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Obstetric emergencies are critical situations that jeopardize the health of both the mother and the baby during pregnancy or childbirth. This study aimed to validate the effectiveness of clinical simulation training in managing these situations. We conducted a narrative review of studies published between 2008 and 2022, collected from databases including Scopus, Sciencedirect, PubMed, Springer, Scielo, and Google Scholar. Data from studies that met our inclusion criteria were meticulously gathered and summarized. Our findings strongly emphasize that clinical simulation emerges as a highly effective tool in the training of healthcare professionals. This training translates into substantial improvements in various aspects, including performance, knowledge, confidence, satisfaction, attitudes, self-efficacy, teamwork abilities, and the skills necessary to confront critical obstetric situations such as postpartum hemorrhage, eclampsia, shoulder dystocia, maternal cardiac arrest, umbilical cord prolapse, and cesarean sections. Importantly, this training reduces the inherent risks associated with learning on real patients and aligns with the highest ethical standards. Additionally, our results underscore that interdisciplinary collaboration in the management of obstetric emergencies proves to be an effective strategy for providing comprehensive patient care. However, it is crucial to highlight that, in order to ensure patient safety and promote a teamwork approach, it is imperative for healthcare professionals to receive adequate training and be duly qualified. Although we acknowledge that implementing clinical simulation training can entail significant costs and require substantial resources, we firmly believe that this strategy continues to hold immeasurable value in the education of professionals in this field. Ultimately, we anticipate that future high-quality research will further fortify the evidence base regarding best practices in clinical simulation training for obstetric emergencies, thus contributing to enhanced patient outcomes and the overall quality of healthcare in this critical domain., Competing Interests: This work is licensed under a Creative Commons Attribution 4.0 International License., (This work is licensed under a Creative Commons Attribution 4.0 International License.)

Aim: To contribute to the development of disciplinary and generic competencies of medical students at Universidad Austral de Chile. through the incorporation of student- centered educational didactics such as remote simulation with a simulated patient (SP)., Material and Method: Quantitative, cross-sectional and descriptive research. Non-probabilistic sample included 68 third-year medical students who played two roles: interviewer and evaluator/observer. An instrument adapted from a satisfaction survey was used, applying it at the end of the experience in an anonymous and voluntary digital format (Google Forms). This tool covered 4 areas: Organization, Methodology, Self-assessment, and Evaluation of teaching performance, with closed Likert-type questions of five ordinal categories, two dichotomous questions (yes/no), and 4 open questions. The quantitative analysis was carried out using the SPSS program, and the qualitative one (open questions) with a progressive reduction scheme through three levels. Confidentiality and the fictional contract were protected with signature., Results: The educational experience was very well valued by the students. Similar tendencies were showed in the perception of simulation among the groups that performed the roles of interviewer and evaluator/observer., Conclusions: It is essential to incorporate this type of educational experience into the medical curriculum, since it constitutes a valuable contribution to the development of competencies, through experiential learning, connecting the student with reality, with their emotions, knowledge, and abilities. This approach promotes empathy and communication skills, promoting reflection and self-criticism.

Objective: to build and validate a simulation-based education roadmap on suicide prevention in the virtual environment., Method: methodological research subdivided into a development and validation stage. The roadmap was built using a previously drafted template based on international guidelines on good clinical simulation practices and scientific literature on suicide prevention in the virtual environment. For validation, the roadmap was validated by experts through self-application of an assessment form with answers based on "adequate, fair, and inadequate", with a field for suggestions. Descriptive statistics and the Content Validity Index (CVI≥0.8) were used., Results: nine experts took part in the study, the majority of whom were nurses (66.7%), female (55.6%), with an average age of 42.22 years. All the items in the roadmap met the acceptance criteria (CVI≥0.8)., Conclusion: this study provides a useful roadmap for teaching suicide prevention in the virtual environment., Background: (1) Innovative study on suicide prevention, simulated teaching, and the virtual environment. (2) Script validated by experts and available in full for simulated teaching. (3) Introduction of a prototype of a fictional virtual social network for simulated practice. (4) Results indicated the appropriateness of the construction, with good agreement in the analyses. (5) The script enhances professional training and development in the mental health context.

Introduction: Due to the pandemic, academic challenges arose, and virtual simulation was used to replace the clinical experiences, offering innovative learning strategies and standardized teaching. Objective: To compare the perception and the level of satisfaction in the acquisition of knowledge, abilities and skills through face-to-face and virtual simulation among medical students. Methods: Analytical cross-sectional study including medical students who received virtual and face-to-face simulation practices. A survey was con-ducted to investigate the sociodemographic and academic characteristics, institutional physical conditions, self-assessment regarding the acquisition of technical and soft skills, and quality and satisfaction with clinical simulation. Results: 105 students with a median age of 22 years were included, who reported greater acquisition of technical skills through face-to-face simulation compared to the virtual modality. In-person simulation resulted in an 85% mastery of some topics compared to virtual simulation (65.7%, p < 0.001). However, for medication presentation and dosage scenarios, 80% reported mastery of the topic through virtual practice compared to 53.3% in the face-to-face modality (p < 0.001). The development of soft skills was similar in both scenarios, such as problem solving (83.8%), effective communication (78.1%), among others. Conclusions: Clinical simulation is crucial to medical training, its face-to- face application is perceived as the most suitable way to use it in the educational environment.

Objective: to compare the decision-making of Nursing students, before and after theoretical training on basic life support, using the practice of high-fidelity simulation and medium-fidelity simulation., Method: an experimental study was developed, pre- and post-test type, with quantitative, descriptive and inferential analysis, with theoretical training on basic life support and clinical simulation practices, and with evaluation of knowledge and decision-making of Nursing students, at three different moments - before the simulation scenario (T0), after the simulation scenario (T1) and after clinical teaching (T2)., Results: 51 students participated in the research, with an average age of 20.25±3.804, of which 92.2% were female. Statistically significant differences (F=6.47; p=0.039) were evident regarding the definition of the problem and development of objectives in decision-making in the experimental group., Conclusion: Nursing students demonstrate an adequate level of knowledge and a good decision-making process, based on the most current instruments produced by scientific evidence, in clinical simulation scenarios in basic life support, and this innovative methodology should be deepened in the Nursing teaching., Highlights: (1) Clinical simulation promotes good decision-making of Nursing students.(2) Students demonstrated adequate knowledge about basic life support.(3) Knowledge and practice define the fidelity of clinical simulation.(4) Basic life support can be developed by high-fidelity simulation.

A review of the mathematical models that predict visual quality of intraocular lenses as a function of the optical quality parameters that characterize them, and a review of the methodologies used for the simulation of vision with intraocular lenses are presented. It is shown that the existing simulation techniques could be useful to evaluate the different models of visual quality in multifocal design intraocular lenses.

Abstract Objective: to compare the decision-making of Nursing students, before and after theoretical training on basic life support, using the practice of high-fidelity simulation and medium-fidelity simulation. Method: an experimental study was developed, pre- and post-test type, with quantitative, descriptive and inferential analysis, with theoretical training on basic life support and clinical simulation practices, and with evaluation of knowledge and decision-making of Nursing students, at three different moments - before the simulation scenario (T0), after the simulation scenario (T1) and after clinical teaching (T2). Results: 51 students participated in the research, with an average age of 20.25±3.804, of which 92.2% were female. Statistically significant differences (F=6.47; p=0.039) were evident regarding the definition of the problem and development of objectives in decision-making in the experimental group. Conclusion: Nursing students demonstrate an adequate level of knowledge and a good decision-making process, based on the most current instruments produced by scientific evidence, in clinical simulation scenarios in basic life support, and this innovative methodology should be deepened in the Nursing teaching.

Objective: translate and adapt the Facilitator Competency Rubric to the Portuguese language and the Brazilian culture, and analyze the measurement properties., Method: methodological study that completed the steps of translation, synthesis of translations, back translation, review by a Committee of Experts composed of 7 professionals, testing of the pre-final version with 33 simulation facilitators, and submission to the author of the original instrument. For content validation, the Content Validity Index and the modified Kappa Coefficient were calculated. For reliability, Cronbach's α and the Intraclass Correlation Coefficient were evaluated by 52 and 15 simulation facilitators, respectively., Results: two rounds of content evaluation were carried out, resulting in changes to 19 items in the first evaluation and 3 items in the second. The overall scale achieved a Cronbach's α of 0.98 and an Intraclass Correlation Coefficient of 0.95 to 0.97., Conclusion: the Facilitator Competency Rubric was translated and culturally adapted to the Brazilian reality and presented content validity, reliability and stability, with safe results for use in teaching and research.

Objective: translate and adapt the Facilitator Competency Rubric to the Portuguese language and the Brazilian culture, and analyze the measurement properties. Method: methodological study that completed the steps of translation, synthesis of translations, back translation, review by a Committee of Experts composed of 7 professionals, testing of the pre-final version with 33 simulation facilitators, and submission to the author of the original instrument. For content validation, the Content Validity Index and the modified Kappa Coefficient were calculated. For reliability, Cronbach’s α and the Intraclass Correlation Coefficient were evaluated by 52 and 15 simulation facilitators, respectively. Results: two rounds of content evaluation were carried out, resulting in changes to 19 items in the first evaluation and 3 items in the second. The overall scale achieved a Cronbach’s α of 0.98 and an Intraclass Correlation Coefficient of 0.95 to 0.97. Conclusion: the Facilitator Competency Rubric was translated and culturally adapted to the Brazilian reality and presented content validity, reliability and stability, with safe results for use in teaching and research.

ABSTRACT Introduction: sedation and analgesia are fundamental procedures for children undergoing invasive interventions, and complications must be avoided during their implementation. In situ simulation allows, in turn, training in real practice environments to improve the technical and non-technical skills of professionals for such procedures. Although it is a very useful tool, it is often not used due to lack of preparation for its planning and application. Objective: develop and validate an in situ simulation scenario in pediatric emergency care using sedation to perform an invasive procedure. Method: descriptive study of construction and content validation of an in situ simulation scenario, using the Delphi method, following the following steps: 1) definition of the problem and selection of experts; 2) development of the initial document; 3) rounds for validation with analysis of responses and feedback (until consensus is reached by the Content Validation Index); 4) final report. Results: The experts indicated suggestions that were duly used and the scenario obtained, in all items, a CVI greater than 80.0%, demonstrating its high validity and reliability. By using experts to validate the scenario, their insights guarantee greater precision and reliability in scenario construction engineering. Conclusion: It is expected that this study will allow the replication of the scenario in different training contexts, facilitating and encouraging professional training based on a scenario model based on best evidence and practices.

This research project explores the effectiveness of simulation-based assessments (SBAs) as an alternative to practical assessments for event management (EM) students, considering the 2020 global pandemic's impact on higher education. SBAs mimic real-world scenarios, enabling innovative and authentic ways for assessors to determine how well candidates can put their knowledge, skills, and talents to use. For example, they give students an opportunity to instil and reinforce ethical principles and values essential for success in the workplace. The study aims to investigate the relationship between SBAs and graduate attributes, via a qualitative approach, to investigate and analyse students' lived experiences. Ten final-year EM students were selected purposively, with inclusion criteria. Semi-structured interviews were conducted using an original set of selected questions, and thematic analysis was used for data analysis. The study's findings suggest that if used correctly, SBAs can be an effective tool for developing students' graduate attributes, preparing them for employment. The article concludes on how to maximise the value of SBAs in preparing students for the workforce, especially when practical assessments are not feasible

Lysimeters are often used in research concerning nutrient leachate all over the globe. However, due to factors such as Florida's high water table (a condition when the water level stays relatively close to the soil surface) in some production areas, the assessment and collection of leachate are not feasible. Another obstacle to the use of lysimeters in field research is the fact that several types of irrigation methods are used in Florida (e.g., subirrigation with seepage or drain-tile, overhead, microsprinkler, and drip irrigation) requiring different strategies for leachate assessment. This publication focuses on the use of crop models as alternatives to estimate nitrate leaching from cropping systems at a field scale. This publication's target audience is growers, extension agents, crop consultants, representatives of the fertilizer industry, state and local agencies, students, instructors, researchers, and interested Florida citizens.

In this work, using the PM3 semi-empirical method, the oxidation of the single-walled carbon nanotube (SWCNT) was studied by sulfuric and nitric acid for the incorporation of carbonyl (C=O), phenol (OH) and carboxylic (COOH) groups in the C=C bonds present on the surface of the nanotube. Subsequently, the crosslinking of the oxidized SWCNT (SWCNTox) and chitosan (Q) was observed through hydrogen bonds of the C=O and OH bonds with 2.34 Å, the process was endothermic and soluble in polar solvents due to the presence of OH and NH groups in the structure of SWCNTox/Q. The Monte Carlo modeling allowed to study the adsorption of pesticides in the SWCNTox/Q at different temperatures, where the QSAR (quantitative structure activity relationship) properties allowed predicting the behavior of the pesticides, that is, the degree of hydrophobicity (log P) and accessible surface area (ASA) were important parameters in the evaluation of SWCNTox/Q as an adsorbent and surface interacting with pesticides respectively. Finally, the adsorption was a physisorption process due to the electronegativity of the CO, OH, NH2, NH and C=O bonds.

Non-anaesthetists commonly administer procedural sedation worldwide, posing the risk of respiratory events that can lead to severe complications. This study aimed to evaluate whether simulation-based learning could lead to enhancements in the clinical proficiency of non-anaesthesiology residents in managing sedation and related respiratory complications. Following the evaluation of baseline clinical performance through a pre-test simulation, 34 residents were randomly allocated to either participate in an innovative simulation-based learning module (intervention group) or view a brief self-learning video (control group). After a one-month period, their clinical performance was assessed again in a post-test simulation involving respiratory arrest during procedural sedation. Two independent assessors rated each resident’s performance using video recordings and a scoring tool with scores ranging from 0 to 19/19. The two assessments were averaged for each performance, and the pre- to post-test change was calculated for each resident. While baseline clinical performance was similar, mean (SD) increase in clinical performance was significantly greater in the intervention group than in the control group (+2.4 (1.6) points versus +0.8 (1.3) points, respectively; p = 0.002). Our simulation-based learning sedation module resulted in the enhanced management of sedation-related complications compared to baseline and minimal self-learning. Simulation-based medical education may offer an effective approach for equipping non-anaesthesiology residents with essential skills to mitigate risks associated with sedation. (ClinicalTrials.gov identifier: NCT02722226).

ABSTRACT As weeds cannot be eradicated in corn fields, a crab claw toe was used as the research object and combined with the agronomic requirements of corn fields to design a bionic weed claw suitable for corn fields. The contour curve of the crab claw toe was extracted and fitted through the Matlab image processing technology and fitting tool to establish a bionic claw finger 3D model using Solid works. According to the mechanical soil dynamics theory of dynamics analysis, the root–soil aggregates are easily broken, loosened, and drained under the action of the bionic claw fingers. Based on single image inverse reconstruction technology, the weed root system–soil aggregates discrete meta-model was established. Recur Dyn was used in the bionic weed claw kinematics simulation to verify the reliability of the movement of the mechanism and to realise the expected action of the weeding operation. We analysed the movement speed, displacement, and trajectory of soil particles in different depth layers through the joint simulation and comparison test. Using the mechanism of weeding and resistance reduction of the bionic weeding claw, under the same working conditions, the average resistance reduction rate of the bionic claw finger compared with the flat claw finger in the grasping process was 16.4%. The resistance of grass roots was reduced 23.3%, making it easier to pull out the more intact grass roots.

ABSTRACT Introduction: the simulation in minimally invasive surgery is fundamental for surgeon in training to learning and training skills, especially in pediatrics, due to the particularities, reduced spaces, specific and rare procedures. The aim of this study was to propose an adapted series of exercises and to simply evaluate the performance of pediatric surgery residents in the initial implementation of a training program. Method: seven basic skills exercises in video surgery, based on series and programs already published and using low-cost materials, were performed by six residents in 2 moments, with an interval of 15 days and evaluated by simple instrument. Results: there was no difficulty with models. Considering the individual averages of the seven exercises together in the two moments, five of the six residents increased the score in the second moment. The average score per exercise increased in five of the seven tasks. Despite the small number of participants and repetition, it has already been possible to observe a trend of better performance with decreased time of all residents after a single repetition. All considered the exercises capable of training essential skills of the specialty, with simple and inexpensive materials. Conclusion: given the challenges of simulated training in pediatric video surgery, it is known the benefit of a continuous program, with exercises that can simulate real situations. A pre-established schedule, more participants and repetitions, supervision of experienced surgeons and validated instruments are fundamental to evaluate surgeons in training and show statistical benefits of simulated exercises in this series.

Objective: to build and validate a simulation-based education roadmap on suicide prevention in the virtual environment. Method: methodological research subdivided into a development and validation stage. The roadmap was built using a previously drafted template based on international guidelines on good clinical simulation practices and scientific literature on suicide prevention in the virtual environment. For validation, the roadmap was validated by experts through self-application of an assessment form with answers based on “adequate, fair, and inadequate”, with a field for suggestions. Descriptive statistics and the Content Validity Index (CVI≥0.8) were used. Results: nine experts took part in the study, the majority of whom were nurses (66.7%), female (55.6%), with an average age of 42.22 years. All the items in the roadmap met the acceptance criteria (CVI≥0.8). Conclusion: this study provides a useful roadmap for teaching suicide prevention in the virtual environment.

[Objective] Plasmodium vivax predominantly infects many people in numerous tropical areas, including Southeast Asia, the Western Pacific, the Americas, and the Eastern Mediterranean. The uniqueness of forming dormant stages can lead to relapse in vivax malaria upon further infection. This study used molecular docking and dynamic simulation to predict potential bioactive compounds from the Zingiberaceae plant family as inhibitors by targeting Plasmodium vivax Duffy Binding Protein (PvDBP). PvDBP-DARC molecular interaction is required to mediate the merozoite invasion process into red blood cells. Inhibiting this process can possibly control parasite growth and development. [Methodology] Molecular docking screening was conducted by using 138 natural compounds from the Zingiberaceae plant family targeting Plasmodium vivax Duffy binding protein (PvDBP). The top two compounds with the lowest binding energy were selected to be analyzed by pharmacokinetics prediction and molecular dynamic (MD) simulation. [Results] Molecular docking screening resulted in the top two compounds with the lowest binding energy value, including 5,7-dihydroxyflavanone (-9.3 kcal/mol) and pinostrobin (-9.2 kcal/mol). These compounds are predicted to have stronger interaction than chloroquine as a control. Furthermore, the potential compounds also interact with DARC binding site residues and maintain them during the molecular dynamic simulation process. Otherwise, chloroquine as a control cannot retain 75% binding residues towards PvDBP. A molecular dynamic study revealed that all three complexes have relatively similar stability. [Conclusions] We predicted that the two bioactive compounds (5,7-dihydroxyflavanone and pinostrobin) have the potential as merozoite invasion inhibitors.

Ionizing radiation detection devices have been widely used in recent years in various applications and experimental fields, such as high energy physics, nuclear physics, and medical imaging. Detailed description of their operational properties and their characterization by means of numerical modelling, as simulations, are key issue to understand the characteristics of radiation detectors in terms of efficiency, resolution and signal-to-noise ratio, since they allow optimising parameters that will be further used. The modelling processes, as the simulations, are routinely carried out using various tools, like Monte Carlo approaches, for instance: PENELOPE, FLUKA or GEANT4 are used to study the interaction of the radiation with the detector accounting for the whole physical processes. However, transporting electron/hole pairs, as generated through the device sensor to conform the corresponding electronic signals uses tools based on the finite element method, such as TCAD (Technology Computer Aided Design), which are developed mainly to help the microelectronics industry to design products. Usually, modelling approaches for radiation transport and electonic signal production are not integrated, thus performing the simulation process by splitting the problem intosucessive independent phases. Within this framework, the present study proposes, implements, and reports on a novel methodology that allows combining the two approaches aimed at integrating the complete simulation, thus achieving a step-by-step integrated modelling flow to describe the interaction of ionizing radiation with the sensor along with the transport of the generated charge to the photodiodes and, finally, to the generation of electronic signals.

This study aims to identify key factors and sensitive intervals affect the school road traffic characteristics. We collect traffic data from the parking area and the school road (400-700 meters). The simulation is calibrated to ensure the error of outputs are within 1.5%. A sensitivity analysis method is proposed, it makes the multifactor comparable. The sensitivity factors of vehicle delay, queue length, and average speed are 1.44, 2.03, and 0.28 in school road, and the bottleneck road are 3.07, 4.44, and 0.65. The traffic indicators change more concentrated in bottleneck road but greater in school road. 6 scenarios are created to analyze school road traffic characteristics. Traffic flow (TF), number of parking spaces (NPS), and stopping time (ST) are selected as variables. Scenarios 1-3 are univariate, and scenarios 4-6 are bivariate. TF is the key factor with a sensitivity interval of [1300,1700].

Este artículo presenta una metodología didáctica aplicada a los estudios de ingeniería. A partir del uso de herramientas digitales se desarrolla una metodología para modelar y simular un proceso de fabricación industrial. La metodología comienza con el análisis del proceso de fabricación, por lo que los estudiantes realizan una aproximación analítica al modelado del sistema productivo analizado. A continuación, se utiliza una herramienta digital para modelar dicho sistema en base a los parámetros previamente analizados. Con la simulación del modelo, los estudiantes de ingeniería analizan los resultados de tiempos y costes específicos de cada proceso y producto. En base a estos se presentan propuestas de mejora para optimizar el proceso que se modela y simula nuevamente para comprobar la eficiencia y beneficio de las mejoras propuestas en el proceso. Con esta metodología, los estudiantes de ingeniería se introducen en un contexto escalable de la industria real para realizar mejoras seguras, al mismo tiempo que desarrollan habilidades en ingeniería de procesos y herramientas digitales. Abstract This paper presents a didactic methodology applied to engineering studies. From the use of digital tools, a methodology is developed to model and simulate an industrial manufacturing process. The methodology begins with the analysis of the manufacturing process, so the students carry out an analytical approach to the modeling of the analyzed production system. Next, a digital tool is used to model said system based on the previously analyzed parameters. With the simulation of the model, engineering students analyze the results of specific times and costs of each process and product. Based on these, improvement proposal are presented to optimize the process that are modelling and simulated again to check the efficiency and benefit of the proposed improvements in the process. With this methodology, engineering students are introduced to a scalable context of real industry for safe improvements, while developing skills in digital tools and processes engineering.

In a global warming context, the diversification of the energy matrix is essential for mitigation. Technologies and solar devices have begun to play an important role in this sense, being flat-plate solar collectors the most practical device. On the other hand, numerical modeling and experimental validation are important tools for improving the performance of these technologies. In this work, a trapezoidal solar air heating collector for food drying processes was modeled by using the Simusol open-access software, and experimental validation was performed. This particular shape presents a geometrical novelty since no other similar designs were found into the available literature, even in such application as food drying. Key parameters, such as air temperature, global efficiency, air mass flow, global heat loss coefficient, and useful heat, are determined and discussed. The proposed air collector numerically behaves as expected. The output air temperature reaches about 100 °C, while the peak heat gain is about 900 W, which makes the air heating collector suitable for drying applications. Due to natural convection is the main heat transferring mechanism, low air mass flows were obtained. For the case analyzed here, this last parameter ranges in 0.012–0.016 kg/s for the optimal thermal behavior.

Introduction: Gaining practical experience in health professions education is a significant challenge. Simulation-based training has emerged as a key solution to this issue, but the high costs associated with advanced equipment and software limit accessibility for many institutions. Hence, to close this gap, this study aims to map the research field of low-cost simulation in health professions education through a bibliometric analysis. Methods: Utilizing a bibliometric study design, we analyzed publications from 2003 to 2022 in the Scopus Database, in accordance to Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. Publications discussing low-cost simulation in English were included. Data points such as research design, study location, and outcomes were extracted. The Scival Platform and VosViewer were used to analyze publication trends, prolific institutions, authors, journals, and conceptual and intellectual structure. Results: The study found an increase in low-cost simulation research from 2003 to 2022, with significant growth after 2015. Observational studies predominated (68.57%), with general surgery being the most studied specialty. Less than half of the studies reported cost details, and only 2 compared the low-cost model with a standard. The United States led in scientific production, with notable collaboration networks. The keyword co-occurrence and co-citation analyses highlighted 4 main clusters in low-cost simulation research, emphasizing surgical training. Conclusions: This investigation highlights the expanding interest in low-cost simulation to enhance access to hands-on training in health professions education, especially under financial constraints. However, the research field requires further development, particularly in validating these models against their more expensive counterparts. Such validation is crucial for ensuring the effectiveness and comparability of low-cost simulation. Resumen: Introducción: Adquirir experiencia práctica en la formación de las profesiones sanitarias es un reto importante. El aprendizaje basado en simulación ha surgido como una solución a este problema, pero los elevados costes asociados a los equipos y programas avanzados limitan la accesibilidad de muchas instituciones. De ahí la necesidad de cerrar esta brecha. Este estudio pretende delimitar el campo de investigación de la simulación de bajo costo en la formación de las profesiones sanitarias mediante un análisis bibliométrico. Métodos: Utilizando un diseño de estudio bibliométrico, analizamos las publicaciones de 2003 a 2022 en la base de datos Scopus, siguiendo las directrices de Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020. Se incluyeron las publicaciones que discutían la simulación de bajo coste en inglés. Se extrajeron datos como el diseño de la investigación, la ubicación del estudio y los resultados. La plataforma Scival y VosViewer se emplearon para analizar las tendencias de publicación, las instituciones prolíficas, los autores, las revistas y la estructura conceptual e intelectual. Resultados: El estudio encontró un aumento de la investigación con simulación de bajo coste desde 2003 hasta 2022, con un crecimiento significativo después de 2015. Predominaron los estudios observacionales (68,57%), siendo la cirugía general la especialidad más estudiada. Menos de la mitad de los estudios informaron sobre detalles de costes, y solo dos compararon el modelo de bajo coste con uno estándar. Estados Unidos lideró la producción científica, con notables redes de colaboración. Los análisis de co-ocurrencia de palabras clave y co-citación destacaron cuatro clusters principales en la investigación sobre simulación de bajo coste, con énfasis en la formación quirúrgica. Conclusiones: Esta investigación pone de relieve el creciente interés en la simulación de bajo coste para mejorar el acceso a la formación práctica en la educación de las profesiones de la salud, especialmente bajo restricciones financieras. Sin embargo, el se requiere un mayor desarrollo, sobre todo en lo que respecta a la validación de estos modelos económicos frente a sus homólogos más caros. Dicha validación es crucial para garantizar la eficacia y comparabilidad de las simulaciones de bajo coste.

Le gouvernement du Québec a investi dans une offensive de transformation numérique. Elle vise à accélérer le virage technologique de plusieurs secteurs d’activités incluant celui de l’enseignement. Pour les universités, cette décision se traduit par un rehaussement de l’intégration pédagogique des technologies de l’information et des communications (TIC). D’ailleurs, dans plusieurs cas, ces TIC rejoignent les personnes dans leur manière d’apprendre. Parmi ces nouvelles méthodes pédagogiques, nous retrouvons la simulation clinique par réalité virtuelle (SimRV), constituant un exemple d’actualisation des approches technopédagogiques au service de l’apprentissage. En reprenant des scénarios de simulation clinique traditionnels, la SimRV amène la personne, par le biais d’expériences immersives, à réaliser des simulations qui, autrefois, nécessitaient l’accès à une structure formelle. Bien que cette approche soit récente, plusieurs avenues viennent lui conférer un grand potentiel d’application. Une équipe de la Faculté des sciences infirmières de l’Université Laval a testé ce potentiel dans un projet exploratoire de simulations interactives par vidéo 360 degrés interactive, dans le programme de deuxième cycle de formation des infirmiers praticiens spécialisés. Cet article présentera les avantages, les limites et les enjeux identifiés pour une intégration pédagogique réussie de cette nouvelle technologie.

Objective: To design and assess a novel penile fracture simulation model for teaching penile fracture repair., Methods: We used a validated circumcision simulator to create a model. Foreskin for a circumcision was divided into two halves. A transverse slit ("simulated fracture") was created on one part of the first half of the foreskin (mimicking "tunica") and was applied over the penile model. A red jelly tablet ("clot") was placed underneath the cut. A second full-length of foreskin was applied over it to cover the defect. The model was assessed by participants and expert faculty at the Urology Simulation Boot Camp. Evaluation was performed using a 5-point Likert Scale questionnaire. Data was analysed using Microsoft Excel and IBM SPSS Statistics V25. The intra-class correlation was calculated using a "One-way random model"., Results: Twenty-two urology trainees and four experts participated in the evaluation. The majority of trainees strongly agreed (59%, n = 13) the model is useful for training with experts similarly agreeing in 75% of cases. The appearance of penile fracture was considered good by both trainees (68%, n = 14) and faculty (75%). Overall, the ability of the model to represent a realistic simulation of the task was considered excellent by 23% of participants and good by 64%. Personal confidence after simulation in managing a similar situation was considered high among trainees. The main difficulties reported were related to fascial planes and urethra., Conclusion: This is the first simulation model for penile fracture repair and has demonstrated face validity at a national urology bootcamp., (Crown Copyright © 2021. Published by Elsevier España, S.L.U. All rights reserved.)

The Monte Carlo method is one of the most powerful mathematical techniques that, through calculation, analyzes risk and allows solving physical and mathematical problems through computer programs. Using historical data creates and predicts models of possible future results by substituting a range of values, calculating results repeatedly, and using a different group of random values of the probability functions to predict the potential effects of some uncertain event related to problems of all kinds.

The spatial stochastic co-simulation method based on copulas is a general method that allows simulating variables with any type of dependency and probability distribution functions. This flexibility comes from the use of a copula model for the representation of the joint probability distribution function. The method has been mainly implemented through a non-parametric approach using Bernstein copulas and has been successfully applied for the simulation of petrophysical properties using elastic seismic attributes as secondary variables. In the present work this method is implemented through two other approaches: parametric and semi-parametric. Specifically, for the parametric approach the family of Archimedean copulas is used. First, the parametric approach is validated against a published case, and then a comparison of the three approaches in terms of accuracy and performance is made. The results showed that the parametric approach is the one that reproduces the data statistics worse and presents greater uncertainty with a lower computational cost, while the non-parametric approach was the one that best reproduces the dependence of the data at a high computational cost. The semi-parametric approach reduces the computational cost by 10% compared to the non-parametric approach, but its accuracy is significantly degraded.

Introduction: Stress factors influence surgical procedures. This study aims to assess the impact of stress factors on surgical performance in ophthalmology simulation. Specifically, the study aims to identify which exercises are most affected by stress and to examine the relationship between stress levels, surgical complexity, and technical skills. Material and methods: A prospective study of a cohort of 13 ophthalmology residents, at Vall Hebron University Hospital. All study participants received basic training before the study to become familiar with the simulator and surgical maneuvers. Once completed, the participants were invited to perform 3 defined exercises (E1, E2, and E3, increasing difficulty level from 1 to 3) in relaxed conditions. Afterwards, the same exercises were performed again under a stressful environment. The stress was created introducing physical, auditory, and interruptions factors. The results in technical skills were evaluated through the relaxation and stress scores, as well as the time required to complete the exercises under relaxation and stress conditions. A detailed metric was used to assess the variables in relation to stress situations, including physical stress, haste, the presence of background music, and scheduled interruptions.The results are expressed by median and interquartile range. To compare them, Wilcoxon test for paired samples and the Whitney U Test were performed. The results were stratified by year of residence (1–2 years vs 3–4 years). Results: The stress score was significantly lower in the 3 exercises compared to the relax score (75 vs 86, 52 vs 90, 55 vs 61, respectively, p>.05). Time to perform the exercises was less predictable and was even lower in stressful situations with no statistical differences. Under stress, both younger and older residents scored worse on the more complex exercises. Conclusion: Stress affects surgery with simulators. The most difficult exercises are the most likely to be affected by stress. These results suggest that through ophthalmic simulators ophthalmologists have the opportunity to train surgical stress and therefore improving patient safety. Resumen: Introducción: Los factores de estrés influyen en los procedimientos quirúrgicos. Este estudio tiene como objetivo evaluar el impacto de los factores de estrés en el desempeño quirúrgico en simulaciones oftalmológicas. Específicamente, el estudio busca identificar qué ejercicios se ven más afectados por el estrés y examinar la relación entre los niveles de estrés, la complejidad quirúrgica y las habilidades técnicas Materiales y métodos: Estudio prospectivo de una cohorte de 13 residentes de oftalmología en el Hospital Universitario Vall Hebron. Todos los participantes del estudio recibieron entrenamiento básico antes del estudio para familiarizarse con el simulador y las maniobras quirúrgicas. Una vez completado, se invitó a los participantes a realizar tres ejercicios definidos (E1, E2, E3, aumentando el nivel de dificultad de 1 a 3) en condiciones relajadas. Posteriormente, los mismos ejercicios se realizaron nuevamente bajo un entorno estresante. El estrés se creó introduciendo factores físicos, auditivos e interrupciones.Los resultados en habilidades técnicas fueron evaluados mediante la puntuación de relajación y estrés, así como el tiempo requerido para completar los ejercicios bajo condiciones de relajación y estrés. Se utilizó una métrica detallada para evaluar las variables en relación con las situaciones de estrés, incluyendo el estrés físico, la prisa, la presencia de música ambiental e interrupciones programadas.Los resultados se expresan mediante la mediana y el rango intercuartílico. Para compararlos, se realizaron la prueba de Wilcoxon para muestras pareadas y la prueba U de Whitney. Los resultados se estratificaron por año de residencia (1-2 años vs. 3-4 años). Resultados: La puntuación de estrés fue significativamente menor en los tres ejercicios en comparación con la puntuación de relajación (75 vs. 86, 52 vs. 90, 55 vs. 61 respectivamente, p>0.05). El tiempo para realizar los ejercicios fue menos predecible y fue aún menor en situaciones estresantes sin diferencias estadísticas. Bajo estrés, tanto los residentes más jóvenes como los más avanzados obtuvieron peores puntuaciones en los ejercicios más complejos. Conclusión: El estrés afecta a la cirugía con simuladores. Los ejercicios más difíciles son los más propensos a ser afectados por el estrés. Estos resultados sugieren que a través de simuladores oftálmicos, los oftalmólogos tienen la oportunidad de entrenar el estrés quirúrgico y por lo tanto mejorar la seguridad del paciente.

ABSTRACT Objective: to identify evidence about the use and effects of clinical simulation for preparing caregivers for discharging patients with chronic conditions. Methods: an integrative peer review in the Scopus, PubMed, Web of Science, Cumulative Index to Nursing and Allied Health Literature, ScienceDirect and Virtual Health Library databases, from July to September 2022. Results: 3,218 studies were identified, with a final sample consisting of four national and two international articles. Using simulation as an educational technology contributed to caregiver preparation in home care. In most studies, using clinical simulation included using other strategies to complement training: expository dialogued class, conversation circle and audiovisual resources. Final considerations: simulation proved to be efficient for training caregivers, with the active participation of family members and nurses in health education actions.

ABSTRACT Objective: to build, evaluate and test two clinical simulation scenarios for the planning and management of infusion therapy by nurses. Methods: methodological study, with construction of scenarios based on the NLN Jeffries Simulation Theory and the theoretical model Vessel Health Preservation; evaluation of the scenario design by judges, with calculation of the Modified Kappa Coefficient (MKC); testing scenarios with the target audience. Results: scenarios built for: 1. Patient assessment and vascular device selection; and 2. Identification and management of deep vein thrombosis. In the evaluation by judges, testing of validated scenarios in relation to educational practices and simulation design, the items evaluated presented MKC values ≥ 0.74. Conclusion: two evidence-based scenarios related to infusion therapy were constructed, with high levels of agreement among judges regarding their design. In testing with nurses, good results were obtained regarding the design and structuring of educational practice.

Obstetric emergencies are critical situations that jeopardize the health of both the mother and the baby during pregnancy or childbirth. This study aimed to validate the effectiveness of clinical simulation training in managing these situations. We conducted a narrative review of studies published between 2008 and 2022, collected from databases including Scopus, Sciencedirect, PubMed, Springer, Scielo, and Google Scholar. Data from studies that met our inclusion criteria were meticulously gathered and summarized. Our findings strongly emphasize that clinical simulation emerges as a highly effective tool in the training of healthcare professionals. This training translates into substantial improvements in various aspects, including performance, knowledge, confidence, satisfaction, attitudes, self-efficacy, teamwork abilities, and the skills necessary to confront critical obstetric situations such as postpartum hemorrhage, eclampsia, shoulder dystocia, maternal cardiac arrest, umbilical cord prolapse, and cesarean sections. Importantly, this training reduces the inherent risks associated with learning on real patients and aligns with the highest ethical standards. Additionally, our results underscore that interdisciplinary collaboration in the management of obstetric emergencies proves to be an effective strategy for providing comprehensive patient care. However, it is crucial to highlight that, in order to ensure patient safety and promote a teamwork approach, it is imperative for healthcare professionals to receive adequate training and be duly qualified. Although we acknowledge that implementing clinical simulation training can entail significant costs and require substantial resources, we firmly believe that this strategy continues to hold immeasurable value in the education of professionals in this field. Ultimately, we anticipate that future high-quality research will further fortify the evidence base regarding best practices in clinical simulation training for obstetric emergencies, thus contributing to enhanced patient outcomes and the overall quality of healthcare in this critical domain.

Quality control seeks to collect and analyze large amounts of data to take appropriate corrective actions and ensure that products or services meet quality requirements. This study proposed a methodological framework to analyze the quality control process employing Monte Carlo simulation. The methodology consists of four steps: (i) Establishment of probability distributions, (ii) Construction of the mathematical model, (iii) Running the simulation, and (iv) Analysis of the results. The application of the methodological framework in a carbonated beverage production made it possible to ensure with 99% confidence that one of the most important quality characteristics of the product, the degrees Brix, varies in a range of ± 0.02. The results show the methodology allows to broadly map the process variables behavior and to make decisions on optimal levels for quality monitoring and control.

This qualitative research aimed to understand the experiences of a fourth-year medical class during two clinical simulation scenarios of type 2 diabetes management in Primary Care. Ten simulated students were interviewed. The results describe the symbolic conception of diabetes and its treatment as anguish, damage, condemnation and an unpleasant sentence that affects the appropriation and performance of the medical role by students. Considering Medical Psychology, we suggest that such subjective factors should be addressed in teaching-learning in addition to commonly cognitive aspects mentioned in the medical education literature in order for students to develop the work profile to cope with diabetes in Primary Care. Clinical simulation facilitates the subjective approach through its group support component to promote reflection, insights and self-awareness.

ABSTRACT Objective: to assess nursing students’ and nurses’ knowledge, satisfaction and self-confidence after a theoretical workshop on emergency care for traumatized children and clinical simulation. Methods: a quasi-experimental study, carried out with nursing students and nurses residing at a public university in southern Brazil. A workshop on pediatric trauma care was created and a mannequin was created for simulations. A knowledge pre-test and post-test and the Student Satisfaction and Self-Confidence in Learning instrument were applied to measure satisfaction and self-confidence in learning. For analysis, descriptive statistics and the Wilcoxon test were used to compare means before and after intervention. Results: the difference between misses and hits was statistically significant (p

Objective: to evaluate the acquisition of cognitive knowledge in cardiorespiratory resuscitation through training mediated by health simulation and to verify satisfaction with the teaching methodology design., Method: a study of quasi-experimental intervention, of the before and after type, with only one group. Population composed of medical students in the internship phase, nurses and resident physicians, nursing technicians and nurses of the institution's effective staff. Convenience sampling consisting of 91 participants. Data collected through the Sociodemographic and Educational Questionnaire, Knowledge Test and Simulation Design Scale. Data was organized in tables and analyzed based on absolute frequencies, measures of central tendency and dispersion, Cronbach's alpha reliability test, Wilcoxon's test., Results: the increase in cognitive learning was 81.9%, being that for nursing technicians it was 117.8 %. Wilcoxon's test showed a significant increase (p<0.0001) in knowledge. The Simulation Design Scale, displayed 4.55 of global mean. Cronbach's alpha pointed good internal consistency (0.898)., Conclusion: the health simulation was effective as a learning-teaching method in cardiorespiratory resuscitation, being effective in increasing knowledge in cardiorespiratory arrest, with a great level of design satisfaction.

In this work, we simulate the dynamics of COVID-19 pandemic using a deterministic SIRD model and its stochastic SIRD model version. The model is used under a closed population of 32 625 984 from the peruvian country, where the coefficient of the transmission rate, the recovery rate, the dead rate and the initial condition are given for the data taken from the initial days reported by the first disease people in Peru.

Context: Alzheimer's disease (AD) is a debilitating neurodegenerative condition primarily afflicting the elderly, causing a progressive decline in cognitive function. It is marked by the presence of beta-amyloid protein plaques that trigger inflammation and neuronal death. Unfortunately, effective treatments for Alzheimer's remain elusive. One promising approach involves targeting the mitochondrial cascade to shield neurons from inflammation-induced cell death, and flavonoids have been identified for their potential neuroprotective properties. Aims: To investigate the most potential bioactive compound that has neuroprotective effects, especially for Alzheimer's, through molecular simulation and in vitro studies. Methods: The study employed molecular simulations to identify apigenin as a potential neuroprotective compound. Quercetin and donepezil were selected as control compounds. The MTT assay was conducted to evaluate the neuroprotective activity of apigenin, quercetin, and donepezil on the SHSY5Y cell line induced by beta-amyloid protein. Results: The MTT assay demonstrated the neuroprotective activity of apigenin and reference compounds quercetin and donepezil against beta-amyloid-induced damage in the SHSY5Y cell line. Conclusions: These findings suggest that apigenin could hold promise as a neuroprotective treatment for AD. However, further research is essential to elucidate its mechanism of action and evaluate its efficacy in more complex organisms. This study underscores the crucial role of bioinformatics tools and experimental validation in the quest for potential neuroprotective compounds for the treatment of AD.

ABSTRACT The shape of a spray droplet from a flat-fan nozzle in the plant protection sector is similar to a ‘U shape’, the middle particle size being small but the diameter of both sides being too large. So, flat-fan nozzles have the defects of wide droplet size and poor uniformity of droplet size. This paper simulates and tests the impingement nozzle, based on the coupling effect of the jet and impinging stream, so as to improve the droplet size uniformity and droplet spectrum. After jet impingement, it was found that the droplet size of the spray fan surface of the impingement nozzle showed the characteristics of large, uniform and smaller sides. This was beneficial in solving the uneven distribution of droplet size distribution in the field operation of the sprayer. The droplet distribution of the impingement nozzle is more concentrated, forming a narrow droplet spectrum. The experimental results are in good agreement with the results of numerical simulations and theoretical analysis. The impingement nozzle solves the shortcomings of wider fan droplets and smaller particle size uniformity, and provides feasible technical support for developing intelligent precision spray equipment.

Objective: to create and validate a high-fidelity simulation scenario about the initial support to suicide bereaved people., Method: a methodological research study to create and validate a simulation scenario about postvention. Its creation was based on scientific recommendations, the validation process was carried out by experts, based on an instrument developed by the authors; the data were statistically analyzed using the Content Validity Index and Gwet concordance coefficient., Results: the scenario was created to provide initial support to suicide bereaved people in the Primary Health Care context. As learning objectives, welcoming, health care and organization monitoring were proposed according to technical-scientific recommendations. The scenario was validated by 10 specialists in the themes of postvention (5 judges) and high-fidelity simulation (5 judges). The scenario items met the acceptance and reliability criteria (Content Validity Index = 0.80) and satisfactory concordance (Gwet coefficient = 0.640)., Conclusion: the study presented in full a scenario on postvention with innovative potential that can be used free of charge in clinical simulation development during training of different categories of health professionals, to act in support of suicide bereaved people.

Introduction. The use of simulation in surgery has made it possible to shorten learning curves through deliberate practice. Although it has been incorporated long ago, there are still no clear recommendations to standardize its development and implementation. This manuscript aims to share recommendations based on our experience of more than twelve years of employing and improving a methodology in laparoscopic surgical simulation. Topics for Reflection. To transfer surgical skills to a trainee, we base our methodology on a three-pillar framework: The hardware and infrastructure (tools to train with), the training program itself (what to do), and the feedback (how to improve). Implementing a cost-effective program is feasible: the hardware does not need to be high fidelity to transfer skills, but the program needs to be validated. These pillars have evolved over time by incorporating technology: the on-site guidance from experts has changed to a remote and asynchronous modality by video recording the trainee’s execution, and by enabling remote and asynchronous feedback. The feedback provider does not necessarily have to be an expert clinician in the subject, but a person previously trained to be a trainer. This allows for deliberate practice until mastery has been reached and learning curves are consolidated. Conclusions. Recommendations based on the experience of our center have been presented, explaining the framework of our strategy. Considering these suggestions, it is hoped that our simulation methodology can aid the development and implementation of effective simulationbased programs for other groups and institutions. Introducción. El uso de la simulación en cirugía ha permitido acortar las curvas de aprendizaje mediante la práctica deliberada. A pesar de que se ha incorporado previamente, aún no existen recomendaciones claras para estandarizar su desarrollo e implementación. Este manuscrito pretende compartir recomendaciones basadas en nuestra experiencia, con más de doce años empleando y mejorando una metodología en la simulación quirúrgica laparoscópica. Temas de reflexión. Para transferir las habilidades quirúrgicas a un aprendiz, basamos nuestra metodología en un marco de tres pilares: El hardware y la infraestructura (herramientas con las que entrenar), el programa de entrenamiento (qué hacer), y la retroalimentación (cómo mejorar). La implementación de un programa rentable es factible: el hardware no necesita ser de alta fidelidad para transferir las habilidades, pero el programa necesita ser validado. Estos pilares han evolucionado a lo largo del tiempo incorporando tecnología: la presencia de expertos ha evolucionado a una modalidad remota y asincrónica mediante la grabación en vídeo de la ejecución del alumno, y permitiendo su retroalimentación. Aquel que entrega retroalimentación no tiene que ser necesariamente un clínico experto en la materia, sino una persona previamente formada como instructor. Esto permite una práctica deliberada hasta dominar la habilidad y establecer curvas de aprendizaje. Conclusiones. Se han presentado recomendaciones basadas en la experiencia de nuestro centro, explicando el marco de nuestra estrategia. Teniendo en cuenta estas sugerencias, se espera que nuestra metodología de simulación pueda ayudar al desarrollo e implementación de programas efectivos basados en la simulación a otros grupos e instituciones. Introdução. O uso de simulação em cirurgia tornou possível encurtar as curvas de aprendizagem por meio da prática deliberada. Embora tenha sido incorporado anteriormente, ainda não há recomendações claras para padronizar seu desenvolvimento e implementação. Este manuscrito pretende compartilhar recomendações com base em nossa experiência, com mais de doze anos usando e aprimorando uma metodologia em simulação cirúrgica laparoscópica. Temas de reflexão. Para transferir habilidades cirúrgicas para um aprendiz, baseamos nossa metodologia em uma estrutura de três pilares: o hardware e a infraestrutura (ferramentas para treinar), o programa de treinamento (o que fazer) e feedback (como melhorar). A implementação de um programa rentável é viável: o hardware não precisa ser de alta fidelidade para transferir as habilidades, mas o programa precisa ser validado. Esses pilares evoluíram ao longo do tempo incorporando a tecnologia: a presença de especialistas evoluiu para uma modalidade remota e assíncrona por meio da gravação em vídeo do desempenho do aluno e permitindo seu feedback. Quem dá feedback não precisa ser necessariamente um clínico especialista na área, mas sim uma pessoa previamente treinada como instrutor. Isso permite a prática deliberada até que a habilidade seja dominada e estabeleça curvas de aprendizado. Conclusões. Foram apresentadas recomendações baseadas na experiência do nosso centro, explicando o enquadramento da nossa estratégia. Levando em consideração essas sugestões, espera-se que nossa metodologia de simulação possa ajudar outros grupos e instituições a desenvolver e implementar programas eficazes baseados em simulação.

The interview with Dr. Gordon Cooke, Director, Researcher and Associate Professor of the Simulation Center of the United States Military Academy West Point (USMA) provides support for a greater understanding of the importance of simulation for military education. The interview was conducted by videoconference and later via email in the ping-pong mode by Jerson Geraldo Neto and Efísio Alves Rolim Neto, edited and approved by the editors of the Journal, João Freire Junior and Arlindo José de Barros Junior. Throughout the interview, Dr. Gordon presents the structure and conception of the Simulation Center of the West Point Military Academy, addressing the simulators employed by the institution, its methodology, as well as the future perspectives regarding technological evolution in military education