An electrogram-guided transvenous temporary pacemaker implant simulator.

INTRODUCTION: Transvenous temporary pacemaker (TvTP) implantation is a critical procedure often performed under time limitations, playing a crucial role in patient survival. However, the amount of training provided for resident cardiologists is variable, due to the availability of patients. Thus, the use of simulators for this cardiologic procedure could be used as training tools. OBJECTIVE: The present study aimed to develop a simulator system for TvTP implantation based on electrograms, called ETTIS (Electrogram-guided Transvenous Temporary-pacemaker Implantation Simulator), and to evaluate its educational potential and cardiology residents' perceived learning efficacy as a training tool. METHODOLOGY: The development of the ETTIS involved three stages: (1) Adaptation of an anatomical mannequin; (2) Design and manufacture of electronic circuits and software capable of identifying the catheter contact site within the heart chambers and reproducing electrograms in both surfaces (mode-on) and intracavitary (mode-off); (3) To evaluate its educational potential, a modified Likert questionnaire was administered to nine cardiology experts. Additionally, to evaluate the perceived learning efficacy, another modified Likert questionnaire was given to six cardiology residents both before and after training with the ETTIS. Descriptive statistics with measures of position and dispersion were employed, and the weighted Kappa test was used for agreement analysis. RESULTS: A high rate of acceptance (over 90%) was found among experts who evaluated the ETTIS. The cardiology residents showed significant self-perceived learning gains, as evidenced by a lack of agreement between their responses to a questionnaire before and after training. CONCLUSION: The ETTIS is a promising tool for medical training, displaying both educational potential and efficacy. It has been shown to be effective in learning a variety of skills, including cardiac catheterization and electrophysiology. Additionally, the ETTIS is highly engaging and allows cardiology residents to practice in a safe and controlled environment.

Heart at risk: electronic educational game with information on doping in athletes / Coração em jogo: jogo eletrônico educativo na informação do doping em atletas / Corazón en juego: juego electrónico educativo en la información del doping en atletas

ABSTRACT Introduction Games are recognized tools that can be used for teaching, awareness-building and behavioral change. In the world of competitive sports, it is necessary to both educate athletes and make them aware that doping is an unsportsmanlike practice, particularly because this conduct can be life-threatening. A game called "Heart at Risk" was developed in this context for the purpose of teaching athletes which substances are characterized as doping by the World Antidoping Agency, and to raise their awareness of health hazards through entertainment. Objective Present and empirically evaluate the efficacy of the game as a tool for educating athletes on substances characterized as doping. Methods The sample group was formed by 20 players in the under-20 category of Clube do Remo (Rowing Club), aged over 18 years. The athletes underwent a pre-test, played the Heart at Risk game, and took a post-test at the end. Both tests were related to healthy sport practices (positive factors) and to doping substances (negative factors). Results Regarding the knowledge of positive factors, there was an increase of knowledge in relation to low doses of caffeine (∆ = 40%; p-value= 0.0125) and doping assessment (∆ = 55%; p-value = 0.0017). Regarding negative factors, there was an increase of knowledge in relation to diuretics (∆ = 25%; p-value = 0.0455), contaminated thermogenic (∆ = 35%; p-value = 0.0191), growth hormone-GH (∆ = 50%; p-value = 0.0025), contaminated supplements (∆ = 65%; p-value = 0.0007), and testosterone (∆ = 55%; p-value = 0.0017). Conclusion The Heart at Risk game proved to be an effective resource in the process of learning about prohibited substances and positive factors for sports performance. Level of Evidence IV; Case series.

RESUMO Introdução Jogos são reconhecidos instrumentos que podem ser usados para ensino, conscientização e mudança de comportamentos. No competitivo mundo esportivo, educar e conscientizar que doping é uma prática antiesportiva são duas necesidades, principalmente porque essa atitude pode colocar a vida do atleta em risco. Nesse contexto, foi desenvolvido um jogo, chamado Coração em Jogo, com o objetivo de ensinar aos atletas quais substâncias são caracterizadas como doping pela World Anti-Doping Agency, e ludicamente conscientizá-los dos riscos para a saúde. Objetivo Apresentar e avaliar empiricamente a eficácia do Coração em Jogo como ferramenta para educação de atletas sobre substâncias caracterizadas como doping. Métodos A amostra foi formada por 20 jogadores da categoria sub-20 do Clube do Remo, com idade superior a 18 anos. Os atletas realizaram pré-teste e jogaram o Coração em Jogo, e, ao término, foi aplicado um pós-teste. Ambos os testes eram relativos a práticas esportivas saudáveis (fatores positivos) e sobre substâncias dopantes (fatores negativos). Resultados Em relação ao conhecimento de fatores positivos, houve aumento do conhecimento em baixas doses de cafeína (∆ = 40%; valor de p = 0,0125) e avaliação de dopagem (∆ = 55%; valor de p = 0,0017). Em relação aos fatores negativos, ocorreu aumento do conhecimento em diuréticos (∆ = 25%; valor de p = 0,0455), termogênico contaminado (∆ = 35%; valor de p = 0,0191), hormônio do crescimento (∆ = 50%; valor de p=0,0025), suplementos contaminados (∆ = 65%; valor de p = 0,0007) e testosterona (∆ = 55%; valor de p = 0,0017). Conclusão O Coração em Jogo mostrou-se recurso eficaz na aprendizagem das substâncias proibidas e dos fatores positivos para desempenho do esporte. Nível de Evidência IV; Série de casos.

RESUMEN Introducción Los juegos son reconocidos instrumentos que pueden ser usados para enseñanza, concientización y cambio de comportamientos. En el competitivo mundo deportivo, educar y concientizar que doping es una práctica antideportiva son dos necesidades, principalmente porque esa actitud puede poner la vida del atleta en riesgo. En este contexto se desarrolló un juego llamado "Corazón en juego (Coração em Jogo en su nombre en portugués)", con el objetivo de enseñar a los atletas qué sustancias son caracterizadas como doping por la World Antidoping Agency, y lúdicamente concientizarse de los riesgos para su salud. Objetivo Presentar y evaluar empíricamente la eficacia de "Corazón en Juego", como una herramienta para la educación de atletas sobre sustancias que se caracterizan como doping. Métodos La muestra fue formada por 20 jugadores de la categoría sub-20 del Club del Remo, con edad superior a 18 años. Los atletas realizaron test previo y jugaron "Corazón en Juego", y al término se aplicó un test posterior. Ambos tests se referían a prácticas deportivas saludables (factores positivos) y sobre sustancias dopantes (factores negativos). Resultados Con relación al conocimiento de factores positivos, hubo aumento del conocimiento en bajas dosis de cafeína (Δ = 40%, valor de p = 0,0125) y evaluación de dopaje (Δ = 55%; valor de p = 0,0017). Con relación a los factores negativos, ocurrió aumento del conocimiento en diuréticos (Δ = 25%, valor de p = 0,0455), termogénico contaminado (Δ = 35%, valor de p = 0,0191), hormona del crecimiento (Δ = 50%, valor de p = 0,0025), suplementos contaminados (Δ = 65%, valor de p = 0,0007) y testosterona (Δ = 55%, valor de p = 0,0017). Conclusión "Corazón en Juego", se mostró un recurso eficaz en el aprendizaje de las sustancias prohibidas y de los factores positivos para desempeño del deporte. Nivel de evidencia IV; Serie de casos.