Training veterinarians to deal with death and the dying process: a scoping review.

The aim of this scoping review was to investigate the range of methods used to guide veterinarians in their approach to the death of their animal patients with the guiding question: how is this topic addressed in the training of veterinarians? We included studies written in Portuguese or English, with a theme aligned with the objective of the review and which answered the guiding question. Studies not fulfilling these criteria were excluded. A total of 22 complete studies were identified by searching the Scopus, Web of Science, PsycINFO and Pubmed databases/libraries, with no restrictions on the date of publication. Studies from 1989 to 2023 were identified, mostly by North American authors. The results were organised into three major themes: topics in the veterinary curriculum about patient death and its impacts on students and future professionals; teaching methods used to cover this topic; and the extracurricular training available to support veterinarians with their direct experience of this topic. Analysis of these papers indicated that the theme of death appeared in three distinct contexts operating at different stages of veterinarians' training: the hidden curriculum, compulsory training initiatives, and extracurricular training. The review included reflections on the challenges inherent in this theme and inferences from the timeline of publications in this area. Our review clearly indicates that there is increasing recognition of the importance of this subject, as well as a feeling within the profession of being unprepared to manage this aspect of veterinary experience and a perception that teaching in this area needs to be improved.

Approach for participatory Delphi method for structuring voices, population empowerment and research training.

A Delphi panel is a methodology used to generate consensus among experts. The development of a participatory Delphi approach consists of including the research population in the design and conduct of the research. It involves panelists in the preparation of an open-ended questionnaire as well as in the responding process. The answers are organized, anonymized and redistributed to produce a synthesis, which becomes a potential consensus statement. This process takes place during a set number of rounds in which the synthesis of each question is analyzed and graded by the panelists. Finally, syntheses are classified as having a higher, medium or lower consensus. We created a 'change-oriented' Delphi panel in which health-related students are considered the expert population. In this study, we propose a methodology to collect and analyze health-related students' views on education, demonstrating the effectiveness of active student participation and the Delphi approach in designing educational curricula.•This research focuses on how to conduct a Delphi participatory panel in which health-related students contribute to the study design, data collection, and analysis, as well as serving as the expert panelists.•This highly replicable methodology could be applied in the development of education curricula.•Delphi participatory approaches offer a research introduction opportunity.

Advances in Shared Decision Making in Brazil: The role of patient autonomy in curriculum reform, health system and clinical care.

Clinical practice in Brazil has rapidly transformed. Doctor-patient relationships are the focus of these transformations, either within health policies or in the context of medical training. The Brazilian Curriculum Guidelines have emphasized the doctor-patient relationship as part of medical skills and competences, based on patient-centered care. In this article, we present the political advances in patient-centered care. In addition, we address an overview of the Brazilian status quo of decision support tools. Finally, we share experiences in curriculum reform for the advances of communication skills and the interfaces with narrative medicine and the arts in curricular medical training as a means to advance towards the practice of shared decision making.

Precision surgical education / Educación quirúrgica de precisión

Information and data are accelerating the implementation of competency-based medical education. The adoption of precision education can contribute to this purpose. This article discusses the extent to which precision surgical education can be used in assessing the minimum reliability standards of future surgeons - given the advent of Entrustable Professional Activities - and as an option to strengthen the career trajectory of residents.

La información y los datos están acelerando la implementación de la educación médica basada en las competencias. La adopción de la educación de precisión puede contribuir a este propósito. Este artículo analiza los alcances de la educación quirúrgica de precisión para la evaluación del desempeño de los futuros cirujanos en sus estándares mínimos de confiabilidad -ante el advenimiento de las actividades profesionales confiables -, y como alternativa para fortalecer la trayectoria profesional de los residentes.

Engagement in Extracurricular Activities During Medical School: A Cross-Sectional Study on Student Motivations and Challenges.

Objectives: Extracurricular activities (EA) are crucial for medical education, fostering professional and personal growth. They complement formal curriculum structures, addressing students' social, psychological, and academic needs. Understanding students' motivations for choosing EA is essential for creating effective educational strategies. Our study examined medical students' engagement in EA, focusing on the most common activities, perceived importance, and the motivations and challenges faced. Methods: This was a cross-sectional study, employing both quantitative and qualitative designs, involving a convenience sample of medical students from Brazil. Data collection was carried out using an anonymous, structured electronic form to gather information on the sociodemographic profile of students and aspects related to EA participation. The analysis included both descriptive statistics and qualitative content analysis, providing detailed insights into student motivations and their experiences with EA. Results: Out of 221 study participants, 82.4% were actively involved in EA. Sports (44.8%), scientific events (39.4%), artistic activities (33.5%), and participation in scientific programs (28.1%) were prominent choices, with students dedicating 8.5 h per week. Students under the age of 28 (P = .017) and those without a previous academic degree (P = .036) showed a higher frequency of involvement in EA, as confirmed by logistic regression analysis revealing significant associations for these variables (OR = 1.16, 95% CI: 1.02-1.32, P = .017; and OR = 0.88, 95% CI: 0.78-1.00, P = .036, respectively). Motivations for EA participation were primarily driven by a desire to enhance curriculum vitae and develop essential professional skills. Challenges such as time management and academic adjustment were common among medical students. Conclusions: Our findings highlight the widespread involvement of medical students in EA, illustrating a diverse range of interests. Younger students and those without previous academic training are more likely to participate. Motivations include enriching the curriculum and refining skills, yet challenges such as time management and adjusting to academic demands are significant, especially for new students.

Changes in Patient Safety Knowledge During Undergraduate Nursing Education: A Scoping Review Protocol.

BACKGROUND/OBJECTIVES: Patient safety is a critical component of healthcare quality, yet there remains a significant gap in understanding how patient safety knowledge progresses among nursing students throughout their educational journey. This scoping review aims to map and analyze the existing literature on the development of patient safety knowledge in undergraduate nursing education. METHODS: This study will follow the Joanna Briggs Institute methodology for scoping reviews and adhere to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Scoping Reviews) guidelines. A comprehensive search strategy will be employed across multiple databases, including CINAHL (Cumulative Index to Nursing and Allied Health Literature), ERIC (Education Resources Information Center), PubMed, Embase, SCOPUS, and Web of Science. The review will include studies published from 2019 to 2024 in English, Portuguese, and Spanish. Two independent reviewers will conduct study selection and data extraction. The data will be synthesized narratively, with quantitative data summarized using descriptive statistics and qualitative data analyzed thematically. RESULTS: The review is expected to identify key patterns in the progression of patient safety knowledge among nursing students, including critical periods for knowledge acquisition, challenges in translating theoretical knowledge into practice, and effective educational strategies. The findings will be presented in both tabular and narrative forms, providing a comprehensive overview of the current state of patient safety education in nursing programs. CONCLUSIONS: The anticipated outcomes of this review have significant implications for nursing education, healthcare policy, and clinical practice. For educators, the findings will inform curriculum development and the design of targeted interventions to enhance patient safety competencies. From a policy perspective, the results could support the standardization of patient safety education across nursing programs. In clinical practice, the study may emphasize the importance of continuous professional development in patient safety. This scoping review aims to fill a critical gap in the literature by providing a comprehensive understanding of how patient safety knowledge progresses among nursing students. The findings are expected to contribute significantly to the advancement of nursing education and patient safety, ultimately fostering a culture of safety that benefits both healthcare providers and recipients.

Development of Leadership Skills in Medical Education: Protocol for a Scoping Review.

BACKGROUND: Leadership is recognized as an essential competency in health care and science, being central for professionals to face health challenges. Few physicians feel prepared to serve as leaders in the health care environment, and few receive training in the leadership skills needed to be successful. Teaching leadership skills together with extensive, longitudinal, clinical education in an authentic and nurturing environment can effectively develop students for leadership in medicine. Studies on the subject still do not show the best way to implement it in medical education, and an updated review is necessary. OBJECTIVE: The aim of this study is to identify the types of available evidence on the teaching of leadership skills in undergraduate courses in the health area, analyze them, determine knowledge gaps, and disseminate the research results. METHODS: This is a scoping review that will consider studies on leadership skills in medical and health undergraduate courses. Primary studies published in English, Spanish, and Portuguese since 2019 will be considered. The search will be performed in 8 databases, and reference lists will be searched for additional studies. Duplicates will be removed, and 2 independent reviewers will examine the titles, abstracts, and full texts of the selected studies. Data extraction will be performed using a tool developed by the researchers. RESULTS: The scoping review is currently in progress. The preliminary database search has been completed, yielding a total of 1213 articles across multiple databases. The next stages, including deduplication, title and abstract screening, and full-text review, are scheduled to be completed by December 2024. Data extraction and analysis are expected to be finalized by March 2025, with the final report anticipated to be ready for submission by June 2025. CONCLUSIONS: This scoping review on leadership in the medical curriculum can significantly contribute to the literature by organizing and synthesizing the available evidence on teaching leadership skills in undergraduate courses in the health area. Furthermore, by analyzing evidence and identifying knowledge gaps, the study can provide valuable insights to develop more efficient and comprehensive medical education programs, thus preparing students to take on leadership roles in the complex environment of health care. TRIAL REGISTRATION: Open Science Framework YEXKB; https://osf.io/yexkb. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/62810.

Evidence-Based Strategies for Reforming the Medical Curriculum at the National Autonomous University of Honduras: A Systematic Literature Review.

Medical education worldwide has undergone numerous stages of reform. Cultural and financial restraints have decelerated progress in developing countries. Current reforms should focus on creating integrated, competency-based, and student-centered curricula that emphasize patient-centered care. The following review of literature published between 2014 and 2023 on global curricular reforms highlighted key components, challenges, and strategies for implementing or evaluating undergraduate medical programs that prioritize student-centered approaches and competency-based models. This review also compared the current curriculum at the National Autonomous University of Honduras (UNAH) with these international experiences to suggest strategies in order to encourage significant reform. The following review identified 47 articles that provided insights into ideal contexts for curricular reforms, while 15 publications detailed the current state of the UNAH medical curriculum and its potential weaknesses. Additionally, 25 articles discussed specific reforms in other countries, offering valuable results and conclusions for consideration. Drawing from these models and experiences, strategies were proposed for UNAH's curriculum reform, including identifying basic needs, defining project vision, training teaching staff and students, and integrating multidisciplinary teams of experts. Although training all teaching staff abroad may be financially unfeasible, selecting and training key individuals to train others could be a viable alternative. Successful reform requires a comprehensive, periodic, and systematic evaluation. Despite the challenges faced by developing countries, global experiences with alternative reform models offer promising solutions, providing an opportunity for the Faculty of Medical Sciences at UNAH to overcome local limitations and fulfill the primary task of training professionals who are clinically, ethically, and adaptively competent, with a focus on patient-centered and primary care approaches.

Evaluation of Non-Technical Skills in Students Throughout the Medical Course in Ecuador.

OBJECTIVES: This research focuses on assessing non-technical skills (NTS), comprising behavioral aspects that support an individual's expertise in personal and professional performance. Due to varied terminology, including "soft skills" and other terms, NTS is less understood, leading to a potential gap in the literature and limited attention to their development. This study establishes the need for a comprehensive evaluation of NTS to obtain an objective and complete profile of NTS in students pursuing medicine at the Universidad Central del Ecuador (UCE) during 2023, using a standardized and benchmarked psychometric instrument. METHODS: A cross-sectional study assessed 1035 students from the first to the 12th semester using the CompeTEA® Test, which evaluates 5 factors encompassing 20 competencies and includes sincerity as a reliability condition. Scores were corrected, analyzed, and standardized using TEAcorrige. RESULTS: The study group comprised 1035 undergraduate medical students (36.8% of students at UCE in 2023), with a mean age of 22.1 years (2.7 standard deviation), and 687 (66.4%) were female. We obtained an average score of 77.7 in sincerity. Factors such as intrapersonal, interpersonal, task development, and managerial skills showed variations throughout the course, with some competencies developing positively in intermediate clinical stages. At the same time, most exhibited a decrease toward the end of the program. Comparisons with population levels revealed 19 competencies at Level 2 and 1 competency predominantly at Level 1. CONCLUSION: The moderate to low development, with no significant differences based on demographic variables, suggests the need for specific interventions in NTS within comprehensive medical education.

Construction and Surgical Training of Coronary Anastomosis on a Low-Cost Portable Simulator: Experience in a Peruvian Multicenter Study.

INTRODUCTION: The operating room is no longer the ideal place for early surgica training of cardiothoracic surgery residents, forcing the search for simulation-based learning options. The study's aim was the construction and surgicaltraining of coronary anastomosis in a portable, low-cost, homemade simulator. METHODS: This is an observational, analytical, and multicenter study. The simulator was built with common materials and was evaluated with the Objective Structured Assessment ofTechnical Skills (or OSATS) Modified. All junior and senior residents from nine national cardiothoracic surgery centers were considered for 90 days. Operative skill acquisition and time in the creation of side-to-side (S-T-S), end-to-side (E-T-S), and end-to-end (E-T-E) coronary anastomoses were evaluated. All sessions were recorded and evaluated by a single senior cardiothoracic surgeon during two time periods. RESULTS: One hundred and forty residents were assessed in 270 sessions. In junior residents, a significant improvement in final scores was identified in S-T-S (use of Castroviejo needle holder, needle angles, and needle transfer) (P<0.05). In seniors, a significant improvement was identified in S-T-S (graft orientation, appropriate spacing, use of forceps, angles, and needle transfer) anastomoses (P<0.05). A significant improvement in the final anastomosis time of senior residents over junior residents was identified in S-T-S (8.11 vs. 11.22 minutes), E-T-S (7.93 vs. 10.10 minutes), and E-T-E (6.56 vs. 9.68 minutes) (P=0.039). CONCLUSION: Our portable and low-cost coronary anastomosis simulator is effective in improving operative skills in cardiothoracic surgery residents; therefore, skills acquired through simulation-based training transfer have a positive impact on the surgical environment.

Moral Harassment and Mental Health in Medical Residents: A Longitudinal Study.

OBJECTIVE: This study investigates if moral harassment contributes to anxiety, depression and burnout among medical residents. METHODS: This three-stage longitudinal study involves 218 first-year residents, with 76 (34.9%) participating throughout all stages. The questionnaire covered demographics, mental health (using Patient Health Questionnaire - 4 - PHQ-4), burnout (using Maslach Burnout Inventory Human Services Survey - MBI-HSS), and harassment experiences. Logistic regression analyzed mental health outcomes and harassment. RESULTS: The study found significant variations in anxiety and depression scores, along with a notable decrease in the personal accomplishment dimension of burnout. Harassment prevalence was above 90%, and most victims were disturbed by harassment suffered. While a direct correlation between harassment victimization and decreased mental health was not found, seeking help exacerbated suffering, and surgical program residents had a smaller increase in depression and emotional exhaustion. CONCLUSIONS: To the extent of our knowledge, this is the first longitudinal study on mental health and harassment among medical residents. Mental suffering after taking action against harassment suggests that safe environments for addressing these issues are lacking in residency. Further studies concerning surgical residents could shed light on their lower levels of suffering. Institutional changes are necessary to embrace victims and create a healthy environment.

La danza afroecuatoriana: alternativa metodológica para la inclusión de estudiantes con hiperactividad en la Educación Física

Se reconoce que la danza afroecuatoriana es un lazo de conexión con los ancestros y la identidad, y aporta una educación del movimiento que facilita, a su vez, el desarrollo de valores educativos en torno al tratamiento del cuerpo; ello favorece la motivación hacia la práctica de la actividad física continuada. El objetivo de la investigación radica en proponer la danza afroecuatoriana como una alternativa metodológica para la inclusión de estudiantes con hiperactividad y se contextualiza en décimo año, con un total de 35 estudiantes, y una muestra de un estudiante con trastorno por déficit de atención e hiperactividad, de la Básica Superior de la Unidad Educativa "José Otilio Ramírez Reina", provincia de Esmeraldas en Ecuador. El estudio, se sustentó en un enfoque cuantitativo-cualitativo y el método dialectico-materialista; se emplearon métodos del nivel teórico como el histórico-lógico y el análisis-síntesis y del nivel empírico el análisis documental, la observación y la encuesta, para interpretar las derivaciones obtenidas en cada etapa que transitó desde el nivel exploratorio, descriptivo, hasta llegar a una explicación del fenómeno investigado. Los resultados revelan el insuficiente reconocimiento de la danza afroecuatoriana para la inclusión de estudiantes con este trastorno, así como la escasa producción científica relacionada con la temática. Del estudio realizado se concluyó que la danza afroecuatoriana constituye una vía expedita para un mejor conocimiento, disfrute y preservación de la identidad, en estos estudiantes.

Reconhece-se que a dança afro-equatoriana é um vínculo de ligação com os ancestrais e a identidade, e proporciona uma educação em movimento que facilita, por sua vez, o desenvolvimento de valores educativos em torno do tratamento do corpo; Isso favorece a motivação para a prática de atividade física continuada. O objetivo da pesquisa consiste em propor a dança afro-equatoriana como alternativa metodológica para a inclusão de alunos com hiperatividade e está contextualizada no décimo ano, com um total de 35 alunos, e uma amostra de um aluno com transtorno de déficit de atenção e hiperatividade, da Escola Básica Superior da Unidade Educacional "José Otilio Ramírez Reina", província de Esmeraldas no Equador. O estudo baseou-se na abordagem quanti-qualitativa e no método dialético-materialista; Métodos do nível teórico como histórico-lógico e análise-síntese e do nível empírico, análise documental, observação e levantamento, foram utilizados para interpretar as derivações obtidas em cada etapa que passou do nível exploratório, descritivo, até chegar a uma explicação do fenômeno investigado. Os resultados revelam o insuficiente reconhecimento da dança afro-equatoriana para a inclusão de alunos com esse transtorno, bem como a limitada produção científica relacionada ao tema. Do estudo realizado concluiu-se que a dança afro-equatoriana constitui um caminho expedito para um melhor conhecimento, diversão e preservação da identidade destes alunos.

Afro-Ecuadorian dance is a bond of connection with ancestors and identity, and provides an education in movement that facilitates, in turn, the development of educational values around the treatment of the body; this favors motivation towards the practice of continued physical activity. The objective of the research lies in proposing Afro-Ecuadorian dance as a methodological alternative for the inclusion of students with hyperactivity and is contextualized in the tenth grade, with a total of 35 students, and a sample of a student with attention deficit hyperactivity disorder, from the Higher Basic School "José Otilio Ramírez Reina" Educational Unit, province of Esmeraldas in Ecuador. The study was based on a quantitative-qualitative approach and the dialectical-materialist method; methods from the theoretical level such as historical-logical and analysis-synthesis and from the empirical level, documentary analysis, observation and survey, were used to interpret the derivations obtained in each stage that went from the exploratory, descriptive level, until reaching an explanation of the phenomenon investigated. The results reveal the insufficient recognition of Afro-Ecuadorian dance for the inclusion of students with this disorder, as well as the limited scientific production related to the topic. From the study carried out, it was concluded that Afro-Ecuadorian dance constitutes an expeditious route for better knowledge, enjoyment and preservation of identity in these students.

From FUSE to a hands-on electrosurgery course using a cadaveric model.

INTRODUCTION: Surgical procedures in contemporary practice frequently employ energy-based devices, yet comprehensive education surrounding their safety and effectiveness remains deficient. We propose an innovative course for residents that aims to provide basic electrosurgery knowledge and promote the safe use of these devices. METHODS: We developed a simulated training course for first-year general surgery and orthopedic residents. First, a survey was conducted regarding their knowledge perception about energy devices. The course consisted of two online theoretical sessions, followed by three in-person practical sessions. First-year residents performed three video-recorded attempts using a cadaveric model and were assessed through a digital platform using the Objective Structured Assessment of Technical Skill (OSATS), a Specific Rating Scale (SRS), and a surgical energy-based devices scale (SEBS). Third-year residents were recruited as a control group. RESULTS: The study included 20 first-year residents and 5 third-year residents. First-year residents perceived a knowledge gap regarding energy devices. Regarding practical performance, both OSATS and checklist scores were statistically different between novices at their first attempt and the control group. When we analyzed the novice's performance, we found a significant increase in OSATS (13 vs 21), SRS (13 vs 17.5), and SEBS (5 vs 7) pre- and post-training scores. The amount of feedback referred to skin burns with the electro-scalpel reduced from 18 feedbacks in the first attempt to 2 in the third attempt (p-value = 0.0002). When comparing the final session of novices with the control group, no differences were found in the SRS (p = 0.22) or SEBS (p = 0.97), but differences remained in OSATS (p = 0.017). CONCLUSION: This study supports the implementation of structured education in electrosurgery among surgical trainees. By teaching first-year residents about electrosurgery, they can acquire a skill set equivalent to that of third-year residents. The integration of such courses can mitigate complications associated with energy device misuse, ultimately enhancing patient safety.

Diseño curricular para el desarrollo sostenible y la ciudadanía global: intervención pedagógica en educación superior / Curricular design for sustainable development and global citizenship: pedagogical intervention in higher education / Projeto curricular para desenvolvimento sustentável e cidadania global: intervenção pedagógica no ensino superior

RESUMEN El artículo tuvo como objetivo plantear el diseño e implementación de una propuesta para el fortalecimiento de las competencias de desarrollo sostenible y la ciudadanía mundial. Se formula el modelo de gestión curricular que contribuye en la solución de los problemas locales y globales, dentro de los procesos pedagógicos de la Institución Universitaria Pascual Bravo en Medellín- Colombia. A través de las fases de caracterización, planificación, aplicación y evaluación, se propuso una investigación cuantitativa, con alcance descriptivo y de tipo experimental aplicada a 152 profesionales en formación de diferentes pregrados, durante el segundo el semestre académico del año 2021. Los resultados indican que el rango medio de la puntuación mediana del post test es mayor que la del pre test con un p-valor 4.553x10-9 menor del 5%. Esto se ve materializado en las capacidades de los estudiantes para ser flexibles y adaptables, tener conocimientos de la comunicación intercultural, ser autosuficiente en relación con los asuntos globales y generar un buen clima escolan De ahí se concluye que, la intervención pedagógica mejoró los resultados, de forma significativa, sobre los aprendizajes de los participantes del estudio.

ABSTRACT The objective of this article was to propose the design and implementation of a proposal to strengthen sustainable development competencies and global citizenship. The curricular management model is formulated that contributes to the solution of local and global problems, within the pedagogical processes of the Pascual Bravo University Institution in Medellín-Colombia. Through the phases of characterization, planning, application and evaluation, quantitative research was proposed, with a descriptive and experimental scope applied to 152 professionals in training from different undergraduate degrees, during the second academic semester of the year 2021. The results indicate that the average range of the median score of the post test is greater than that of the pretest with a p-value 4.553x01-9 less than 5%. This is materialized in the students' abilities to be flexible and adaptable, have knowledge of intercultural communication, be self-sufficient in relation to global issues, and generate a good school climate. From this it is concluded that the pedagogical intervention significantly improved the learning results of the study participants.

RESUMO O objetivo do artigo foi propor a elaboração e a implementação de uma proposta para fortalecer as competências de desenvolvimento sustentável e a cidadania global. Ele formula o modelo de gestão curricular que contribui para a solução de problemas locais e globais, dentro dos processos pedagógicos da Instituição Universitária Pascual Bravo em Medellín-Colômbia. Por meio das fases de caracterização, planejamento, aplicação e avaliação, foi proposta uma pesquisa quantitativa, com escopo descritivo e tipo experimental, aplicada a 152 profissionais em formação de diferentes cursos de graduação, durante o segundo semestre acadêmico do ano de 2021. Os resultados indicam que a faixa média da pontuação mediana do pós-teste é maior do que a do pré-teste, com um p-valor de 4,553x01-9 inferior a 5%. Isso se materializa nas habilidades dos alunos de serem flexíveis e adaptáveis, de terem conhecimento de comunicação intercultural, de serem autoconfiantes em relação a questões globais e de gerarem um bom clima escolar Portanto, conclui-se que a intervenção pedagógica melhorou significativamente os resultados de aprendizagem dos participantes do estudo.

Por una cultura de seguridad en las facultades de odontología / For a culture of safety in dental schools / Rumo a uma cultura de segurança nas escolas de odontologia

RESUMEN Es necesario fundamentar teóricamente la inclusión de la cultura de seguridad del paciente en los currículos de las facultades de odontología, con el fin de impulsar comportamientos y acciones acordes con el derecho a los cuidados en salud seguros y de calidad. La presente es una investigación de revisión narrativa de la literatura científica, fundamentada en la bioética latinoamericana y los derechos humanos de los pacientes. Las interpretaciones se basan en el análisis del contenido de artículos y presentadas de acuerdo con la legislación sobre derechos humanos de los pacientes y el currículo en odontología. La cultura de seguridad es una intervención para propiciar vivencias que consoliden valores y conocimientos, asimismo, requiere estrategias que centren su adopción entre todos los actores, partiendo de la relación estudiante-paciente-docente.

ABSTRACT It is necessary to theoretically substantiate the inclusion of the culture of patient safety in the curricula of dental schools to promote behaviors and actions in line with the right to safe and quality health care. This is a narrative review investigation of the scientific literature based on Latin American bioethics and the human rights of patients. The interpretations are based on a content analysis of the articles and presented per the legislation on the human rights of patients and the dental curriculum. Safety culture is an intervention that promotes experiences to consolidate values and knowledge; it also requires strategies that focus on its adoption by all actors, starting from the student-patient-teacher relationship.

RESUMO É necessário fundamentar teoricamente a inclusão da cultura de segurança do paciente nos currículos das faculdades de odontologia, a fim de promover comportamentos e ações de acordo com o direito à assistência à saúde segura e de qualidade. Esta é uma revisão narrativa da literatura científica, baseada na bioética latino-americana e nos direitos humanos dos pacientes. As interpretações são baseadas na análise de conteúdo dos artigos e apresentadas de acordo com a legislação de direitos humanos dos pacientes e com os currículos odontológicos. A cultura de segurança é uma intervenção para promover experiências que consolidem valores e conhecimentos, e requer estratégias que focalizem sua adoção entre todos os atores, começando pela relação aluno-paciente-professor.

Leveraging a realistic synthetic database to learn Shape-from-Shading for estimating the colon depth in colonoscopy images.

Colonoscopy is the choice procedure to diagnose, screening, and treat the colon and rectum cancer, from early detection of small precancerous lesions (polyps), to confirmation of malign masses. However, the high variability of the organ appearance and the complex shape of both the colon wall and structures of interest make this exploration difficult. Learned visuospatial and perceptual abilities mitigate technical limitations in clinical practice by proper estimation of the intestinal depth. This work introduces a novel methodology to estimate colon depth maps in single frames from monocular colonoscopy videos. The generated depth map is inferred from the shading variation of the colon wall with respect to the light source, as learned from a realistic synthetic database. Briefly, a classic convolutional neural network architecture is trained from scratch to estimate the depth map, improving sharp depth estimations in haustral folds and polyps by a custom loss function that minimizes the estimation error in edges and curvatures. The network was trained by a custom synthetic colonoscopy database herein constructed and released, composed of 248400 frames (47 videos), with depth annotations at the level of pixels. This collection comprehends 5 subsets of videos with progressively higher levels of visual complexity. Evaluation of the depth estimation with the synthetic database reached a threshold accuracy of 95.65%, and a mean-RMSE of 0.451cm, while a qualitative assessment with a real database showed consistent depth estimations, visually evaluated by the expert gastroenterologist coauthoring this paper. Finally, the method achieved competitive performance with respect to another state-of-the-art method using a public synthetic database and comparable results in a set of images with other five state-of-the-art methods. Additionally, three-dimensional reconstructions demonstrated useful approximations of the gastrointestinal tract geometry. Code for reproducing the reported results and the dataset are available at https://github.com/Cimalab-unal/ColonDepthEstimation.

Digital technology in national curricula: a dialogue among Iberoamerican countries.

Introduction: In today's world, digital technologies have become pervasive, impacting every aspect of our lives. Even in subjects such as Health and Physical Education (HPE), which traditionally emphasizes experiential, active, and corporeal learning, there is a growing interest in the role and influence of new technologies. These technologies not only have the potential to transform human movement and health cultures, but they also offer valuable tools to facilitate teachers' work and enhance student learning. Considering the context of the Research Network on Interactive Digital Didactic Materials, which includes researchers from Iberoamerican countries, this research examines how media and digital technologies are considered in the official Physical Education and curriculum documents from Brazil, Uruguay, Chile, Colombia, and Spain. Methods: The research comprises a content analysis of official National Curricular Proposals of the selected countries. Considering the specificities of each country to publish their curricula policies, we selected eight different documents from five countries (Brazil, Uruguay, Spain, Colombia, and Chile). We looked for indicators expressed by terms such as "media," "digital culture," and "technology" in the documents, all of them related to Physical Education. Results: The findings show arguments and proposals for using technology in Physical Education in all documents. However, the curricula trigger this theme in different forms, as an autonomous or transversal character integrated into subjects such as HPE. This fact may be highlighted by the goals of learning areas, which sometimes trigger teaching themes through technology. Discussion: Under the Media-Education theory lens, we argue that there is no standard for educational investment in curricula in media and technology. Some documents point to the technology use dimension, while others point to the critical or productive dimension that technology makes possible. The literature highlights the need for an organic approach between these dimensions, and educators and policymakers are asked to rethink their curriculum proposals.

Advancing nursing education in Brazil: A systematic literature review of curricular evolution and emerging challenges.

OBJECTIVE: This study assesses changes and challenges within the nursing curriculum in the Brazilian context, focusing on addressing contemporary professional and societal demands. DESIGN: A systematic literature review (SLR) was conducted to identify and analyze the changes in Brazil's nursing curricula over time. DATA SOURCES: Articles published between 1987 and 2023 were selected from Scopus and Web of Science databases for the systematic review. REVIEW METHODS: A hybrid review approach was employed, integrating Systematic Literature Review (SLR), Bibliometrics, and metanarrative. The study adhered to the SPAR-4-SLR (Scientific Procedures and Rationale for Systematic Literature Reviews) protocol, involving three main stages: (i) aggregation, (ii) organization, and (iii) evaluation. The analysis primarily focused on identifying emerging trends and evaluating curricular changes over the specified timeframe. RESULTS: Analysis of the selected literature identified four principal thematic groups that emerged during the review period: (i) longitudinal curriculum assessment, (ii) biological and health sciences, (iii) human and social sciences, and (iv) nursing sciences. Noteworthy trends included the integration of emerging topics like mental health and care for victims of violence, coupled with a notable increase in emphasis on transformative and competency-based education. Nevertheless, significant gaps were observed in the existing literature, particularly concerning the absence of perspectives from students and recent graduates and limited research on vulnerabilities within the curriculum structure. CONCLUSIONS: This study underscores the imperative for flexible and adaptable nursing curricula that effectively address Brazil's diverse regional and social realities. It emphasizes the significance of adopting a holistic and inclusive approach to nursing education, preparing professionals to confront contemporary health challenges in a nation characterized by extensive cultural diversity and vast geographical dimensions. Further research and input from students and recent graduates are indispensable to rectify the gaps and ensure the continuous evolution of nursing education in Brazil.

The progress test as a structuring initiative for programmatic assessment.

BACKGROUND: The Progress Test is an individual assessment applied to all students at the same time and on a regular basis. The test was structured in the medical undergraduate education of a conglomerate of schools to structure a programmatic assessment integrated into teaching. This paper presents the results of four serial applications of the progress test and the feedback method to students. METHODS: This assessment comprises 120 items offered online by means of a personal password. Items are authored by faculty, peer-reviewed, and approved by a committee of experts. The items are classified by five major areas, by topics used by the National Board of Medical Examiners and by medical specialties related to a national Unified Health System. The correction uses the Item Response Theory with analysis by the "Rasch" model that considers the difficulty of the item. RESULTS: Student participation increased along the four editions of the tests, considering the number of enrollments. The median performances increased in the comparisons among the sequential years in all tests, except for test1 - the first test offered to schools. Between subsequent years of education, 2nd-1st; 4th-3rd and 5th-4th there was an increase in median scores from progress tests 2 through 4. The final year of undergraduate showed a limited increase compared to the 5th year. There is a consistent increase in the median, although with fluctuations between the observed intervals. CONCLUSION: The progress test promoted the establishment of regular feedback among students, teachers and coordinators and paved the road to engagement much needed to construct an institutional programmatic assessment.