Evaluación de habilidades comunicativas desde una perspectiva 360° durante escenarios de Tele-rehabilitación simulada / Evaluation of communication skills from a 360° perspective at simulated Tele-rehabilitation scenarios

BACKGROUND: Communication skills (CS) are competencies required by health professionals. Clinical simulation with a simulated/standardized patient (SP) is a good resource for teaching this skill. However, it requires trained teachers to guide the process. Not all teachers have this training. HC short evaluation instruments are required to develop a structured observation during the activity, especially those that can be applied by all the participants to guide and understand the process from a broader perspective. AIM: Validate a short HC assessment questionnaire to evaluate these skills from a 360° analysis, i.e., from the learner, facilitator/teacher, and PS perspective. METHOD: A brief HC questionnaire was created, subjected to construct and content validity, and thus applied to 40 Kinesiology undergraduate students, facilitator/teacher, and PS during a simulated teleconsultation scenario. We analyzed the result of the communication by descriptive statistics, Lashe, Cronbach, KMO, Bartlett, IVC, Fisher and Cohen tests, and exploratory factorial analysis. RESULTS: The questionnaire showed content validity for 5 of 6 items. Construct validity with commonalities over 50% for each item. With good reliability (Cronbach's alpha > 0.79). We found high levels of HC in the students, but the concordance between observers was weak (Cohen's Kappa < 0.4). CONCLUSION: The short questionnaire for HC is a valid assessment tool during clinical simulation. Incorporating the views and perceptions of all the simulation participants can improve the understanding of health communication.

Efectos sobre factores ocupacionales y en el medio ambiente originados por el proceso de descarne a partir del curtido / Effects on occupational factors and environment as a result from rawhide process of the tanning

La ciudad de León cuenta con 500 empresas de curtiduría y 9 dedicadas al procesamiento del sebo cuyos subproductos (descarne) son desechos que se vierten al medio ambiente en grandes cantidades, ya que no representan un interés para su procesamiento y comercialización, lo que ha causado diversos problemas de contaminación en las zonas habitacionales circundantes por el vertido de aguas residuales, residuos sólidos y emisiones atmosféricas. El impacto al medio se puede considerar como adverso, directo y temporal; reversible, pero con un alto costo económico, lo que implica la necesidad de establecer medidas preventivas de control y mitigación. En el presente estudio se describen las etapas delproceso, las buenas y malas prácticas, los procedimientos estándares de operación y los impactos al medio ambiente originados por el inadecuado manejo de los residuos de las industrias sebaderas. Los resultados muestran que el 80 por ciento de las empresas procesadoras carece de sistemas de almacenamiento adecuado y no poseen sistemas de control ambiental. De igual manera, la mayoría de los operarios no cuenta con equipos de protección personal y no existe un adecuado manejo de sustancias utilizadas en los procesos, lo que incrementa el riesgo de accidentes laborales.

The city of León has 500 tannery companies and nine work in fat processing, whose by-product waste (rawhide) is dumped to the environment in tons because there is no interest in processing and commercializing this substance. This situation has caused several contamination problems in surrounding residential areas because ofthe discharge of wastewater, solid waste, and atmospheric emissions. Impact on environment can be considered as adverse, direct and temporal, as well reversible, but excessively expensive, which involvesthe need of established preventive measures of control and mitigation.The present study describes the different stages of the process, goodand bad practices, standard operational procedures, and environmentalimpacts due to the inadequate handling of waste by these companies. Results show that 80 percent of the processing companies lack appropriate storage systems and do not have an environmental control system. Additionally, most of the operators do not have personal protective equipment and there is not a proper handling of the substances used in processes; this increases the risk of work-related accidents.