ABSTRACT
BACKGROUND: The collaborative clinical simulation (CCS) model is a structured method for the development and assessment of clinical competencies through small groups working collaboratively in simulated environments. From 2016 onward, the CCS model has been applied successfully among undergraduate and graduate medical students from the Universidad de Talca, Chile; the Universität de Barcelona, Spain; and the Universidad de Vic-Manresa, Spain. All the templates for building the clinical cases and the assessment instruments with CCS were printed on paper. Considering the large number of CCS sessions and the number of participating students that are required throughout the medical degree curriculum, it is impossible to keep an organized record when the instruments are printed on paper. Moreover, with the COVID-19 pandemic, web platforms have become important as safe training environments for students and medical faculties; this new educational environment should include the consolidation and adaptation of didactic sessions that create and use available virtual cases and use different web platforms. OBJECTIVE: The goal of this study is to describe the design and development of a web platform that was created to strengthen the CCS model. METHODS: The design of the web platform aimed to support each phase of the CCS by incorporating functional requirements (ie, features that the web platform will be able to perform) and nonfunctional requirements (ie, how the web platform should behave) that are needed to run collaborative sessions. The software was developed under the Model-View-Controller architecture to separate the views from the data model and the business logic. RESULTS: MOSAICO is a web platform used to design, perform, and assess collaborative clinical scenarios for medical students. MOSAICO has four modules: educational design, students' collaborative design, collaborative simulation, and collaborative debriefing. The web platform has three different user profiles: academic simulation unit, teacher, and student. These users interact under different roles in collaborative simulations. MOSAICO enables a collaborative environment, which is connected via the internet, to design clinical scenarios guided by the teacher and enables the use of all data generated to be discussed in the debriefing session with the teacher as a guide. The web platform is running at the Universidad de Talca in Chile and is supporting collaborative simulation activities via the internet for two medical courses: (1) Semiology for third-year students (70 students in total) and (2) Medical Genetics for fifth-year students (30 students in total). CONCLUSIONS: MOSAICO is applicable within the CCS model and is used frequently in different simulation sessions at the Universidad de Talca, where medical students can work collaboratively via the internet. MOSAICO simplifies the application and reuse of clinical simulation scenarios, allowing its use in multiple simulation centers. Moreover, its applications in different courses (ie, a large part of the medical curriculum) support the automatic tracking of simulation activities and their assessment.
ABSTRACT
Se analiza la experiencia adquirida en 132 casos de embarazo ectópico atendidos en el Hospital Clínico Regional de Concepción entre el 1ª de enero de 1982 y el 30 de junio de 1984. La frecuencia observada fue de 1 por cada 113 partos; la edad promedio fue de 28,9 años, con una variación de 18 a 41 años. Entre los antecedentes causales de mayor frecuencia aparecen usuarias de dispositivo intrauterino, DIU; aborto, y cirugía tubaria y ovárica. Se detallan los hallazgos del examen físico y los métodos de ayuda diagnóstica. Entre estos últimos destacan la punción del fondo de saco de Douglas, la ecografía, la biopsia de endometrio, la celiotomía exploradora y la laparoscopia. El diagnóstico fue correcto y oportuno en 84,8% de los casos; se sospechó en 8,3%, e incorrecto en 6,8%. No hubo mortalidad materna. Se discuten y comentan los resultados, poniéndose de relieve la importancia de la observación y de la cuidadosa evaluación clínica de cada paciente
