Surgical Residents' Perception of Feedback on Their Education: Protocol for a Scoping Review.

BACKGROUND: Feedback is an essential tool for learning and improving performance in any sphere of education, including training of resident physicians. The learner's perception of the feedback they receive is extremely relevant to their learning progress, which must aim at providing qualified care for patients. Studies pertinent to the matter differ substantially with respect to methodology, population, context, and objective, which makes it even more difficult to achieve a clear understanding of the topic. A scoping review on this theme will unequivocally enhance and organize what is already known. OBJECTIVE: The aim of this study is to identify and map out data from studies that report surgical residents' perception of the feedback received during their education. METHODS: The review will consider studies on the feedback perception of resident physicians of any surgical specialty and age group, attending any year of residency, regardless of the type of feedback given and the way the perceptions were measured. Primary studies published in English, Spanish, and Portuguese since 2017 will be considered. The search will be carried out in 6 databases and reference lists will also be searched for additional studies. Duplicates will be removed, and 2 independent reviewers will screen the selected studies' titles, abstracts, and full texts. Data extraction will be performed through a tool developed by the researchers. Descriptive statistics and qualitative analysis (content analysis) will be used to analyze the data. A summary of the results will be presented in the form of diagrams, narratives, and tables. RESULTS: The findings of this scoping review were submitted to an indexed journal in July 2024, currently awaiting reviewer approval. The search was executed on March 15, 2024, and resulted in 588 articles. After the exclusion of the duplicate articles and those that did not meet the eligibility criteria as well as the inclusion of articles through a manual search, 13 articles were included in the review. CONCLUSIONS: Conducting a scoping review is the best way to map what is known about a subject. By focusing on the feedback perception more than the feedback itself, the results of this study will surely contribute to gaining a deeper understanding of how to proceed to enhance internal feedback and surgical residents' learning progress. TRIAL REGISTRATION: Open Science Framework yexb; https://osf.io/yexkb. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/56727.

How is feedback perceived by Brazilian students and faculty from a nursing school?

AIM: This study aims to explore the perceptions of feedback among undergraduate students and faculty members at a Brazilian private nursing school. BACKGROUND: Feedback plays a crucial role in the socioemotional development of learners, with its interpretation varying across different sociocultural contexts. Student evaluations frequently express dissatisfaction regarding both the quality and quantity of feedback received. Conversely, delivering feedback poses a challenge for faculty, requiring the establishment of an empathetic connection that fosters trust and credibility. Brazil, being a developing country characterized by social disparities and economic challenges, presents a unique backdrop for examining feedback dynamics. DESIGN: Qualitative research, employing Inductive Content Analysis, was used to understand feedback perceptions in Brazilian nursing education. Symbolic interactionism was adopted as methodological framework and guided data interpretation. METHODS: We carried out five virtual focus groups composed of a group of teachers (n=5) and four of students (n=34). Semi-structured interviews guided data collection. The recorded sessions were subsequently analyzed to identify key themes and codes. Symbolic interactionism was employed as a framework to derive meaning from qualitative data. RESULTS: Content analysis generated two categories that reveal the perception of teachers and students in the feedback process. The first, called "Feedback in Education: Sociocultural Influences for Students and Teachers", expresses the beliefs and interpretations of students and teachers within the shared feedback environment. The second called "Challenging resonance, transformative construction: Navigating the dualities of feedback for teachers and students", which elucidated how relational dynamics shape behaviors and attitudes, promoting the development of social skills and learning. Faculty's previous feedback experiences significantly influence their self-perception and behavior with students. As a result of the resonance of these past interactions, we recognize that the teaching self also plays a crucial role in the quality and perception of feedback. Furthermore, students construct social reality with similar beliefs and values, they believe in the learning potential generated by feedback. Our findings also corroborate that perceptions of feedback are deeply influenced by the sociocultural context and the narratives corroborate previous findings indicating that, in Brazil, honest feedback can be implicitly perceived as criticism rather than an opportunity for growth. CONCLUSIONS: Faculty members often draw on their past experiences when providing feedback, highlighting the adaptive nature of feedback interactions. Additionally, the feedback process is consistently influenced by the commitment to maintaining positive relationships with students. Students recognize the constructive dimension of feedback as a valuable tool for learning and personal growth.

Designing feedback processes in the workplace-based learning of undergraduate health professions education: a scoping review.

BACKGROUND: Feedback processes are crucial for learning, guiding improvement, and enhancing performance. In workplace-based learning settings, diverse teaching and assessment activities are advocated to be designed and implemented, generating feedback that students use, with proper guidance, to close the gap between current and desired performance levels. Since productive feedback processes rely on observed information regarding a student's performance, it is imperative to establish structured feedback activities within undergraduate workplace-based learning settings. However, these settings are characterized by their unpredictable nature, which can either promote learning or present challenges in offering structured learning opportunities for students. This scoping review maps literature on how feedback processes are organised in undergraduate clinical workplace-based learning settings, providing insight into the design and use of feedback. METHODS: A scoping review was conducted. Studies were identified from seven databases and ten relevant journals in medical education. The screening process was performed independently in duplicate with the support of the StArt program. Data were organized in a data chart and analyzed using thematic analysis. The feedback loop with a sociocultural perspective was used as a theoretical framework. RESULTS: The search yielded 4,877 papers, and 61 were included in the review. Two themes were identified in the qualitative analysis: (1) The organization of the feedback processes in workplace-based learning settings, and (2) Sociocultural factors influencing the organization of feedback processes. The literature describes multiple teaching and assessment activities that generate feedback information. Most papers described experiences and perceptions of diverse teaching and assessment feedback activities. Few studies described how feedback processes improve performance. Sociocultural factors such as establishing a feedback culture, enabling stable and trustworthy relationships, and enhancing student feedback agency are crucial for productive feedback processes. CONCLUSIONS: This review identified concrete ideas regarding how feedback could be organized within the clinical workplace to promote feedback processes. The feedback encounter should be organized to allow follow-up of the feedback, i.e., working on required learning and performance goals at the next occasion. The educational programs should design feedback processes by appropriately planning subsequent tasks and activities. More insight is needed in designing a full-loop feedback process, in which specific attention is needed in effective feedforward practices.

Validation of clinical simulation scenarios for the teaching of soft skills in child-centered care.

Consultations with children and their families are complex and require soft skills. However, there is a gap in the medical curriculum concerning these skills, especially as encounter training is often adult-centered. We developed, validated, and applied simulation scenarios that prioritize active participation of children to train soft skills in child-centered care for undergraduate medical students. This is a methodological study to develop three scenarios and a checklist of what is expected. The content was validated by 18 experts. A pre-test was carried out for adjustments. Then, the simulations were applied and evaluated by 18 medical undergraduate students. They included the participation of 6 pediatric simulated patients aged 9-12 years trained by a drama teacher. According to the results, the scenarios and checklist proved to be valid instruments in content terms (ICV-I > 0.8). The scripts were followed by the simulated pediatric patients, but they had difficulty mimicking a hypoactive state. Some were anxious, but everyone enjoyed participating in the feedback. The simulated parents had difficulty participating and giving space to the child's speech. Participants assessed that the simulations performed as they were proposed and, after experimenting them, felt more prepared. The simulations provided an opportunity for students to practice soft skills by interacting with children in a safe environment. Using children as simulated patients is feasible but presents some challenges. Our study has expanded the ways in which children's health content can be taught. We are investigating whether this training leads to better patient outcomes in real clinical settings.

Critical transitions in the Amazon forest system.

The possibility that the Amazon forest system could soon reach a tipping point, inducing large-scale collapse, has raised global concern1-3. For 65 million years, Amazonian forests remained relatively resilient to climatic variability. Now, the region is increasingly exposed to unprecedented stress from warming temperatures, extreme droughts, deforestation and fires, even in central and remote parts of the system1. Long existing feedbacks between the forest and environmental conditions are being replaced by novel feedbacks that modify ecosystem resilience, increasing the risk of critical transition. Here we analyse existing evidence for five major drivers of water stress on Amazonian forests, as well as potential critical thresholds of those drivers that, if crossed, could trigger local, regional or even biome-wide forest collapse. By combining spatial information on various disturbances, we estimate that by 2050, 10% to 47% of Amazonian forests will be exposed to compounding disturbances that may trigger unexpected ecosystem transitions and potentially exacerbate regional climate change. Using examples of disturbed forests across the Amazon, we identify the three most plausible ecosystem trajectories, involving different feedbacks and environmental conditions. We discuss how the inherent complexity of the Amazon adds uncertainty about future dynamics, but also reveals opportunities for action. Keeping the Amazon forest resilient in the Anthropocene will depend on a combination of local efforts to end deforestation and degradation and to expand restoration, with global efforts to stop greenhouse gas emissions.

Self-regulated learning microanalysis feedback for developing clinical skills: A pilot study.

INTRODUCTION: The development of clinical skills requires the appropriate use of self-regulated learning (SRL). Students' use of key SRL processes as they perform a clinical skill can be identified by SRL microanalysis and used to provide feedback. SRL-microanalysis feedback only on students' key SRL processes has not been previously researched for developing clinical skills. The aim of this study was to investigate whether SRL-microanalysis feedback only on students' key SRL processes can improve both their use of SRL and their clinical skill performance. METHODS: Twenty-three final year medical students with no experience in the clinical skill required for mechanical ventilation participated in this study. Key SRL processes and clinical skill performance were measured before and after SRL microanalysis feedback. RESULTS: Overall, we found an improvement in the key SRL processes of planning and monitoring of performance, with a significant difference in monitoring. We also found an increase in students' clinical skill performance. DISCUSSION: This study, which is the first in clinical skills, demonstrated that SRL microanalysis feedback only on key SRL processes can improve both students' SRL and their clinical skill performance. studies are recommended with a great number of students and across a variety of clinical skills.

circCPA4 induces malignant behaviors of prostate cancer via miR-491-5p/SHOC2 feedback loop.

OBJECTIVE: circCPA4 has been defined to be an oncogenic gene. This study examined whether circCPA4 regulates Prostate Cancer (PC) development and revealed its molecular mechanism. METHODS: PC tissues and PC cell lines were collected, in which circCPA4/miR-491-5p/SHOC2 levels were evaluated by RT-qPCR and immunoblot. Colony formation assay and EdU assay assessed cell proliferation, flow cytometry measured apoptosis, and Transwell assessed invasion and migration. Ki-67, cleaved caspase-3, E-cadherin, and N-cadherin were evaluated by immunoblot. Based on the luciferase reporter assay and RIP assay the authors investigated the targeting relationship between circCPA4/miR-491-5p/SHOC2. The effect of circCPA4 on tumor growth was evaluated by xenotransplantation in nude mice. RESULTS: circCPA4 and SHOC2 levels were abundant while miR-491-5p expression was low in PC. Loss of circCPA4 decreased the proliferation and EdU-positive rate of PC cells, enhanced apoptosis, and inhibited invasion, migration, and EMT. Upregulation of circCPA4 forced the malignant behaviors of PC cells, and this promotion could be abolished when miR-491-5p was overexpressed or SHOC2 was silenced. CircCAP4 competitively decoyed miR-491-5p mediating SHOC2 expression. circCAP4 suppression inhibited PC tumor growth. CONCLUSION: circCAP4 acts as a novel oncogenic factor in PC, accelerating the malignant behavior of PC cells via miR-491-5p/SHOC2 interaction. This novel ceRNA axis may be a potential target for PC drug development and targeted therapy in the future.

The Cyclin D3 Protein Enforces Monogenic TCRß Expression by Mediating TCRß Protein-Signaled Feedback Inhibition of Vß Recombination.

In jawed vertebrates, adaptive immunity depends on the process of V(D)J recombination creating vast numbers of T and B lymphocytes that each expresses unique Ag receptors of uniform specificity. The asynchronous initiation of V-to-(D)J rearrangement between alleles and the resulting protein from one allele signaling feedback inhibition of V recombination on the other allele ensures homogeneous receptor specificity of individual cells. Upon productive Vß-to-DßJß rearrangements in noncycling double-negative thymocytes, TCRß protein signals induction of the cyclin D3 protein to accelerate cell cycle entry, thereby driving proliferative expansion of developing αß T cells. Through undetermined mechanisms, the inactivation of cyclin D3 in mice causes an increased frequency of αß T cells that express TCRß proteins from both alleles, producing lymphocytes of heterogeneous specificities. To determine how cyclin D3 enforces monogenic TCRß expression, we used our mouse lines with enhanced rearrangement of specific Vß segments due to replacement of their poor-quality recombination signal sequence (RSS) DNA elements with a better RSS. We show that cyclin D3 inactivation in these mice elevates the frequencies of αß T cells that display proteins from RSS-augmented Vß segments on both alleles. By assaying mature αß T cells, we find that cyclin D3 deficiency increases the levels of Vß rearrangements that occur within developing thymocytes. Our data demonstrate that a component of the cell cycle machinery mediates TCRß protein-signaled feedback inhibition in thymocytes to achieve monogenic TCRß expression and resulting uniform specificity of individual αß T cells.

Determinantes da proatividade e do capital psicológico: fatores individuais e organizacionais / Determinants of proactivity and psychological capital: individual and organizational factors / Determinantes de la proactividad y del capital psicológico: factores individuales y organizacionales

A proatividade e o capital psicológico (PsyCap) são construtos associados às virtudes psicológicas, recursos despertados por fatores individuais e organizacionais, que podem maximizar resultados. Este estudo visou investigar qualitativamente os determinantes e aspectos que podem estimular o PsyCap e a proatividade, a partir da perspectiva de trabalhadores de duas empresas brasileiras. A pesquisa foi realizada por meio de entrevistas semiestruturadas com uma amostra de 26 funcionários. Os resultados revelaram determinantes comuns para a proatividade e o PsyCap, dentre eles a aprendizagem formal e informal, o feedback, a felicidade, a persistência, a curiosidade, os desafios e a estratégia. Foram observados alguns consequentes positivos, como euforia, alegria, realização, entusiasmo, engajamento e gratidão. Notou-se também que a ausência de proatividade e níveis baixos de PsyCap podem desencadear reações negativas, como indignação, tristeza, procrastinação, paralisação, desequilíbrio e frustração. Esses resultados sugerem que intervenções focadas no desenvolvimento da proatividade e do PsyCap podem ser essenciais para potencializar o bem-estar individual e resultados positivos nas organizações.(AU)

Proactivity and psychological capital (PsyCap) are concepts associated with psychological virtues, resources awakened from individual and organizational factors, which can maximize results. This study aimed to investigate qualitatively the determinants and aspects that can stimulate PsyCap and proactivity, from the perspective of workers of two Brazilian businesses. The research was carried out with semi-structured interviews with a sample of 26 employees. The results revealed common determinants for proactivity and PsyCap, among them formal and informal learning, feedback, happiness, persistence, curiosity, challenges, and strategy. Some positive consequences were observed, such as euphoria, joy, fulfillment, enthusiasm, engagement, and gratitude. Also note that the absence of proactivity and low levels of PsyCap could trigger negative reactions, such as indignation, sadness, procrastination, paralysis, imbalance, and frustration. These results suggest that interventions focused on the development of proactivity and PsyCap can be essential to enhance individual well-being and positive results in organizations.(AU)

La proactividad y el capital psicológico (PsyCap) son constructos asociados a las virtudes psicológicas, recursos que pueden ser despertados por factores individuales y organizacionales para maximizar los resultados. Este estudio tuvo como objetivo investigar cualitativamente los determinantes y aspectos que pueden despertar el PsyCap y la proactividad desde la perspectiva de los trabajadores de dos empresas brasileñas. Este estudio se realizó mediante entrevistas semiestructuradas en una muestra de 26 empleados. Los resultados revelaron determinantes comunes para la proactividad y el PsyCap, entre ellos, el aprendizaje formal e informal, la retroalimentación, la felicidad, la persistencia, la curiosidad, los desafíos y la estrategia. Se observaron algunas consecuencias positivas, como euforia, alegría, logro, entusiasmo, compromiso y gratitud. También se señaló que la ausencia de proactividad y los bajos niveles del PsyCap pueden desencadenar reacciones negativas, como indignación, tristeza, procrastinación, parálisis, desequilibrio y frustración. Estos resultados sugieren que las intervenciones centradas en el desarrollo de la proactividad y del PsyCap pueden ser esenciales para mejorar el bienestar individual y los resultados positivos en las organizaciones.(AU)

Avaliação e ensino de emoções com crianças e jovens adultos com autismo ou síndrome de down mediado pela família / Assessment and teaching of emotions with children and young adults with autism or down syndrome mediated by family / Evaluación y enseñanza de las emociones con niños y jóvenes con autismo o síndrome de down mediadas por la familia

Este estudo avaliou o reconhecimento (imitação, identidade e identificação) e a nomeação de estímulos emocionais de valência negativa (raiva e tristeza) e positiva (alegria e surpresa) em conjunto com a influência dos tipos de estímulos utilizados (social-feminino, social-masculino, familiar e emoji) em crianças e jovens adultos com autismo ou síndrome de Down, por meio de tarefas aplicadas pela família e mediadas por recursos tecnológicos durante a pandemia de covid-19. Participaram cinco crianças e dois jovens adultos com autismo e uma criança e dois jovens adultos com síndrome de Down. Foram implementadas tarefas de identidade, reconhecimento, nomeação e imitação, com estímulos faciais de função avaliativa (sem consequência diferencial) e de ensino (com consequência diferencial, uso de dicas e critério de aprendizagem), visando a emergência da nomeação emocional por meio do ensino das tarefas de reconhecimento. Os resultados da linha de base identificaram que, para os participantes que apresentaram menor tempo de resposta para o mesmo gênero, a diferença de tempo de resposta foi em média 57,28% menor. Em relação à valência emocional, 50% dos participantes apresentaram diferenças nos acertos, a depender da valência positiva e negativa, sendo que 66,66% apresentaram diferenças para o tempo de resposta a depender da valência emocional. Após o procedimento de ensino, os participantes mostraram maior número de acertos nas tarefas, independentemente do gênero de estímulo e valência emocional, criando ocasião para generalização da aprendizagem de reconhecimento e nomeação de emoções, além de consolidar a viabilidade de estratégias de ensino mediadas por recursos tecnológicos e aplicadas por familiares.(AU)

This study evaluated the recognition (imitation, identity, and identification) and naming of negative (anger and sadness) and positive (joy and surprise) emotional stimuli alongside the influence of the types of stimuli (social-female, social-male, family, and emoji) in children and young adults with autism and Down syndrome, via tasks applied by the family and mediated by technological resources, during the COVID-19 pandemic. Five children and two young adults with autism and one child and two young adults with Down syndrome participated. Identity, recognition, naming, and imitation tasks were planned and implemented using facial stimuli with evaluative (without differential consequence) and teaching (with differential consequence, tips, and learning criteria) functions, aiming at the emergence of emotional naming from the recognition teaching tasks. The baseline results showed that, for participants who had a shorter response time for the same gender, the response time difference was on average 57.28% lower. Regarding the emotional valence, 50% of the participants showed differences in the correct answers, depending on the positive and negative valence, and 66.66% showed differences in the response time depending on the emotional valence. After the teaching procedure, the participants showed a greater number of correct answers in the tasks, regardless of the stimulus type and emotional valence, creating an opportunity for generalizing learning of emotion recognition and naming, in addition to consolidating the feasibility of teaching strategies mediated by technological resources and applied by family members.(AU)

Este estudio evaluó el reconocimiento (imitación, identidad e identificación) y la denominación de estímulos emocionales negativos (enfado y tristeza) y positivos (alegría y sorpresa) y la influencia de los tipos de estímulos utilizados (social-femenino, social-masculino, familiar y emoji ) de niños y jóvenes con autismo o síndrome de Down, a través de tareas aplicadas por la familia, mediadas por recursos tecnológicos durante la pandemia de la covid-19. Participaron cinco niños y dos adultos jóvenes con autismo, y un niño y dos adultos jóvenes con síndrome de Down. Se planificaron e implementaron tareas de identidad, reconocimiento, nombramiento e imitación con estímulos faciales con función evaluativa (sin consecuencia diferencial) y enseñanza (con consecuencia diferencial, uso de ayudas y criterios de aprendizaje), buscando la emergencia del nombramiento emocional después de la enseñanza de tareas de reconocimiento. Los resultados de la línea de base identificaron que para los participantes que tenían un tiempo de respuesta más corto para el mismo género, la diferencia en el tiempo de respuesta fue un 57,28% menor. En cuanto a la valencia emocional, el 50% de los participantes mostraron diferencias en las respuestas correctas, en función de la valencia positiva y negativa, y el 66,66% tuvieron diferencias en el tiempo de respuesta, en función de la valencia emocional. Después del procedimiento de enseñanza, los participantes mostraron mayor número de aciertos en las tareas evaluadas, independientemente del tipo de estímulo o valencia emocional, lo que genera una oportunidad para la generalización del aprendizaje de reconocimiento y denominación de emociones, además de consolidar la viabilidad de estrategias de enseñanza mediadas por recursos tecnológicos y aplicadas por la familia.(AU)

Nurseped: educational technology for safety in the management of intravenous antibiotics in pediatrics. / Nurseped: tecnología educativa para la seguridad en el manejo de antibióticos intravenosos en pediatría.

OBJECTIVE: to develop and validate the content of a serious game on the safe management of intravenous medications in pediatrics. METHOD: methodological study for the development and content validation of an educational technology. The cases and challenges of the serious game were developed based on a literature review and validated by 11 nurses with training and experience in the area. Content validity and agreement indices were adopted to analyze agreement and internal consistency (minimum of 0.8). RESULTS: the content is based on the main antibiotics used in the clinical management of infections in hospitalized children and patient safety. Absolute agreement was obtained in 60 of the 61 items evaluated, and the minimum obtained was 0.82 in the content validation index and 0.80 in agreement. Adjustments were suggested by experts in the response statement for a specific case and implemented to improve the quality of the technology content. CONCLUSION: the content of the serious game Nurseped was validated by nurse experts in child health regarding clinical cases, question statements and multiple-choice answers, in addition to feedback that presents the user with an evidence-based answer after getting the challenge right or wrong.

Modifications of auditory feedback and its effects on the voice of adult subjects: a scoping review. / Modificações do feedback auditivo e seus efeitos sobre a voz de indivíduos adultos: uma revisão de escopo.

INTRODUCTION: The auditory perception of voice and its production involve auditory feedback, kinesthetic cues and the feedforward system that produce different effects for the voice. The Lombard, Sidetone and Pitch-Shift-Reflex effects are the most studied. The mapping of scientific experiments on changes in auditory feedback for voice motor control makes it possible to examine the existing literature on the phenomenon and may contribute to voice training or therapies. PURPOSE: To map experiments and research results with manipulation of auditory feedback for voice motor control in adults. METHOD: Scope review following the Checklist Preferred Reporting Items for Systematic reviews and Meta-Analyses extension (PRISMA-ScR) to answer the question: "What are the investigation methods and main research findings on the manipulation of auditory feedback in voice self-monitoring of adults?". The search protocol was based on the Population, Concept, and Context (PCC) mnemonic strategy, in which the population is adult individuals, the concept is the manipulation of auditory feedback and the context is on motor voice control. Articles were searched in the databases: BVS/Virtual Health Library, MEDLINE/Medical Literature Analysis and Retrieval System online, COCHRANE, CINAHL/Cumulative Index to Nursing and Allied Health Literature, SCOPUS and WEB OF SCIENCE. RESULTS: 60 articles were found, 19 on the Lombard Effect, 25 on the Pitch-shift-reflex effect, 12 on the Sidetone effect and four on the Sidetone/Lombard effect. The studies are in agreement that the insertion of a noise that masks the auditory feedback causes an increase in the individual's speech intensity and that the amplification of the auditory feedback promotes the reduction of the sound pressure level in the voice production. A reflex response to the change in pitch is observed in the auditory feedback, however, with particular characteristics in each study. CONCLUSION: The material and method of the experiments are different, there are no standardizations in the tasks, the samples are varied and often reduced. The methodological diversity makes it difficult to generalize the results. The main findings of research on auditory feedback on voice motor control confirm that in the suppression of auditory feedback, the individual tends to increase the intensity of the voice. In auditory feedback amplification, the individual decreases the intensity and has greater control over the fundamental frequency, and in frequency manipulations, the individual tends to correct the manipulation. The few studies with dysphonic individuals show that they behave differently from non-dysphonic individuals.

INTRODUçÃO: A percepção auditiva da voz e sua produção envolvem o feedback auditivo, as pistas cinestésicas e o sistema de feedforward, os quais produzem efeitos distintos para a voz. Os efeitos Lombard, Sidetone e o Pitch-Shift-Reflex são os mais estudados. O mapeamento de experimentos científicos sobre as modificações do feedback auditivo para o controle motor da voz possibilita examinar a literatura existente sobre o fenômeno e pode contribuir para o treinamento ou terapias da voz. OBJETIVO: Mapear os experimentos e resultados das pesquisas com manipulação do feedback auditivo para o controle motor da voz de indivíduos adultos. MÉTODO: Revisão de escopo seguindo o Checklist Preferred Reporting Items for Systematic reviews and Meta-Analyses extension (PRISMA-ScR) para responder à pergunta: "Quais os métodos de investigação e principais achados das pesquisas sobre a manipulação do feedback auditivo no automonitoramento da voz de indivíduos adultos?". O protocolo de busca foi baseado na estratégia mnemônica População, Conceito e Contexto (PCC). A população são os indivíduos adultos; o conceito é a manipulação do feedback auditivo e o contexto é o controle motor da voz. Os artigos foram pesquisados nas bases de dados: BVS/ Biblioteca Virtual em Saúde, MEDLINE/Medical Literature Analysis and Retrieval Sistem on-line, COCHRANE, CINAHL/Cumulative Index to Nursing and Allied Health Literature, SCOPUS e WEB OF SCIENCE. RESULTADOS: Foram encontrados 60 artigos, sendo 19 da temática do Efeito Lombard, 25 do efeito Pitch-shift-reflex, 12 do efeito Sidetone e quatro sobre o efeito Sidetone/Lombard. Os estudos são concordantes que a inserção de um ruído que mascara o feedback auditivo provoca um aumento na intensidade de fala do indivíduo e que a amplificação do feedback auditivo promove a redução do nível de pressão sonora na produção da voz. Observa-se uma resposta reflexa à mudança de tom no feedback auditivo, porém, com características individuais em cada estudo. CONCLUSÃO: O material e método dos experimentos são distintos, não há padronizações nas tarefas, as amostras são variadas, muitas vezes reduzidas. A diversidade metodológica dificulta a generalização dos resultados. Os principais achados das pesquisas a respeito o feedback auditivo sobre o controle motor da voz confirmam que, na supressão do feedback auditivo, o indivíduo tende a aumentar a intensidade da voz. Na amplificação do feedback auditivo, o indivíduo diminui a intensidade e tem maior controle sobre a frequência fundamental e, nas manipulações da frequência, o indivíduo tende a corrigir a manipulação. Os poucos estudos com sujeitos disfônicos mostram que eles se comportam diferentemente dos não disfônicos.

Nurseped: tecnología educativa para la seguridad en el manejo de antibióticos intravenosos en pediatría / Nurseped: educational technology for safety in the management of intravenous antibiotics in pediatrics / Nurseped: tecnologia educacional para a segurança no manejo de antibióticos endovenosos em pediatria

Objetivo: desarrollar y validar el contenido de un serious game sobre el manejo seguro de medicamentos intravenosos en pediatría. Método: estudio metodológico para el desarrollo y validación de contenido de una tecnología educativa. Los casos y desafíos del serious game se basaron en una revisión de la literatura y fueron validados por 11 enfermeros con formación y experiencia en el área. Se adoptaron índices de validez de contenido y concordancia para el análisis de concordancia y consistencia interna (mínimo de 0,8). Resultados: el contenido se basa en los principales antibióticos utilizados en el manejo clínico de infecciones en niños hospitalizados y en la seguridad del paciente. Se obtuvo una concordancia absoluta en 60 de los 61 ítems evaluados, y el mínimo obtenido fue de 0,82 en el índice de validación de contenido y 0,80 en concordancia. Los expertos sugirieron ajustes en la formulación de respuestas de un caso específico y se implementaron para mejorar la calidad del contenido de la tecnología. Conclusión: el contenido del serious game Nurseped fue validado por enfermeros expertos en salud infantil en cuanto a casos clínicos, enunciados de preguntas y respuestas de opción múltiple, además del feedback que presenta al usuario una respuesta basada en evidencia tras acertar o fallar en el desafío.

Objective: to develop and validate the content of a serious game on the safe management of intravenous medications in pediatrics. Method: methodological study for the development and content validation of an educational technology. The cases and challenges of the serious game were developed based on a literature review and validated by 11 nurses with training and experience in the area. Content validity and agreement indices were adopted to analyze agreement and internal consistency (minimum of 0.8). Results: the content is based on the main antibiotics used in the clinical management of infections in hospitalized children and patient safety. Absolute agreement was obtained in 60 of the 61 items evaluated, and the minimum obtained was 0.82 in the content validation index and 0.80 in agreement. Adjustments were suggested by experts in the response statement for a specific case and implemented to improve the quality of the technology content. Conclusion: the content of the serious game Nurseped was validated by nurse experts in child health regarding clinical cases, question statements and multiple-choice answers, in addition to feedback that presents the user with an evidence-based answer after getting the challenge right or wrong.

Objetivo: desenvolver e validar o conteúdo de um serious game sobre o manejo seguro de medicamentos endovenosos em pediatria. Método: estudo metodológico para o desenvolvimento e validação de conteúdo de uma tecnologia educacional. Os casos e desafios do serious game foram desenvolvidos com base em revisão da literatura e validados por 11 enfermeiros com formação e atuação na área. Adotou-se os índices de validade de conteúdo e concordância, para análise de concordância e consistência interna (mínimo de 0,8). Resultados: o conteúdo é baseado nos principais antibióticos utilizados no manejo clínico de infecções em crianças hospitalizadas e na segurança do paciente. Obteve-se concordância absoluta em 60 dos 61 itens avaliados, o mínimo obtido foi 0,82 no índice de validação de conteúdo e 0,80 na concordância. Ajustes foram sugeridos pelos experts no enunciado de respostas de um caso específico e implementados para o aprimoramento da qualidade do conteúdo da tecnologia. Conclusão: o conteúdo do serious game Nurseped foi validado por enfermeiros experts em saúde da criança quanto aos casos clínicos, aos enunciados das perguntas e às respostas de múltipla escolha, além do feedback que apresenta ao usuário uma resposta baseada em evidências após o acerto ou erro do desafio.

Exploring the potential of eye tracking on personalized learning and real-time feedback in modern education.

Eye tracking is one of the techniques used to investigate cognitive mechanisms involved in the school context, such as joint attention and visual perception. Eye tracker has portability, straightforward application, cost-effectiveness, and infant-friendly neuroimaging measures of cognitive processes such as attention, engagement, and learning. Furthermore, the ongoing software enhancements coupled with the implementation of artificial intelligence algorithms have improved the precision of collecting eye movement data and simplified the calibration process. These characteristics make it plausible to consider eye-tracking technology a promising tool to assist the teaching-learning process in school routines. However, eye tracking needs to be explored more as an educational instrument for real-time classroom activities and teachers' feedback. This perspective article briefly presents the fundamentals of the eye-tracking technique and four illustrative examples of employing this method in everyday school life. The first application shows how eye tracker information may contribute to teacher assessment of students' computational thinking in coding classes. In the second and third illustrations, we discuss the additional information provided by the eye-tracker to the teacher assessing the student's strategies to solve fraction problems and chart interpretation. The last illustration demonstrates the potential of eye tracking to provide Real-time feedback on learning difficulties/disabilities. Thus, we highlight the potential of the eye tracker as a complementary tool to promote personalized education and discuss future perspectives. In conclusion, we suggest that an eye-tracking system could be helpful by providing real-time student gaze leading to immediate teacher interventions and metacognition strategies.

A dynamical adaptation model of visual spatiotemporal processing in cones and horizontal cells.

In this work, we introduce a phenomenological model for the cone-horizontal cell assembly, including spatial integration and formation of receptive field-like structures. The model extends our previous dynamical adaptation description with gain control accounting for processes in single cones, valid in severe nonlinear regimes. Here, a spatially extended feedback mechanism is introduced from horizontal cells to cones to account for experimental evidence, contributing thus to the development of a center-surround receptive field in cones and downstream bipolar cells. Feedback gain is defined on different spatial scales by weighting spatial filters: a short scale accounting for cone input to the feedback mechanism and a large scale driven by the syncytium characteristics of horizontal cells. A third spatial scale improves the description, mimicking neighboring cone-cone coupling. This overall spatial integration couples to temporal signal processing, thus obtaining a spatiotemporal model of outer retina responses capable of reproducing nonlinear features in both dimensions (space and time). The model was tested and validated using measurements on horizontal cells from different studies, with excellent performance. By its phenomenological nature, signal processing properties are inferred from model parameters. The model can be used in arrays of processing units with more complex incoming patterns of visual stimuli.

Daily Formative Assessment in Undergraduate Medical Training: construction and presentation of an instrument / Avaliação diária de atitudes e profissionalismo na Graduação Médica: apresentação de um instrumento

The objective is to present a daily attitudes and professionalism assessment instrument for medical students in theoretical-practical activities. The development of the instrument was based on the manuals of the program for student integration with the community, on the program's pedagogical project, and on the National Curricular Guidelines for Undergraduate Programs in Medicine, and was carried out by professors. These were consulted in weekly 50-minute meetings held between August and November 2016. At the end of the process, a version of the instrument was consolidated with five items and six descriptors to discriminate learning situations that enable competency-based assessment from the simplest to the most complex level. With the use of the instrument, points considered important in medical training in theoretical-practical activities cannot be overlooked (AU).

Objetiva-se apresentar um instrumento de avaliação diária de atitudes e profissionalismo para estudantes de Medicina em atividades teórico-práticas. A elaboração do instrumento foi baseada nos manuais do programa de integração do aluno com a comunidade, projeto pedagógico do curso e nas Diretrizes Curriculares Nacionais da Graduação em Medicina, realizada por docentes. Os docentes foram consultados em reuniões com duração de 50 minutos, com periodicidade semanal, entre agosto e novembro de 2016. Ao final do processo foi consolidada uma versão do instrumento com cinco itens e seis descritores para discriminação de situações de aprendizagem que permitem a avaliação da competência de um nível mais simples até o mais complexo. Com a utilização do instrumento elaborado não se deixa de avaliar pontos considerados importantes para a formação médica em atividades teórico-prática (AU).

Bio-geophysical feedback to climate caused by the conversion of Amazon Forest to soybean plantations.

Over the past two decades, soybean cultivation has become one of the principal replacements for forests in the Brazilian Amazon. Previous studies showed that the conversion of forests into large-scale soybean farms has different effects on local and regional climate than other forms of land use, e.g., conversion to pasture. The bio-geophysical feedbacks that lead to changes in temperature and rainfall caused by the expansion of commodity crops is not fully understood, and this has implications for both modelling potential future climatic change and understanding its impact. Here we performed model simulations to characterize the feedback to climate caused by the replacement of Amazonian forests with soybean and pastures. Our results show that: when compared to deforestation caused by pastures, the conversion of forests into soybean plantations results in more pronounced changes in the atmospheric boundary layer. Because they are characterized by a period of the year with bare soil, soybean fields transmit more long-wave radiation to the atmosphere than pastures, leading to an increase in boundary layer average temperature by 2.4 K. Although soybean plantations tend to strengthen convective lifting, the decrease in boundary layer water vapor content plays a decisive role in reducing rainfall. Finally, we demonstrate that the climatic impacts associated with the replacement of forests by soybean is likely to be magnified with agricultural expansion along new frontiers in the northern and western regions of the Amazon basin due to a more pronounced reduction in water vapor content.

Effectiveness of a Variable-Speed Control Based on Auditory Feedback: Is It Possible?

PURPOSE: Variable-speed control in the field is challenging for motion science. Tests were performed to evaluate speed, Froude number, and oxygen consumption if these varied when using the same frequency of steps. The objective of this study was to evaluate the use of auditory feedback to control variable speed on the treadmill and track during acceleration cycles around the transition speed. METHODS: Twenty-four trained men participated. The protocol was based on 5 ramps of 50 seconds each around 80%, 90%, 100%, 110%, and 120% of the walking-running transition speed, recording the frequency of steps with a mobile phone during the treadmill test. The tests were replicated on the track using auditory feedback. RESULTS: When evaluating each speed of the protocols separately for the same frequency of steps, the average speed on the track was always higher on average at 54.7% compared to the laboratory (P < .050), and on the track, it was 16.2% higher than in the laboratory (P > .050). CONCLUSIONS: It cannot be considered that the same frequency of steps is equivalent to the same speed in the laboratory and on the track. These results point to the importance of reliable speed control during open field tests.