Simulation in medical education: a synopsis (Rev Med Chile 2013; 141: 70-79).

BackgroundCentral venous catheterization (CVC) is a basic requirement for many medical specialties. Simulated training in CVC may allow the acquisition of this competency but few reports have established a valid methodology for learning and acquiring procedural skills for CVC. This study aims to validate the use of a tracking motion device, the imperial college surgical assessment device (ICSAD), by comparing it with validated global rating scales (GRS) to measure CVC performance in a simulated torso.MethodsSenior year medical students, first and last year residents (PGY1, LYR), and expert anesthesiologists performed a jugular CVC assessment in a simulated model (Laerdal IV Torso). A validated GRS for objective assessment of technical skills and motion analysis by ICSAD was used. Statistical analysis was performed through Mann–Whitney and Kruskal–Wallis tests for construct validity and Spearman correlation coefficients between the ICSAD and GRS scores for concurrent validity between both.Results32 subjects were recruited (10 medical students, 8 PGY1, 8 LYR and 8 experts). Total path length measured with ICSAD and GRS scores were significantly different between all groups, except for LYR compared to experts (p = 0.664 for GRS and p = 0.72 for ICSAD). Regarding jugular CVC procedural time, LYR and experts were faster than PGY1 and MS (p < 0.05). Spearman correlation coefficient was −0.684 (p < 0.001) between ICSAD and GRS scores.ConclusionsICSAD is a valid tool for assessment of jugular CVC since it differentiates between expert and novice subjects, and correlates with a validated GRS for jugular CVC in a simulated torso.

After one year of implementation, this paper describes a programme designed to support literacy learning in low performing schools from poor sectors in Santiago, Chile. School-based intensive training on theory and practice of a literacy learning framework for classroom instruction and longterm support were used to impact the achievement of students from disadvantaged families in 16 kindergarten classrooms and 16 1st-grade classrooms in nine primary schools. Preliminary results showed an improvement in learning achievement positively related to level of implementation of the literacy instruction framework in the classrooms and teachers' perception of an improvement in their knowledge and classroom practices. Although findings from this study cannot support definite conclusions, because of the lack of experimental conditions, they provide relevant information for future experimental studies on how to meet the literacy learning needs of children from disadvantaged backgrounds.

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