Simulación en cirugía mínimamente invasiva / Simulation in minimally invasive surgery

Introducción: El entrenamiento basado en la simulación de técnicas mínimamente invasivas es uno de los medios de enseñanza clave para la formación del cirujano. La optimización del trabajo en simuladores y el diseño e implementación de programas de entrenamiento son acciones importantes para su desarrollo. Objetivo: Presentar los contenidos más importantes de los programas de entrenamiento en simuladores y la metodología de enseñanza aplicada. Métodos: Se realizó una investigación cualicuantitativa, retrospectiva, en el Centro Nacional de Cirugía de Mínimo Acceso (CNCMA) desde enero de 2007 hasta diciembre de 2017. Se presentaron los programas de entrenamiento utilizados, incluyendo los tipos de simuladores y la metodología de enseñanza. Las unidades de análisis de dichos programas fueron: objetivos, contenidos, métodos, formas y medios de enseñanza y evaluación. Se revisaron los PNI (técnica evaluativa de aspectos positivos, negativos e interesantes) aplicados a los educandos en cada entrenamiento, así como las evaluaciones teóricas y prácticas realizadas por los profesores en la evaluación final. Resultados: Se impartió un total de 1 105 actividades de superación profesional (entrenamientos, cursos, talleres, diplomado, rotaciones de residentes y pasantías), se graduaron un total de 3 659 profesionales (médicos y enfermeras), 3 141 (86 por ciento) nacionales y 518 (14 por ciento) extranjeros. Se realizaron 951 entrenamientos (86 por ciento) y se certificaron 2 177 educandos (59,5 por ciento); 633 (29 por ciento) en procedimientos básicos y 1 544 (71 por ciento) en procedimientos de avanzada. Conclusiones: Los programas de entrenamiento en simuladores con una metodología de enseñanza estructurada, constituyen una herramienta muy útil en el desarrollo de la cirugía mínimamente invasiva. Su empleo, tanto para la adquisición de habilidades profesionales como con fines evaluativos deviene un elemento importante del proceso docente, que tiene ventajas para el educando, el profesor y los pacientes(AU)

Introduction: Training based on the simulation of minimally invasive techniques is one of the key teaching methods for the surgeon's training. The optimization of the work in simulators and the design and implementation of training programs are important actions for its development. Objective: To present the most important contents of the training programs using simulators and the applied teaching methodology. Methods: A retrospective study, both qualitative and quantitative, was carried out at the National Center for Minimally Invasive Surgery (CNCMA), from January 2007 to December 2017. The training programs used were presented, including the types of simulators and the teaching methodology. Results: A total of 1105 professional improvement activities were provided (trainings, courses, workshops, diploma curses, rotations of residents, and internships), a total of 3659 professionals (doctors and nurses) graduated, together with 3141 (86 percent) nationals and 518 (14 percent) foreigners. 951 trainings were carried out (86 percent) and 2177 students were certified (59.5 percent); 633 (29 percent), in basic procedures and 1544 (71 percent), in advanced procedures. Conclusions: Training programs with simulators with a structured teaching methodology are a very useful tool in the development of minimally invasive surgery. Its use, both for the acquisition of professional skills and for evaluative purposes, becomes an important element of the teaching process, which has advantages for the student, the teacher and the patients(AU)

Deterioro psicomotor por déficit de sueño en estudiantes de Medicina / Sleep deficit in medical students and psychomotor skills deteriorations

Introducción: Durante los últimos años se ha enfatizado la importancia que los trabajadores de la salud deban tener una cantidad mínima de horas de sueño. Se ha encontrado que los daños por la falta de sueño se ven implicados en el deterioro físico y mental, además se ha asociado al error médico. Objetivos: El objetivo de este estudio es evaluar si existe un deterioro psicomotor en estudiantes de medicina y así establecer si es necesario modificar las prácticas médicas para mejorar la función cognitiva de estudiantes y así optimizar la atención a pacientes. Métodos: En este estudio se utilizó el programa de entrenamiento cognitivo, Lumosity. (5) Con esta herramienta fue posible realizar mediciones de destrezas psicomotoras en estudiantes de medicina en un estado de desvelo y en un estado en el que habían dormido más de seis horas. Además, se compararon los resultados y se determinó si existía o no una diferencia significativa en ambas poblaciones. Estudio abierto transversal de 52 estudiantes de sexto y séptimo año de la Facultad de Medicina de la Universidad Francisco Marroquín. Resultados: Se encontró evidencia estadísticamente significativa que indica que hay deterioro psicomotor por falta de sueño en estudiantes de sexto y séptimo año de medicina. Se obtuvieron mayores puntuaciones en Lumosity en los grupos pre guardia que en los grupos post guardia (puntaje promedio de grupo pre guardia: 2912 vs. puntaje promedio de grupo post guardia: 2515). Conclusiones: Existe un deterioro psicomotor por falta de sueño en estudiantes de sexto y séptimo año de medicina. Palabras clave: Deterioro psicomotor, Lumosity, guardia y pre guardia

Background. Recent papers have emphasized the importance of sufficient sleep in health practitioners to avoid skill deterioration. Lack of sleep often leads to physical and mental deterioration and medical error. Objective. The purpose of this study is to evaluate if there is a psychomotor deterioration in medical students and to determine if modifying medical practices is necessary to improve cognitive function in medical students, thus assuring a better quality service to patients. Methods. Lumosity test (5) cognitive training program was used, which allowed data recollection of psychomotor skills from medical students who were sleep deprived and from students who had slept at least six hours; then, the data was compared. Open transversal study with 52 medical students in the last two years of their career from Universidad Francisco Marroquín. Results: There was statistically significant evidence indicating that there is a psychomotor deterioration due to sleep deprivation in medicine students during their last year. Lumosity mean scores in the group that had slept six hours and in the sleep-deprived group were 2912 and 2515, respectively. Conclusions: There is a psychomotor deterioration due to a lack of sleep in medical students working long hospital calls. Key words: Sleep deficit; psychomotor skills; Lumosity test

Correlation between Academic and Psychomotor Skills Performances of Dental Students in Complete Denture Prosthodontics.

Aims: This study was designed to determine if there is correlation between academic performance of students in complete denture prosthodontics and psychomotor skills for record blocks fabrication/complete denture teeth set up. Study Design: It was a cross-sectional study conducted at the Department of Restorative Dentistry of the University of Port Harcourt between July and October 2015. Methodology: Departmental examination records of all dental students who had done complete denture prosthodontic course and sat for professional examination in the subject since 2011 when the very first was organized were reviewed. The examination involved written, test of psychomotor skills for fabrication of record blocks/complete denture teeth set up and viva. The practical evaluation was conducted by experienced external and internal examiners using already prepared checklist. The checklist includes occlusal vertical dimension, occlusion (inter-digitations, overbite & overjet), setting up on the ridge, adaptation and thickness of the denture base, extension of the flange and finishing. Spearman’s rank test was used to assess the correlation between academic and psychomotor skills performances. Results: Six sets and a total number of 65 students had taken the course and sat for professional examination since the very first was organized in 2011. Spearman’s correlation coefficient was very low (0.237) and the relationship was almost statistically significant (P value was 0.06). Conclusion: There was poor correlation between academic and psychomotor skills performances of dental students as it relates to complete denture prosthodontics. Conscious efforts should be made to recognize candidates who lag behind in psychomotor skills acquisition and to assist them.

Use of computerized tests to evaluate psychomotor performance in children with specific learning disabilities in comparison to normal children.

Background & objectives: Children with specific learning disabilities (SpLD) have an unexplained difficulty in acquiring basic academic skills resulting in a significant discrepancy between their academic potential and achievements. This study was undertaken to compare the performance on a battery of six psychomotor tests of children with SpLD and those without any learning disabilities (controls) using computerized tests. Methods: In this study, 25 children with SpLD and 25 controls (matched for age, socio-economic status and medium of instruction) were given three training sessions over one week. Then children were asked to perform on the six computerized psychomotor tests. Results were compared between the two groups. Results: children with SpLD fared significantly worse on finger tapping test, choice reaction test, digit picture substitution test and card sorting test compared to the controls (p<0.05). Interpretation & conclusions: Children with SpLD have impairment of psychomotor skills like attention, sensory-motor coordination and executive functioning. Further research is needed to evaluate if the remedial education plan results in improvement in psychomotor performance of children with SpLD on these selected tests.

Modelo de enseñanza de las habilidades psicomotoras básicas en anestesia para estudiantes de ciencias de la salud: sistematización de una experiencia / Teaching model of basic psychomotor skills in anesthesia for students of health sciences: systematization of an experience

Esta investigación, de tipo cualitativo, propone un modelo pedagógico orientado a facilitar los procesos de enseñanza y aprendizaje de las siguientes habilidades psicomotoras básicas en anestesia: intubación oro-traqueal, colocación de máscara laríngea y canalización venosa en niños y adultos. El modelo se elaboró mediante la adopción de algunas teorías y diseños propuestos en la literatura, la recuperación de la experiencia docente y pruebas piloto de los modelos de instrucción con estudiantes que realizan prácticas hospitalarias. Los objetivos generales fueron: primero, sistematizar la experiencia de construcción de un modelo pedagógico orientado a facilitar los procesos de enseñanza y aprendizaje de las habilidades psicomotoras básicas en anestesia; segundo, aportar a la cualificación de la práctica del anestesiólogo y del educador en anestesia, a partir del reconocimiento del saber de un equipo de expertos anestesiólogos y docentes en el área. resultados de la sistematización fueron: primero, la descripción de los supuestos teóricos más relevantes para el diseño de un modelo de instrucción de enseñanza de las competencias psicomotoras; segundo, la propuesta de un método para la enseñanza de estas competencias y la elaboración de un instrumento de evaluación de las competencias psicomotoras del estudiante. Las conclusiones de la sistematización fueron: primero, que la enseñanza de las competencias psicomotoras se puede fundamentar en supuestos, teorías y modelos definidos en la literatura en forma sinérgica; segundo, que la enseñanza de las competencias psicomotoras exige planificación y estructuración coherentes y pertinentes, dado que estas competencias se consideran como "capacidades productoras"; y tercero, que los modelos de instrucción de evaluación deben considerar tanto el proceso como los resultados, para lograr una mayor retroalimentación de los procesos de aprendizaje y una mejor interacción entre el aprendiz y el maestro.

This type of qualitative research, proposes a pedagogical model designed to facilitate teaching and lear-ning processes of the following basic psychomotor skills in anesthesia: orotracheal intubation, placement of laryngeal mask and channeling vein in children and adults. The model was designed through the adoption of some theories and designs proposed in the literature, the systematization of teaching experience, and leading tests of the instructions to students who perform hospital practices. The general objectives set for the systematization were: first, systematize the experience of building a pe-dagogical model aimed at facilitating the process of teaching and learning of psychomotor skills in basic anesthesia. Second, help improve the qualifcation of the practice of anesthesiologists and educators in anes-thesia, upon recognition of knowledge of an expert team of anesthesiologists and teachers in the area. The results of the systematization were: first, the description of the more relevant assumptions used for the design of an instructive teaching tool of psychomotor skills. Second, proposing a method for teaching these skills and developing a tool for evaluating the students’ psychomotor skills. The conclusion of the systematization was: first, the teaching of psychomotor skills can be based on as-sumptions, theories and models defned in the literature in a synergistic manner. Second, the teaching of psychomotor skills requires coherent planning and structuring, given that these competencies are considered as "producing capabilities." And third, instructional evaluation should consider both the processes and results, to achieve greater input from the processes of learning and better interaction between master and apprentice.