todos os diferentes domínios de aprendizagem: físico, social, cognitivo e afetivo. Entretanto, a implementação do SEM não é fácil e precisa de formação específica de professores. O SEM parece ser uma abordagem pedagógica adequada para praticar esporte, ao mesmo tempo em que desenvolve habilidades motoras, conhecimento técnico-tático e valores

El objetivo del estudio fue ofrecer una revisión de las implementaciones más recientes del Modelo Sport Education (SEM), desde primero de Educación Primaria hasta segundo de Bachillerato (6-18 años), incluyendo las más nuevas tendencias de investigación para estudios futuros. Se realizó una revisión sistemática desde 2013 hasta 2017, usando las principales bases de datos y los artículos originales que incluían informaciones sobre las implementaciones del SEM en cualquier grado escolar. La implementación del SEM se ha expandido enormemente en los últimos cinco años para incluir a todos los dominios del aprendizaje: físico, social, cognitivo y afectivo. Sin embargo, dicha implementación no es fácil y requiere formación específica del profesorado. El SEM parece un abordaje pedagógico adecuado para practicar deporte, al mismo tiempo que desarrolla habilidades motoras, conocimiento técnico-táctico y valores

Educación médica y diversidad cultural en Chile: un diálogo pendiente / Medical education and cultural diversity in Chile: a pending dialogue

Medical education in Chile has a good research productivity. National educators are skilled in complex curricular design processes and in didactic innovation. However, the question of what it means to be doctor in a society that moves towards interculturality, has not been addressed thoroughly. Using the structure of a clinical record, we outline our critical view about the relationship between medical education and diversity. To describe the medical history, we refer to some variables of the training process such as the Hegemonic Model of Medicine, the epistemological beliefs of the students, the hidden curriculum and the educational environment. Then, the empirical evidence of the clinical picture, diagnosis and internationally recommended treatment is described, to end with a local therapeutic proposal.

Perspectivas sobre o uso das diretrizes de desenho instrucional para a simulação na saúde: revisão da literatura / Perspectives on the use of instructional design guidelines for health simulation: a literature review

OBJETIVOS: Este artigo teve dois objetivos principais: apresentar um breve resumo de conceitos cognitivos introdutórios sobre aprendizagem e instrução na simulação, incluindo as diretrizes de desenho instrucional; e oferecer uma visão geral quanto às evidências disponíveis sobre perspectivas instrucionais na efetividade da simulação na saúde, diferentes formatos instrucionais da simulação, fidelidade e local da simulação. MÉTODOS: Uma busca foi realizada nas bases de dados MEDLINE/PubMed, Embase, Cochrane, ERIC, LILACS e SciELO, a partir dos termos "simulação em saúde", "efetividade da simulação", "treinamento", "diretrizes de desenho instrucional", "aprendizagem complexa" e "transferência da aprendizagem" e seus correspondentes em inglês. O início das datas de publicação não foi especificado e a última busca foi conduzida em 19 de setembro de 2017. Todos os artigos em inglês e português foram considerados para inclusão. Artigos específicos foram intencionalmente incluídos em busca de conceitos introdutórios. RESULTADOS: A busca identificou 3.196 artigos nas diferentes bases de dados. Após avaliação preliminar de títulos, resumos e análise de conteúdo, foram selecionados 56 artigos. Adicionalmente, nove artigos clássicos e um livro foram intencionalmente incluídos para a apresentação de conceitos cognitivos sobre aprendizagem e instrução, resultando em 66 referências consultadas em detalhes para esta revisão. CONCLUSÕES: A simulação oferece a oportunidade de aprendizagem ativa para profissionais de saúde ao proporcionar um ambiente de aprendizagem complexa, com integração do conhecimento, habilidades e atitudes. Com potencial de impacto nos diferentes níveis de aprendizagem, comportamento e resultados, especial atenção deve ser dada ao formato instrucional da simulação. Entre as diretrizes de desenho instrucional, destaca-se a autenticidade como um dos elementos de fundamental relevância para a aprendizagem. Outros elementos instrucionais, como complexidade crescente, local do treinamento adequado, debriefing, oportunidade de autoavaliação e outras formas de avaliação, têm também influência positiva e devem ser utilizados no planejamento de diferentes desenhos instrucionais da simulação.

AIMS: This article had two main objectives: to present a brief summary of introductory cognitive concepts on learning and instruction for simulation, including instructional design guidelines; and provide an overview of the current available evidence on the instructional perspectives on healthcare simulation training effectiveness, in particular with regards to simulation formats, fidelity and simulation site. METHODS: We searched for articles at MEDLINE/PubMed, Embase, Cochrane, ERIC, LILACS and SciELO databases, using the keywords "instructional design guidelines", "healthcare simulation", "simulation training", "simulation effectiveness", "complex learning", and "transfer of learning". No specific beginning date of publication was specified and last date of search was September 19th 2017. All articles in English and Portuguese were considered for inclusion with no specific exclusion criteria. A few articles were purposefully selected in search of introductory concepts on learning and instruction. RESULTS: Our search retrieved 3196 articles in the different databases. After preliminary title, abstract and content analysis, we selected 56 articles. Additionally, nine traditional articles and one book were included to present the best available evidence, reviews, reflections and critiques on simulation instructional perspectives, resulting in 66 references consulted in detail for this review. CONCLUSIONS: Simulation offers the opportunity for active learning for health professionals by providing a complex learning environment with integration of knowledge, skills and attitudes. With potential impact on the different levels of learning, behavior and results, special attention should be given to the instructional format of the simulation. Among the instructional design guidelines, authenticity stands out as one of the elements of fundamental relevance for learning. Other instructional elements, such as increasing complexity, proper training location, debriefing, self-assessment opportunity, and other forms of assessment, also have positive influence and should be used in planning different simulation instructional designs.

Estilos de aprendizaje en estudiantes de medicina / Learning styles of undergraduate medical students

Introducción: Según la teoría del aprendizaje basada en la experiencia, cada persona desarrolla un estilo de aprendizaje que caracteriza su forma de adquirir y transformar experiencias para crear conocimiento. El objetivo de este trabajo fue identificar los estilos de aprendizaje de los estudiantes de medicina. Métodos: Se aplicó el Inventario de Estilos de Aprendizaje a los estudiantes de los tres primeros semestres de Medicina de la Pontificia Universidad Javeriana durante el segundo semestre del 2009. Resultados: Se encuestaron 204 estudiantes (la edad media fue 18,5 años; 55% eran mujeres). Prevalecieron los estilos de aprendizaje abstractos, que incluyen el estilo asimilador (47%) y el convergente (27%). Discusión: Conocer el estilo de aprendizaje de los estudiantes puede ayudar a los profesores a diseñar estrategias de enseñanza que favorezcan un aprendizaje más efectivo. Paralelamente, conviene proporcionarles una variedad de contextos de aprendizaje que promuevan el fortalecimiento de sus habilidades.

Introduction: According to the experiential learning theory, each person develops a learning style that characterizes her preferred way to acquire and transform experiences to create knowledge. The objective of this study was to identify the learning styles of undergraduate medical students. Methods: The Kolb Learning Style Inventory was applied to first-year medical students at the Pontificia Universidad Javeriana (Bogotá, Colombia) during the second period of 2009. Results: 204 students completed the questionnaire (the average age was 18.5 years; 55% were women). Students preferred the abstract styles of learning, including assimilating (47%) and convergent (27%) styles. Conclusions: Having information about medical students learning style preferences can help educators to design teaching strategies that promote a more effective learning. Teachers should provide a variety of learning contexts to stimulate the strengthening of their abilities.