Aprendizaje en investigación clínica: experiencia de enseñanza híbrida con estudiantes de medicina / Learning in Clinical Research: Hybrid Teaching Experience with Medical Students

Introducción: la pandemia de COVID-19 indujo un cambio en nuestro sistema de salud y de educación. Los programas formativos también tuvieron que adaptarse y exigieron un cambio rápido. Objetivos: describir una experiencia educativa de enseñanza virtual/híbrida en investigación clínica, entre docentes del Servicio de Clínica de un hospital universitario y estudiantes de Medicina de una institución privada, que participaron del Programa ESIN (EStudiantes en INvestigación). Metodología: los contenidos y las estrategias educativas incluyeron las clases teóricas audiograbadas o videograbadas (asincrónicas y autoadministradas), el aprendizaje basado en proyectos, los talleres prácticos (encuentros sincrónicos virtuales y grupales), mediante la adopción de modelos de aprendizaje como el aula invertida, y la tutoría individual entre docente-estudiante. Los datos se recopilaron mediante la observación en contextos académicos, y basándonos en elementos de encuestas anónimas de satisfacción, previo consentimiento informado de los participantes. Resultados: participaron 14 estudiantes, 6 durante el año 2021 y 8 durante 2022. Todas mujeres y estudiantes de medicina (50% de cuarto año, 35% de sexto año y 15% de quinto año). Las técnicas implementadas favorecieron la participación y promovieron el aprendizaje activo, basado en proyectos. Mencionaron aspectos positivos como el enfoque académico práctico, la disponibilidad del equipo docente para atender cualquier duda, el tiempo y el entusiasmo por enseñar y fomentar la participación. Los videos teóricos resultaron útiles como herramientas de repaso, y los encuentros grupales fueron especialmente valorados, si bien los encuentros individuales fueron destacados como ayuda y apoyo previo a los congresos científicos. En general, manifestaron que fue una experiencia enriquecedora que demostró que se puede lograr lo que se creía imposible. Todas participaron activamente de al menos un congreso científico, y el 50% resultó coautora de una publicación académica. Conclusión: los estudiantes asumieron compromisos y responsabilidades, e incorporaron competencias y habilidades en la implementación y en la difusión de los proyectos. Esta experiencia educativa facilitó que el tiempo de clase pudiera optimizarse para intercambio, discusión y dudas. Los recursos producidos, las actividades desarrolladas y los contenidos abordados quedan disponibles a nivel institución. (AU)

Introduction: the COVID-19 pandemic brought about a change in our health and education system. Training programs also had to adapt and required rapid change. Objectives: to describe an educational experience of virtual/hybrid teaching in clinical research between teachers of the Clinical Service of a university hospital and medical students of a private institution who participated in the ESIN Program (Students in Research). Methodology: the contents and educational strategies included audio or videotaped lectures (asynchronous and self-administered), project-based learning, practical workshops (virtual and group synchronous meetings) by adopting learning models such as the inverted classroom, and individual tutoring between teacher and student. We gathered the data through observation in academic contexts and based on elements of anonymous satisfaction surveys, with prior informed consent of participants. Results: fourteen students participated, six in 2021 and eight in 2022. All were women and medical students (50% fourth year, 35% sixth year, and 15% fifth year). The techniques implemented favored participation and promoted active, project-based learning. They mentioned positive aspects such as the practical academic approach, the availability of the teaching team for any doubts, the time and enthusiasm for teaching, and encouraging participation. The theory videos were a valuable review tool, and team meetings received high praise even if the one-on-one meetings received much attention as help and support before the scientific congresses. In general, they stated that it was an enriching experience that showed that you can achieve what you thought impossible. All of them actively participated in at least one scientific congress, and 50% were co-authors of an academic publication. Conclusion: the students assumed commitments and responsibilities and incorporated competencies and skills in project implementation and dissemination. This educational experience helped to optimize class time for exchange, discussion, and doubts. The resources produced, the activities developed, and the contents addressed are now available at the institutional level. (AU)

Revisão por pares das estratégias de busca para revisões sistemáticas: o PRESS, histórico, tradução para o português e funcionalidade / Peer review of search strategies for systematic reviews: the PRESS, history, Portuguese translation and functionality / Revisión por pares de las estrategias de búsqueda para revisiones sistemáticas: el PRESS, historia, traducción al portugués y funcionalidad

O Peer Review of Electronic Search Strategies (PRESS) é um instrumento elaborado na Canadian Agency for Drugs & Technologies in Health (CADTH) para avaliar cada elemento das estratégias de busca em bases de dados eletrônicas que podem influenciar a base das evidências das revisões sistemáticas. Os autores obtiveram licença para traduzir o PRESS para o português. O objetivo é contribuir para disseminação, uso e posterior implementação do PRESS, especialmente entre os bibliotecários, consolidando uma prática de avaliação de estratégias de busca das revisões sistemáticas. A metodologia foi o relato de experiência. Para contextualizar, inicia-se com o histórico da construção do PRESS, seguido do processo da tradução e apresentação das funcionalidades de cada tabela. O resultado é a disponibilização da versão do PRESS em português na página da CADTH. Conclui-se que a tradução deve impactar positivamente na qualidade das estratégias de busca das revisões sistemáticas com participação de bibliotecários brasileiros

The Peer Review of Electronic Search Strategies (PRESS) is an instrument developed at the Canadian Agen-cy for Drugs & Technologies in Health (CADTH) to evaluate each element of search strategies in electronic databases that may influence the evidence base of systematic reviews. The authors obtained a license to translate the PRESS into Portuguese. The objective is to contribute to the dissemination, use and sub-sequent implementation of PRESS, especially among librarians, to consolidate the practice of evaluating search strategies for systematic reviews. The methodology used was the experience report. It begins with the history of the construction of PRESS, followed by the report of the translation process and the function-alities of each table. The result is the availability of the PRESS version in portuguese on the CADTH page. It is concluded that the translation should have a positive impact on the quality of search strategies for systematic reviews involving Brazilian librarians

El Peer Review of Electronic Search Strategies (PRESS) es un instrumento de la Canadian Agency for Drugs & Technologies in Health (CADTH) para evaluar cada elemento de las estrategias de búsqueda en bases de datos electrónicas que pueden influir en la base de evidencia de revisiones sistemáticas. Los autores obtu-vieron permiso para traducir PRESS al portugués. El objetivo es contribuir para difusión, uso e implemen-tación del PRESS, especialmente entre bibliotecarios, para consolidar la práctica de evaluar las estrategias de búsqueda de revisiones sistemáticas. La metodología utilizada fue relato de experiencias. Comienza con la historia de la construcción de PRESS, sigue el relato de la traducción, y de las funcionalidades de cada ta-bla. Como resultado el PRESS en portugués está en el sitio web de CADTH. Se concluye que esta traducción debe tener un impacto positivo en la calidad de las estrategias de búsqueda de revisiones sistemáticas que involucren bibliotecarios brasileños

Revisión de pares, preprints y revistas depredadoras. Ética editorial versus publicidad aplicada a la ciencia médica / Peer review, preprints and predatory journals. Publication ethics versus publicity applied to medical science

Abstract The publication of medical articles has become increasingly complex, linked to multiple factors. It poses difficult problems for both authors and journals themselves. This Editorial addresses current and controversial issues: peer review, preprints as a new way of disseminating knowledge, the growing number of publications without peer review and its variants, and the risks of predatory publications. The article proposes future guidelines as an editorial policy of MEDICINA. The controversy continues, and surely the passage of time will place our proposal in a changing scientific world like knowledge itself.

Construção e validação das definições para indicadores de resultados do instrumento Iniciare-26 / Elaboración y validación de las definiciones para indicadores de resultados del instrumento Iniciare-26 / Construction and validity of definitions for outcome indicators of the INICIARE-26 instrument

Resumo Objetivo Construir e validar com especialistas as definições conceituais (DC), as definições operacionais (DO) e a magnitude das definições operacionais (MDO) dos 26 indicadores de resultados da Nursing Outcomes Classification (NOC), componentes do instrumento INICIARE-26, que mede a dependência do paciente dos cuidados de enfermagem. Métodos Estudo metodológico, em duas etapas, entre janeiro e julho de 2022. Na primeira, foram desenvolvidas, com base na literatura científica, as DC, as DO e as MDO. Observaram-se as equivalências semânticas e conceituais, além da uniformização da formulação textual dos indicadores. Na segunda, utilizou-se o método Delphi para validação de conteúdo por oito especialistas que avaliaram a relevância das definições sob os seguintes aspectos: "não relevante"; "pouco relevante"; "bastante relevante"; "altamente relevante". Utilizou-se o índice de validação de conteúdo (IVC), com valor superior a 0,78, para análise de concordância. Resultados O IVC das DC foi unânime, para 15 indicadores; as DO foram integralmente consensuais, para 17 indicadores; a MDO obteve IVC de 1,00, para 13 indicadores. Os demais itens obtiveram IVC de 0,88. Os itens que não atingiram 1,00 de concordância foram revisados, de acordo com as sugestões dos especialistas, com o objetivo de aprimorar e de proporcionar maior clareza para aplicação do instrumento. Conclusão As definições foram construídas e por ocasião da validação alcançaram grau satisfatório de concordância dos especialistas; algumas obtiveram unanimidade.

Resumen Objetivo Elaborar y validar con especialistas las definiciones conceptuales (DC), las definiciones operativas (DO) y la magnitud de las definiciones operativas (MDO) de los 26 indicadores de resultados de la Nursing Outcomes Classification (NOC), componentes del instrumento INICIARE-26, que mide la dependencia del paciente de los cuidados de enfermería. Métodos Estudio metodológico, de dos etapas, realizado entre enero y julio de 2022. En la primera, se elaboraron las DC, DO y MDO basadas en la literatura científica. Se observaron las equivalencias semánticas y conceptuales, además de la uniformidad de la formulación textual de los indicadores. En la segunda, se utilizó el método Delphi para la validación de contenido por ocho especialistas, que evaluaron la relevancia de las definiciones según los siguientes aspectos: "no relevante", "poco relevante", "bastante relevante", "altamente relevante". Se utilizó el Índice de Validez de Contenido (IVC), con valor superior a 0,78, para el análisis de concordancia. Resultados El IVC de las DC fue unánime en 15 indicadores, las DO fueron totalmente consensuales en 17 indicadores, la MDO obtuvo IVC de 1,00 en 13 indicadores. Los demás ítems obtuvieron IVC de 0,88. Se revisaron los ítems que no tuvieron 1,00 de concordancia, de acuerdo con las sugerencias de los especialistas, con el objetivo de mejorarlos y proporcionar mayor claridad para la aplicación del instrumento. Conclusión Se elaboraron las definiciones y, luego de la validación, alcanzaron un nivel satisfactorio de concordancia de los especialistas. Algunas obtuvieron unanimidad.

Abstract Objective To construct and validate with experts the conceptual definitions (CD), operational definitions (OD) and magnitude of the operational definition (MOD) of the 26 outcome indicators of the Nursing Outcomes Classification (NOC), INICIARE-26 instrument components, which measures patients' dependency on nursing care. Methods A methodological study, in two stages, between January and July 2022. In the first, CD, OD and MOD were developed based on scientific literature. Semantic and conceptual equivalences were observed, in addition to standardization of the indicators' textual formulation. In the second, the Delphi method was used for content validity by eight experts who assessed the relevance of the definitions under the following aspects: "not relevant"; "little relevant"; "quite relevant"; "highly relevant". The Content Validity Index (CVI) was used, with a value greater than 0.78 for agreement analysis. Results The CD CVI was unanimous for 15 indicators; CD were fully consensual for 17 indicators; MOD was obtained a CVI of 1.00 for 13 indicators. The other items had a CVI of 0.88. The items that did not reach 1.00 of agreement were revised, according to experts' suggestions, with the aim of improving and providing greater clarity for instrument application. Conclusion The definitions were constructed and, at the time of validity, reached a satisfactory degree of agreement among experts, and some were unanimous.

Validação externa do instrumento inventario del nivel de cuidados mediante indicadores de clasificación de resultados de enfermería (INICIARE-26) para uso no Brasil / External validation of the care level inventory instrument using nursing outcome classification indicators (INICIARE-26) for use in Brazil

Introdução: ao longo das últimas décadas, a enfermagem vem utilizando estratégias para mensurar sua carga de trabalho. Nesse intuito, o uso de instrumentos confiáveis de mensuração é necessário para dar a conhecer a dependência do paciente quanto ao cuidado de enfermagem. Métodos dessa natureza viabilizam ajustes qualitativos e quantitativos na atuação da enfermagem. Esse é o caso da versão 26 do INICIARE (Inventario del Nivel de Cuidados Mediante Indicadores de Clasificación de Resultados de Enfermería), um instrumento desenvolvido na Espanha que foi adaptado transculturalmente para o Brasil. Construído a partir da classificação de resultados de enfermagem, a ferramenta está estruturada em cinco dimensões, compostas por 26 indicadores. Ao final da avaliação, o INICIARE-26 classifica o paciente em quatro níveis de dependência (alta, moderada, risco de dependência e independência), em relação aos cuidados de enfermagem. Objetivos: construir as definições conceituais, as definições operacionais e a magnitude das definições operacionais, para cada indicador componente do instrumento; validar o conteúdo construído com especialistas; validar externamente através de propriedades psicométricas; construir um Guia de Bolso com as definições visando a translação do conhecimento. Método: estudo metodológico em três fases: na primeira, foram construídas definições, validadas posteriormente por oito especialistas, entre janeiro e julho de 2022; na segunda, fez-se a validação externa, entre agosto e outubro de 2022 (foram incluídos pacientes adultos, clínicos e cirúrgicos, internados em unidades de internação de um hospital público e de um hospital privado de Porto Alegre, RS, Brasil); na terceira fase, foi construído um guia para uso prático. Os dados foram analisados inicialmente pelo índice de validação de conteúdo (≥ 0,78). Em seguida, foram analisados pelos testes psicométricos: a) fidedignidade ­ consistência interna verificada pelo alfa de Cronbach (> 0,70), e equivalência verificada pelos coeficientes de correlação intraclasse (> 0,50) e Bland-Altman; e b) validade de constructo, aferida pela análise fatorial confirmatória. Resultados: as definições conceituais obtiveram índice de validação de conteúdo de 1,00 para 15 indicadores; as definições operacionais foram integralmente consensuais, para 17 indicadores; as magnitudes das definições conceituais obtiveram índice de 1,00, para 13 indicadores. Os demais itens obtiveram concordância de 0,88, e foram revisados seguindo sugestões dos especialistas. Na validação externa, foram pesquisados 260 pacientes; a maioria, 55,8%, de mulheres; a média de idade dos pacientes é 60,6 ±18,5 anos. A correlação intraclasse foi excelente (0,97), e a confiabilidade pelo alfa de Cronbach foi de 0,90. A análise fatorial confirmatória apontou bom ajuste do modelo, com os seguintes índices:  2 / g.l = 1,551; RMSEA = 0,04; NFI = 0,996; CFI = 0,999; SRMR = 0,16. Conclusão: o instrumento INICIARE-26, versão brasileira, se mostrou válido, confiável e capaz de mensurar a dependência do paciente, com relação aos cuidados de enfermagem. Quando aplicado com apoio das definições conceituais, apresentou melhor eficiência à realidade da enfermagem brasileira. Espera-se que o Guia de Bolso construído favoreça a utilização do INICIARE-26 pelo enfermeiro no momento de sua aplicação, minimizando a subjetividade da avaliação, e que seja um recurso didático eficiente para a educação permanente do enfermeiro.

Introduction: over the last decades, nursing has been using strategies to measure its workload. To this end, the use of reliable measurement instruments is necessary to make known the patient's dependence on nursing care. Methods of this nature enable qualitative and quantitative adjustments in nursing practice. This is the case of version 26 of the INICIARE (Inventario del Nivel de Cuidados Mediante Indicadores de Clasificación de Resultados de Enfermería), an instrument developed in Spain that was cross-culturally adapted for Brazil. Built from the nursing outcomes classification, the tool is structured in five dimensions, composed of 26 indicators. At the end of the assessment, the INICIARE-26 classifies the patient into four levels of dependence (high, moderate, risk of dependence and independence) in relation to nursing care. Purpose: to build conceptual definitions, operational definitions and the magnitude of operational definitions, for each indicator component of the instrument; validate content built with experts; externally validate through psychometric properties; build a Pocket Guide with definitions aimed at knowledge translation. Method: methodological study in three phases: in the first, definitions were built, later validated by eight experts, between January and July 2022; in the second, external validation was carried out, between August and October 2022 (adult, clinical and surgical patients admitted to inpatient units of a public hospital and a private hospital in Porto Alegre, RS, Brazil) were included; in the third phase, a guide for practical use was built. Data were initially analyzed using the content validation index (≥ 0.78). Then, they were analyzed by psychometric tests: a) reliability ­ internal consistency verified by Cronbach's alpha (> 0.70), and equivalence verified by intraclass correlation coefficients (> 0.50) and Bland-Altman; and b) construct validity, measured by confirmatory factor analysis. Results: the conceptual definitions obtained a content validation index of 1.00 for 15 indicators; operational definitions were fully consensual, for 17 indicators; the magnitudes of the conceptual definitions obtained an index of 1.00, for 13 indicators. The other items obtained an agreement of 0.88, and were revised following the experts' suggestions. In the external validation, 260 patients were surveyed; the majority, 55.8%, were women; the mean age of patients is 60.6 ±18.5 years. The intraclass correlation was excellent (0.97), and the reliability by Cronbach's alpha was 0.90. Confirmatory factor analysis showed a good fit of the model, with the following indices:  2 / g.l = 1.551; RMSEA = 0.04; NFI = 0.996; CFI = 0.999; SRMR = 0.16. Conclusion: the INICIARE-26 instrument, Brazilian version, proved to be valid, reliable and capable of measuring the patient's dependence on nursing care. When applied with the support of conceptual definitions, it presented better efficiency to the reality of Brazilian nursing. It is expected that the Pocket Guide built favors the use of INICIARE-26 by nurses at the time of its application, minimizing the subjectivity of the evaluation, and that it is an efficient didactic resource for the continuing education of nurses.

Diseño y validación de una escala de autoeficacia en la evaluación de tesis de grado en ciencias de la salud

Introducción. Las tesis de grado requieren de una adecuada evaluación para asegurar la calidad metodológica y su potencial publicable. Objetivos. Diseñar y validar una escala de autoeficacia en la evaluación de tesis de grado en jurados dictaminadores de ciencias de la salud (EAE-Te). Métodos. Estudio instrumental y transversal, donde participaron 221 jurados de tesis de grado de medicina, odontología, enfermería, nutrición y psicología, quienes laboran en instituciones privadas y estatales de las tres regiones del Perú. La escala se diseñó en base a indicadores teóricos hallados en la literatura científica, teniendo como primera versión 16 ítems. La validez basada en el contenido se evaluó con el coeficiente V de Aiken, la validez de constructo con el análisis factorial exploratorio y la confiabilidad con el coeficiente alfa de Cronbach y sus respectivos intervalos de confianza. Resultados. Los valores V de Aiken fueron favorables para todos los ítems. El análisis factorial exploratorio evidenció un modelo unidimensional con 13 ítems (KMO = 0,868; Bartlett = 2302.1; gl = 66; p < 0,001), donde el factor alcanzado explica el 60,99% de la varianza total de la escala y sus cargas factoriales oscilan entre 0,605 y 0,872; finalmente, la confiabilidad fue aceptable (α = 0,943; IC95% = 0,92-0,95). Conclusiones. La EAE-Te es una medida unidimensional y demuestra evidencias psicométricas iniciales de validez basada en el contenido, de estructura interna y fiabilidad; por tanto, puede aplicarse para evaluar el nivel de autoeficacia de los jurados para evaluar tesis de grado.

Introduction. Graduate theses require adequate evaluation to ensure their methodological quality and publishable potential. Objectives. To design and validate a scale of self-efficacy in the evaluation of graduate theses in health sciences jurors (EAE-Te). Methods. Instrumental and cross-sectional study, with the participation of 221 medical, dental, nursing, nutrition and psychology graduate thesis jurors who work in private and state institutions in the three regions of Peru. The scale was designed based on theoretical indicators found in the scientific literature, with a first version of 16 items. Content-based validity was evaluated with Aiken's V coefficient, construct validity with Exploratory Factor Analysis and reliability with Cronbach's Alpha coefficient and their respective confidence intervals. Results. Aiken's V values were favorable for all items. The exploratory factor analysis evidenced a unidimensional model with 13 items (KMO = 0.868; Bartlett = 2302.1; gl = 66; p < 0.001), where the factor reached explains 60.99% of the total variance of the scale and its factor loadings range between 0.605 and 0.872; finally, reliability was acceptable (α = 0.943; 95%CI = 0.92-0.95). Conclusions. The SEA-Te is a unidimensional measure and demonstrates initial psychometric evidence of content-based validity, internal structure and reliability; therefore, it can be applied to assess the level of jurors' self-efficacy to evaluate graduate theses.

El destino de los artículos originales rechazados. Análisis en una revista de salud pública en Latinoamérica

Introducción: Las investigaciones publicadas en revistas científicas permiten generar evidencias para la toma de decisiones. Sin embargo, el destino de las investigaciones que se reciben en una revista científica no siempre es su publicación. Objetivo: Determinar el destino de los artículos originales que fueron rechazados en la Revista Peruana de Medicina Experimental y Salud Pública (RPMESP) durante 2014 y 2015 y los factores asociados a su publicación. Materiales y métodos: Durante junio y julio del 2019 se realizó una búsqueda en Google Académico de los artículos originales que fueron rechazados en la RPMESP, se evaluaron como variables independientes el género, la procedencia y el grado académico del autor corresponsal, además si el rechazó fue realizado por el comité editor o luego de ser revisado por pares. Para determinar los factores asociados se calcularon riesgos relativos bivariados (RR) y multivariados (RRa) con intervalos de confianza al 95% (IC 95%) utilizando un modelo de regresión de Poisson simple y múltiple. Resultados: De 285 artículos originales rechazados el 45,6% tuvo como destino su publicación en otras revistas científicas de las cuales el 61,5% fueron revistas del extranjero, los autores corresponsales con filiación extranjera (RRa 1,34, IC 95%: 1,02-1,77) y estudiantes de pregrado (RRa 1,56, IC 95%: 1,12-2,17) incrementaron la probabilidad de publicación, pero disminuyó si el rechazo fue luego de la revisión por pares (RRa 0,71, IC 95%: 0,52-0,97). Conclusiones: Menos de la mitad de los artículos originales que fueron rechazados tuvo como destino su publicación en otra revista científica. Los autores deben analizar los motivos del rechazo y continuar con el proceso de publicación.

Introduction: Research published in scientific journals allows generating evidence for decision making. However, the destination of the research received in a scientific journal is not always its publication. Objective: To determine the destination of the original articles that were rejected in the Peruvian Journal of Experimental Medicine and Public Health (RPMESP) during 2014 and 2015 and the factors associated with their publication. Materials and methods: During June and July 2019, a Google Scholar search was carried out for the original articles that were rejected in the RPMESP, the gender, origin and academic degree of the corresponding author were evaluated as independent variables, in addition to whether he rejected was made by the editorial committee or after being reviewed by peers. To determine the associated factors, bivariate (RR) and multivariate (RRa) relative risks were calculated with 95% confidence intervals (95% CI) using a simple and multiple Poisson regression model. Results: Of 285 original articles rejected, 45.6% were destined for publication in other scientific journals, of which 61.5% were foreign journals, the corresponding authors with foreign affiliation (RRa 1.34, CI 95%: 1.02-1.77) and undergraduate students (RRa 1.56, 95% CI: 1.12-2.17) increased the probability of publication, but it decreased if the rejection was after peer review (RRa 0.71, 95% CI: 0.52-0.97). Conclusions: Less than half of the original articles that were rejected were destined for publication in another scientific journal. The authors must analyze the reasons for the rejection and continue with the publication process.

How Indian physiologists are contributing to the peer review of scientific literature? An audit of publons profiles

Background: Peer review is one of the cornerstones of sound scientific publication. When a paper is submitted to a journal, after an initial assessment, the editor sends the article to reviewers with similar research experiences for comprehensive comments. Aims and Objectives: In this article, we aimed to analyze the pattern of peer review by the reviewers in the physiology domain from India as found in publons.com. Materials and methods: We searched https://publons.com and clicked on 揃rowse� to search the profile of 揜esearchers.� The research field was selected as 揚hysiology� and the country as 揑ndia.� A total of 158 profiles were found with the search criteria. The number of publications, citations, peer review, H-index, and the editorial record was obtained for further analysis. The number of the peer review was tested with the number of publications and citations for any existing correlation. Results: Among the 158 researchers in the physiology domain, an average verified review was 8.09 � 32.12 and an average number of publications were 15.7 � 31.1. Their number of citations was 359.75 � 1296.24 with an average H-index of 4.15 � 7.85. There was a significant positive correlation with peer review versus number of publication (0.39 [95% CI: 0.24 to 0.51], P < 0.0001) and peer review versus number of citation (0.26 [95% CI: 0.11 to 0.41)], P = 0.0008). Conclusion: Peer reviewers in the physiology domain from India have contributed by reviewing an average of 8 peer reviews. However, many of the profiles showed zero contribution. More publications and more citations would expose the researchers to a wider audience worldwide, including the editors. Hence, they would get peer review requests.

Adesão ao formato preprint por docentesde odontologia das universidades públicas do Rio Grande do Sul / Adherence to the preprint format by dentistry professors from public universities in Rio Grande do Sul

Objetivo: Avaliar a aderência à publicação de preprints pelos professores dos cursos de pós-graduação em Odontologia, das três Universidades Federais do Estado do Rio Grande do Sul (UFRGS, UFPel e UFSM) (n = 97). Materiais e métodos: Quatro revisores realizaram a busca de publicações em formato preprint, em maio de 2021, nas plataformas MedArxive SciELO Preprints, por cada professor incluído. Os mesmos revisores extraíram os dados que foram checados por um quinto revisor. Para a avaliação e comparação das dife-rentes universidades foi utilizado o teste exato de Fisher, com posterior análise dos resíduos com α corrigido. Para a comparação entre as plataformas foi realizado o teste do Qui-quadrado de Pearson (α = 0,05). Resultados: Os resul-tados mostraram que 16,5% (n=16) do total de professores incluídos já haviam publicado pelo menos 1 preprint em alguma das duas plataformas, sendo que a UFPel diferiu estatisticamente das outras universidades, apresentando o maior número de aderência seguido pela UFRGS e UFSM (p=0,038). Não houve diferença estatística quanto a com-paração das plataformas pesquisadas (p=0,306). Discussão: Os achados demonstram que este formato, mesmo que de forma incipiente, já é uma realidade na área de Odontologia. Conclusão: Os achados deste estudo indicam uma baixa taxa de aderência ao formato de publicação preprint pelos professores dos programas de pós-graduação em Odontologia das universidades públicas do Rio Grande do Sul.

Aim: To evaluate the adherence to the publication of preprints by professors of postgraduate programs in Dentistry, from the three Federal Universities of the Rio Grande do Sul (UFRGS, UFPel and UFSM) (n = 97). Mate-rials and methods: Four reviewers performed a search for publications in the preprint format, in May 2021, on the MedArxiv and SciELO Preprints platforms, for each included professor. The same reviewers extracted the data which were checked by a fifth reviewer. Fisher's exact test was used for the evaluation and comparison of the different universities. For comparison between platfor-ms, Pearson's Chi-square test was applied with α = 0.05. Results: The results showed that 16.5% (n=16) of the total number of professors included had already published at least 1 preprint on either of the platforms, with UFPel differing statistically from the other universities, with the highest membership followed by UFRGS and UFSM (p = 0.038). There was no statistical difference between the platforms concerning the number of published pre-prints (p=0,306). Discussion: The findings demonstrate that this format, even incipiently, is already a reality in the Dentistry field. Conclusion: The findings of this study indicate a low rate of adherence to the preprint publication model by professors of the postgraduate programs in Dentistry in the public universities in of the Rio Grande do Sul state in Brazil.

Impact of COVID-19 on gender gap in dental publications: a retrospective cohort with three Brazilian journals

Abstract This was a retrospective cohort study to investigate the impact of COVID-19 pandemic on the gender gap in articles submitted to three international dental journals based in Brazil. All submissions performed to Brazilian Dental Journal, Brazilian Oral Research, and Journal of Applied Oral Science before (2019) and during the pandemic (2020) were assessed. Gender of the first, last, and corresponding authors were collected. Other variables collected were journal, continent studied by authors and stage of their careers (classified according to authors' highest degree), and final decision reached in the article. Absolute and relative frequencies with 95% confidence intervals, Pearson's Chi-square tests, and Fisher's Exact test were used (α = 0.05). In total, 4,726 unique submissions were analyzed. A higher proportion of early-career authors was observed during the pandemic (44.8% to 49.3%, p = 0.021). Most articles were rejected but without association with gender. Increased proportion of male first authors from before to during the pandemic was observed (39% to 42.1%, p = 0.034). Drop in the proportion of articles with women as first authors was observed for researchers in their early- (65.9% to 58.8%, p = 0.02) and mid-career stages (63% to 55.8%, p = 0.014). Reduction in women as first authors was observed during the pandemic in South and Central Americas (66.7% to 61.5%, p = 0.010), and when the last author was a female, or the corresponding author was a male. In conclusion, a disproportionate impact on female dental researchers in submitting articles in the period from before to during the pandemic was observed when considering first authorship, suggesting that the COVID-19 may have increased the gender inequality in dental science.

Lessons learnt from UNAIDS virtual technical support to countries applying for funding from the Global Fund COVID-19 Response Mechanism

In 2020 the Global Fund for AIDS, Tuberculosis and Malaria initiated a new funding modality, the COVID-19 Response Mechanism, to mitigate the pandemic's effects on HIV, TB and malaria programmes and health systems in implementer countries. In 2021 UNAIDS introduced an innovative technical virtual support mechanism for COVID-19 Response Mechanism proposal development to help countries quickly implement COVID-19 interventions while at the same time adapting HIV and related services to the pandemic's circumstances and mitigate its impact while maintaining hard-won gains. It also intended to ensure more attention was paid to communities, human rights and gender considerations in proposal development, resulting in successful proposals to mitigate COVID-19's impact, bring human rights-based and people-centred HIV programmes back on track and even expand their reach through using new delivery platforms. In 2021, applications from 18 sub-Saharan African and Asian countries received in-depth remote peer reviews. We discuss the reviews' key findings and recommendations to improve proposal quality and identify future opportunities for virtual technical support. The model was successful and contributed to better quality funding applications, but also highlighted challenges in pandemic mitigation, adaptations and innovations of HIV programmes. Countries still fell short on comprehensive community, human rights and gender interventions, as well as innovations in HIV service delivery, especially in prevention and gender-based violence. Several other weaknesses meant that some countries would have to refine their programme design and implementation model in the final version of their funding application. There are implications for future assistance to countries trying to mitigate the impact of COVID-19 on their health programmes and innovative ways to deliver technical support using new technologies and local expertise.

Revisión por pares en la publicación científica: recomendaciones desde ODOVTOS / Peer Reviews in Scientific Journals: Recommendations from ODOVTOS

Resumen El proceso editorial de una revista, específicamente la revisión por pares, valida la publicación científica con el respaldo de la experiencia y el conocimiento de los revisores. Sin embargo, a pesar de que existen programas que capacitan en la parte investigativa a los miembros de la comunidad científica, son escasas las herramientas de capacitación para participar en el arbitraje de un manuscrito. El propósito de este artículo es presentar una guía con una serie de recomendaciones sobre cómo un artículo científico debe ser revisado por pares. Se realiza una sumatoria de recomendaciones y criterios que servirán para que los revisores de Odovtos-International Journal of Dental Sciences puedan utilizar como referencia y respaldo para su labor.

Abstract The editorial process of a journal, specifically peer review, validates the scientific publication supported by the experience and knowledge of the reviewers. However, despite the fact that there are programs that instruct members of the scientific community in research, there are few training tools to participate in the arbitration of a manuscript. The purpose of this article was to present a guide with a series of recommendations on how a scientific article should be peer-reviewed. A synopsis of recommendations and criteria is presented and will be used by the reviewers of Odovtos-International Journal of Dental Sciences as a reference to support their work.

Validación de contenido y adaptación de la escala de sentido de coherencia 29 para la población colombiana / Content validation and adaptation of the 29-item Sense of Coherence scale for the Colombian population / Validação de conteúdo e adaptação da escala senso de coerência (soc-29) para a população colombiana

Resumen Objetivo: Validar el contenido de la escala de sentido de coherencia 29 para la población colombiana, la cual mide la capacidad de las personas para aprovechar los recursos materiales e inmateriales que dispone para enfrentar los estímulos presentes a lo largo de la vida. Metodología: Investigación del tipo validación de instrumentos, realizada bajo la técnica de juicio de expertos. El procedimiento contiene cinco pasos: preparación de instrucciones y planilla, selección de expertos, explicación del contexto, discusión y establecimiento de acuerdos. Los criterios de calidad valorados para la validación de contenido fueron: "pertinencia", "relevancia", "utilidad", "suficiencia", "claridad" y "apariencia". Se contó con el consentimiento informado de los participantes. Resultados: La escala de sentido de coherencia fue adaptada acorde con ciertos términos desde el punto de vista semántico y sintáctico, y según las pruebas realizadas, posee buena consistencia interna, con un Alfa de Cronbach de 0,838 y un valor global del índice de validez de contenido considerado como esencial de 0,83. Conclusiones: Los hallazgos cuantitativos y cualitativos del proceso de validación confirman que la escala en versión español puede ser aplicada en población colombiana, con el fin de medir el sentido de coherencia, entendido como la capacidad de aprovechar los recursos para enfrentar los estímulos.

Abstract Objective: To validate, for the Colombian population, the content of the 29-item Sense of Coherence scale, which measures the ability of people to take advantage of material and immaterial resources available for them to face the stimuli present throughout life. Methodology: Instrument validation research, carried out under the expert judgment technique. The procedure contains five steps: preparation of instructions and worksheet, selection of experts, explanation of the context, discussion, and establishment of agreements. The quality criteria assessed for content validation were: "pertinence," "relevance," "usefulness," "sufficiency," "clarity," and "appearance." Informed consent was obtained from all the participants. Results: The Sense of Coherence scale was adapted according to certain terms from the semantic and syntactic point of view, and according to the tests carried out, it has good internal consistency, with a Cronbach's alpha of 0.838 and a global value of the content validity index considered as essential of 0.83. Conclusions: The quantitative and qualitative findings of the validation process confirm that the scale version in Spanish can be applied in the Colombian population with the aim of measuring the sense of coherence, understood as the ability to take advantage of resources to face stimuli.

Resumo Objetivo: Validar o conteúdo da escala senso de coerência 29 para a população colombiana, a qual mede a capacidade das pessoas para aproveitar os recursos materiais e imateriais disponíveis para enfrentar os estímulos presentes ao longo da vida. Metodologia: Estudo do tipo validação de instrumentos, realizado com a técnica de julgamento de especialistas. O procedimento está composto por cinco passos: preparação de instruções e planilha, seleção de especialistas, explicação do contexto, discussão e estabelecimento de acordos. Os critérios de qualidade analisados para a validação de conteúdo foram: "pertinência", "relevância", "utilidade", "suficiência", "clareza" e "aparência". Contou-se com o consentimento informado dos participantes. Resultados: A escala senso de coerência foi adaptada de acordo com certos termos partindo do ponto de vista semântico e sintático, e de acordo com os testes realizados, possui boa consistência interna, com um Alfa de Cronbach de 0,838 e um valor global de índice de validade de conteúdo considerado como essencial de 0,83. Conclusões: As descobertas quantitativas e qualitativas do processo de validação confirmam que a escala na versão em espanhol pode ser aplicada na população colombiana, com o objetivo de medir o sentido de coerência, entendido como a capacidade de aproveitar os recursos para enfrentar os estímulos.

Distribución geográfica y brecha de género en la revisión por pares de una revista científica biomédica en Latinoamérica / Geographic distribution and gender gap in the peer review of a Latin American biomedical scientific journal

La revisión por pares es un proceso importante al permitir tomar decisiones previas a la publicación de un artículo. Sin embargo, existe escasa información en revistas científicas de Latinoamérica sobre los profesionales que participan en estos procesos. Este trabajo se propuso determinar la distribución geográfica y de género en la revisión por pares realizada en la Revista Peruana de Medicina Experimental y Salud Pública. Se analizaron las listas de agradecimiento de quienes participaron en la revisión por pares de esta revista desde el año 2010 hasta el 2017. El país de procedencia se identificó a partir de la afiliación institucional, mencionada inicialmente por los revisores, y para la identificación del género se utilizaron los nombres. En caso de existir duda con el género se realizó una búsqueda de imágenes y de perfiles académicos públicos disponibles en Internet. Se encontraron 1 628 menciones de agradecimientos a profesionales que participaron en la revisión por pares; el 60,4 por ciento (n = 983) fueron procedentes del extranjero, principalmente de España, México, Chile, Colombia y Argentina. El 71,1 por ciento (n = 1158) fueron revisores hombres y el 28,9 por ciento (n = 470) revisoras. según la procedencia de las revisoras, el 35,0 por ciento (n = 344) fueron del extranjero y el 19,6 por ciento (n = 126) de Perú; y en los revisores hombres el 65,0 por ciento fueron del extranjero y el 80,6 por ciento de Perú. La revisión por pares en una revista científica biomédica en Perú fue realizada principalmente por profesionales de otros países de habla hispana. Existe una brecha de género que es mayor para la participación de revisoras de Perú(AU)

Peer review is an important process that makes it possible to take decisions before the publication of an article. However, little information is available in Latin American scientific journals about the professionals involved in this process. The purpose of the study was to determine the geographic and gender distribution of peer review in the Peruvian Journal of Experimental Medicine and Public Health. Data about peer reviewers were obtained from the acknowledgements sections of journal issues published from 2010 to 2017. The country of origin was identified from the institutional affiliation reported by peer reviewers, and gender was derived from their proper names. In the event of doubt about a reviewer's gender, a search was conducted for images and public academic profiles available on the Internet. A total 1 628 acknowledgement mentions were found, 60.4percent (n = 983) of which referred to overseas reviewers, mainly from Spain, Mexico, Chile, Colombia and Argentina. 71.1percent (n = 1 158) of the reviewers were male and 28.9percent (n = 470) were female. 35.0percent (n = 344) of the female reviewers were foreign and 19.6percent (n = 126) were from Peru, whereas 65.0percent of the male reviewers were foreign and 80.6percent were from Peru. Peer review in a Peruvian biomedical scientific journal was mainly conducted by professionals from other Spanish-speaking countries. A gender gap was observed which is wider for participation of Peruvian female reviewers(AU)

Validación de encuesta a pacientes con insuficiencia cardíaca crónica en cuidados paliativos para el trabajo de enfermería / Validation of a Survey for Nursing Work with Patients with Chronic Heart Failure in Palliative Care

Introducción: En Cuba, las enfermedades del corazón son primera causa de muerte. En etapas avanzadas de la insuficiencia cardiaca, la terapia curativa pierde eficacia y los cuidados paliativos constituyen una opción válida, pero su uso no está aún generalizado. Objetivo: Validar una encuesta para caracterizar la situación psicosocial educativa y de salud y la opinión sobre la atención a pacientes con insuficiencia cardíaca crónica en cuidados paliativos. Métodos: Estudio instrumental en el área de salud del Policlínico "XX Aniversario", del municipio Remedios, Villa Clara, Cuba, entre enero-diciembre de 2018. Basado en el método Delphi para determinar la validez, a través del criterio de expertos, de una encuesta para aplicar a pacientes con insuficiencia cardiaca crónica. La investigación se desarrolló en tres etapas: adecuación del cuestionario, validación de contenido y prueba piloto. Se seleccionó una muestra de 35 pacientes. La validación de la funcionabilidad del cuestionario se determinó a través del cálculo del coeficiente Alfa de Cronbach. Resultados: La encuesta elaborada para la investigación, validada y enriquecida por el criterio de expertos, permite caracterizar la situación psicosocial educativa y de salud de pacientes con insuficiencia cardíaca crónica que reciben cuidados paliativos y ayuda a conocer sus criterios sobre la atención que reciben. Conclusiones: El instrumento construido es pertinente para su empleo efectivo en su contexto de aplicación y es posible su generalización a otros escenarios(AU)

Introduction: In Cuba, heart diseases are the leading cause of death. In advanced stages of heart failure, the curative therapy loses efficacy and palliative care is a valid option; however, its use is not yet widespread. Objective: To validate a survey for characterizing the educative psychosocial and health situation, as well as the opinion about the care of patients with chronic heart failure in palliative care. Methods: Instrumental study carried out, between January and December 2018, in the health area of XX Aniversario Polyclinic of Remedios Municipality, Villa Clara Province, Cuba. The study was based on the Delphi method to determine the validity, through expert judgment, of a survey to apply with patients with chronic heart failure. The research was developed in three stages: adaptation of the questionnaire, content validation, and pilot test. A sample of 35 patients was selected. The validation of the questionnaire's functionality was determined through calculation of Cronbach's alpha coefficient. Results: The survey prepared for the research, validated and enriched by expert judgement, allows to characterize the educative psychosocial and health situation of patients with chronic heart failure who receive palliative care and helps to know their criteria about the care they receive. Conclusions: The obtained instrument is appropriate for its effective use in its application context, while its generalization to other settings is possible(AU)

Concepto de gestión por competencias desde los riesgos, necesidad en la cultura de entidades médicas / Concept of management by competencies from risks, a need in the culture of medical entities

RESUMEN Fundamento: la gestión por competencias, se gesta sobre pilares básicos, de los cuales se apropian los recursos humanos, para adquirir conocimientos y desarrollar los diferentes saberes que necesitan; acción que está sujeta a riesgos, a partir de la interconexión de comportamientos, conductas y emociones, durante el despliegue de sus funciones. Objetivo : construir un concepto de gestión por competencia, sobre la base de los riesgos, que garantice una cultura favorable al logro de los objetivos de la organización. Métodos: se entrevistaron 15 expertos en gestión humana, se realizó un estudio bibliométrico, con el análisis de diferentes bases de datos, se efectuaron debates y tormentas de ideas sobre las tendencias y particularidades del enfoque de gestión por competencias en relación con las incertidumbres y los riesgos; en el procesamiento de la información relacionada con la conceptualización estudiada, se emplearon métodos estadísticos, con la ayuda de los software Statistics Program for Social Sciences para Windows, UCINET. Resultados : luego de estudiar los postulados, de un conjunto de autores, emerge un análisis que visualiza la vulnerabilidad del trabajo con las competencias, de ahí la necesidad de incluir el enfoque de riesgo en la gestión por competencias; se obtiene una aproximación conceptual de este constructo con enfoque de riesgos. Conclusiones : la articulación del enfoque de competencias con el de riesgos permitirá que se establezcan sistemas de vigilancias, que tributen a la gestión de los recursos humanos, bajo los principios de integración con los procesos organizacionales.

Lógica difusa: metodología cuantitativa útil para determinar el consenso entre expertos de ciencias estomatológicas / Fuzzy logic: a useful quantitative methodology to determine consensus among dental science experts

RESUMEN La lógica difusa trata de copiar la forma en que los humanos toman decisiones. Específicamente en el área médica, se utiliza desde hace varios años en estudios aplicados a áreas como: ingeniería biomédica, sistemas expertos, modelos epidemiológicos y sistemas diagnósticos. Se confeccionó un cuestionario para medir la calidad de vida relacionada con la salud oral en adolescentes cubanos; se utilizó la lógica difusa en el proceso de validación por expertos, mediante el software PROCESA_CE (2013). En el nivel de concordancia de los expertos se rechazó la hipótesis nula de que no existe comunidad de preferencia entre ellos, para un nivel de significación de 0,01; esto garantizó, con un 99% de confiabilidad, que es posible hacer valoraciones a partir del consenso de estos expertos. Además, se corroboró la existencia de un consenso de 5 en todos los ítems.

ABSTRACT Fuzzy logic tries to copy the way humans make decisions. It has been used for several years, specifically in the medical field, in studies applied to areas such as biomedical engineering, expert systems, epidemiological models and diagnostic systems. A questionnaire was prepared to measure the quality of life related to oral health in Cuban adolescents; Fuzzy logic was used in the validation process based on expert criteria, using the PROCESA_CE (2013) software. According to expert agreements, the null hypothesis that there is no community of preference among them was rejected, for a significance level of 0.01; this guaranteed, with 99% reliability, that it is possible to make assessments based on their consensuses. In addition, the existence of a consensus of five in all items was corroborated.

Brazilian authors don't cite Brazilian authors: Nothing has changed since 1994 / Os Autores brasileiros não citam os autores brasileiros: Nada mudou desde 1994

Abstract Objective To outline the profile of self-citations from Revista Brasileira de Ortopedia (Rev Bras Ortop) and citations of this journal in other medical orthopaedic journals with general or specific content in a knowledge area of the specialty. Methods This is an observational cross-sectional study of the frequency of self-citations and citations from Rev Bras Ortop in five other medical orthopaedic journals from different countries, all published in English. The last 15 articles published in 2020 in each of the six journals were analyzed. The references used in each of them were evaluated to identify the journal in which they were originally published. The frequency of distribution of the four main journals cited, their position, and the relative percentage to the total number of citations were observed and recorded in each of the six journals. The number of times that the Rev Bras Ortop was cited in each of the selected foreign journals was assessed using its absolute and relative frequencies. Results The total number of citations evaluated in this study was 2,527 (ranging from 386 to 486 per magazine). Rev Bras Ortop showed a low rate of self-citation (2.6%), being the sixth journal cited in the journal itself (10 out of a total of 386 references). Moreover, Rev Bras Ortop was not mentioned in any of the other five medical journals included in the study (absolute frequency 0, relative frequency 0). Conclusion Rev Bras Ortop has a low reference of itself, with a self-citation rate of 2.6% in the studied period, showing that the Brazilian orthopaedic surgeons do not mention the Brazilian orthopaedic surgeon who publishes in the journal. We suggest the elaboration and implementation of strong strategies to improve the journal's visibility in the world academic-scientific scenario. In addition, it is essential that Brazilian orthopaedic surgeons understand this reality and assist directly and effectively to change this scenario.

Resumo Objetivo Observar o perfil de autocitações da Revista Brasileira de Ortopedia (Rev Bras Ortop) e de citações deste periódico em outras revistas médicas de ortopedia de conteúdo geral ou específico de uma determinada área de conhecimento da especialidade. Métodos Trata-se de estudo observacional transversal da frequência de autocitações e citações da Rev Bras Ortop em outros cinco periódicos médicos de ortopedia de diferentes países, todas publicadas em língua inglesa. Foram analisados os 15 últimos artigos publicados em 2020 em cada uma das seis revistas estudadas. As referências usadas em cada um delas foi avaliada para identificação do periódico em que foram publicadas originalmente. A distribuição de frequência dos quatro principais periódicos citados, sua posição e o percentual relativo ao total de citações foram observados e registrados em cada uma das seis revistas. O número de vezes em que a Rev Bras Ortop foi citada em cada um dos periódicos estrangeiros selecionados foi avaliado por meio de suas frequências absoluta e relativa. Resultados O total de citações avaliadas neste estudo foi de 2527 (variando de 386 a 486 por revista). A Rev Bras Ortop apresentou baixa taxa de autocitação (2,6%), sendo citada na própria revista na sexta posição (10 de um total de 386 referências). No período estudado, a Rev Bras Ortop não foi citada em nenhum dos outros cinco periódicos médicos incluídos no estudo (frequência absoluta 0, frequência relativa 0). Conclusão Observou-se que a Rev Bras Ortop apresenta baixa referência de si própria, com taxa de autocitação de 2,6% no período estudado, mostrando que de fato o ortopedista brasileiro não cita o ortopedista brasileiro que publica na revista. Sugerimos a elaboração e a implementação de estratégias fortes de melhora da visibilidade do periódico no cenário acadêmico-científico mundial. Além disso, é fundamental que os ortopedistas brasileiros entendam esta realidade e auxiliem direta e efetivamente em sua mudança.

Técnica Delphi no processo de validação do Questionário de Avaliação da Atenção Básica (QualiAB) para aplicação nacional / Delphi Technique in the validation process of the national application of the Questionnaire for Primary Care Assessment (QualiAB)

Resumo Este trabalho tem como objetivo descrever o uso da Técnica Delphi no processo de atualização e validação de conteúdo do Questionário de Avaliação da Qualidade de Serviços de Atenção Básica (QualiAB) para aplicação nacional. Deste estudo participaram 19 especialistas com experiência em pesquisa em avaliação em saúde, assistência e gestão em atenção primária à saúde (APS). Uma versão revisada do instrumento QualiAB com 105 indicadores foi encaminhada para avaliação quanto ao grau de relevância, aplicabilidade nacional e aceitabilidade. A Técnica Delphi modificada foi realizada em duas rodadas. Os resultados apontam que a taxa de resposta na primeira rodada foi de 73,6%, 40 indicadores foram aceitos e 65 não obtiveram consenso, dos quais 54 receberam sugestões de alteração da questão e/ou do indicador. Na segunda rodada a taxa de resposta foi de 92,8%. Foram reenviados 65 indicadores com incorporação de alterações, dos quais seis foram aceitos. Dos 59 restantes, 51 obtiveram sugestões de alteração. A Técnica Delphi modificada contribuiu para o aprimoramento do instrumento QualiAB enquanto etapa intermediária de um processo de validação iterativa. Contudo, a realização em duas rodadas demonstrou ser insuficiente para validação dos indicadores de qualidade organizacional diante da abrangência e diversidade das ações realizadas pelos serviços de APS.

Abstract This article aims to describe the use of the Delphi Technique in a process of updating and validating the content of the Primary Care Services Quality Assessment Questionnaire (QualiAB) for national application. In this study, 19 experts with experience in research in health evaluation, care and management in Primary Health Care (PHC) agreed to participate. A revised version of the QualiAB instrument with 105 indicators was submitted for evaluation as to its relevance, national applicability and acceptability. The modified Delphi Technique was performed in two rounds. The response rate of experts in the first round was 73.6%, 40 indicators were accepted and 65 did not reach consensus, of which 54 obtained suggestions to change the question and/or indicator. In the second, the response rate was 92.8%, and 65 indicators were resent with incorporation of changes, of which six were accepted. Of the remaining 59, 51 obtained suggestions for change. The modified Delphi Technique contributed to the improvement of the QualiAB instrument as an intermediate step in an iterative validation process. However, the performance in two rounds proved to be insufficient to validate the organizational quality indicators in view of the scope and diversity of the actions performed by the PHC services.