Simulation-based education in neurology: lessons from the COVID-19 pandemic. (preprint)

Objectives The COVID-19 pandemic has led to the disruption of all sectors of the economy including education. According to UNESCO over 1.37 million young people including medical students, were affected by the lockdowns in response to COVID-19 and the subsequent closure of the education system. The primary challenge for medical education was to provide clerkships in a biosafety environment. This study aimed to determine the impact of a simulated hospital in a neurology clerkship of 5-year medical students during the coronavirus pandemic and compare their results with a non-pandemic group in Bogotá, Colombia.Results The students in the pandemic group answered a Likert scale survey regarding their satisfaction with the simulated hospital. Both groups were required to perform an oral, mid-term and final examination. From the results, it is clear that students perceived that exposure to a simulated hospital facilitated their learning process (93.1%) and allowed greater interaction with the teacher compared to a face-to-face environment (77.3%). There were no clinically significant differences in test results. This experience indicates that a simulated hospital is a valuable method to acquire clinical skills in trainees, that could be integrated into the curricular milestones of medical education programs regardless of the pandemic.

A simulated hospital: an effective teaching tool during the COVID-19 pandemic (preprint)

Background: The COVID-19 pandemic has led to the disruption of all sectors of the economy including education. According to UNESCO, over 1.37 million young people, including medical students, were affected by the lockdowns in response to COVID-19 and the subsequent closure of the education system. The main challenge for medical education has consisted in offering clerkships within a biosafety environment. The simulated hospital emerges as a teaching tool that guarantees the development of medical skills in a biosafety environment.Methods: A quasi-experimental design was conducted in a population of 5th-year medical students during their neurology clerkship. The sample comprised two similar groups. The first one received a traditional face-to-face format during 2019, whereas the second group received a mixed virtual and simulation-based clerkship in 2020. At the end of the course, all students in the pandemic group answered a Likert scale survey regarding their satisfaction with the simulated hospital. To evaluate theoretical knowledge acquisition, students of the pandemic and the non-pandemic group were required to perform a mid-term and a final examination.Results: Most of the students considered the simulated hospital a useful addition that should be incorporated into their medicine curriculum regardless of the pandemic. From the results, it is clear that students perceived that exposure to a simulated hospital facilitated their learning process (93.1%) and allowed greater interaction with the teacher compared to a face-to-face environment (77.3%). Although there was a difference in test results, it was not clinically significant.Conclusions: This study shows that a simulated hospital is a highly efficient method to acquire clinical skills in trainees with improvement in medical knowledge and satisfaction evidenced by the Likert scales and comparable results in academic evaluations. The authors experience indicates that exposure to a simulated hospital should be integrated into the curricular milestones of the medical education program regardless of the pandemic.

Simultaneous Arterial and Venous Brain Infarctions in a Patient with COVID-19. (preprint)

Introduction: Stroke is one of the manifestations of COVID-19 associated coagulopathy. Arterial infarcts are the most common presentation, however involvement of both arterial and venous irrigation is possible but rare. We report, what is, to our knowledge, the second case of concomitant arterial and venous brain thrombosis evidenced in magnetic resonance. Case presentation: A 62-year-old man presented with acute weakness of the left hand and lack of coordination in the left arm. Nine days earlier, he was positive for SARS-CoV-2 RT-PCR. The brain images revealed two subacute infarcts, one corresponding to the territory of the right middle cerebral artery, and the other in the right frontal cortical vein. Conclusion: The existence of both venous and arterial brain infarcts due to COVID-19 infection, has been previously reported once. Most of the cases of stroke are due to only arterial thrombosis, therefore this could be the starting point to start collecting data about simultaneous compromise in order to assess and compare outcomes, severity of the disease, among other variables.