Percepción de estudiantes de pregrado de Medicina de talleres de simulación de procedimientos médico-quirúrgicos / Undergraduate student's perception of clinical simulation workshops: assessment of an instrument

Background: Simulation is a useful training tool for undergraduate medical students. A valid instrument is needed to assess students' perception of simulation workshops. Aim: To adapt and validate an instrument to assess the undergraduate medical student's perception of simulation workshops of clinical procedures. Material and Methods: Delphi Methodology was used to adapt the instrument. Exploratory and confirmatory analyses were performed to determine the construct validity and Cronbach's Alpha (0 to 1) for internal consistency of the instrument. Results: A Delphi panel of 10 experts adapted a seven-item questionnaire (Likert scale 1-5; ranging from 7 to 35) and four open-questions. After 3-delphi-rounds, the instrument was administered to 210 students in six simulation training programs (Paracentesis, Cardiopulmonary Resuscitation, Airway management, Sutures, Thoracentesis and Nursing Procedures). The instrument was considered unidimensional in the factorial analysis. The overall median (Q1-Q3) score was 34 ranging from 32 to 35 and the Cronbach Alpha coefficient was 0.72, indicating a good reliability. Conclusions: The perception questionnaire is a useful and reliable instrument to assess students' perceptions of clinical simulations.

Arteria braquial superficial bilateral. una variación anatómica infrecuente con implicancias clínicas y quirúrgicas / Bilateral superficial brachial artery. a rare anatomical variation with clinical and surgical implications

Las variaciones del sistema arterial en el miembro superior son relevantes debido a la gran cantidad de procedimientos diagnósticos, invasivos y terapéuticos realizados en la actualidad. Reportamos una variante poco frecuente de la arteria braquial superficial (ABS) encontrada bilateralmente en los miembros superiores. En ambos miembros la ABS descendió superficial y lateral al nervio mediano y medial a la cabeza corta del músculo bíceps braquial. La ABS derecha terminó en la fosa cubital se unió a la arteria braquial en un tronco común, una variación anatómica rara de tipo isla, mientras que la ABS izquierda terminó en el antebrazo como arteria radial. La presencia unilateral de la ABS se ha informado con una frecuencia relativa, pero una variación bilateral es extremadamente rara. La relevancia de la embriología, incidencia y clínica de esta variación anatómica se discuten.

Variations of the upper limb arterial system are an important consideration due to the large number of invasive, diagnostic and therapeutic procedures performed in this region. We report a rare variant of the superficial brachial artery (SBA) found bilaterally in the upper limbs. In both limbs the SBA desending superficial and lateral of median nerve, and medial to the short head of bicep brachii muscle. Right SBA finished in the cubital fossa joined the deep brachial artery in a common trunk, a rare anatomical variation of island type, while the left SBA finished in the forearm and radial artery. The unilateral presence of the SBA reported with relative frequency, but a bilateral variation is extremely rare. The relevance of embryology, and clinical incidence of this anatomical variation are discussed.