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ABSTRACT Objective: To identify, synthesize, and analyze the scientific knowledge produced regarding the implications of using clinical simulation for undergraduate nursing or medical students' motivation for learning. Methods: The search for articles was conducted between July 28 and August 3, 2022, on the PubMed/MEDLINE, Scopus, Web of Science, and SciELO databases. The following was used for the search: P - undergraduate students attending Nursing or Medicine courses; C - motivation for learning, and C - skills and clinical simulation laboratory. The following research question guided the study: “What are the implications of clinical simulation on the motivation for learning of undergraduate students of nursing and medicine?” Of the 1,783 articles found, 13 were included in the sample for analysis. All stages of the selection process were carried out by two independent evaluators. The results were presented as charts and a discursive report. Results: The studies analyzed indicated the beneficial effects of clinical simulation on students' motivation, in addition to other gains such as competencies, technical and non-technical skills, knowledge, belonging, autonomy, clinical judgment, critical and reflective thinking, self-efficacy and decreased anxiety, self-management, and improvements in learning and learning climate. Conclusion: Clinical simulation provides a positive learning environment favorable to the development of technical and interpersonal skills and competencies, and raising the level of motivational qualities.

ABSTRACT Objective To investigate if there is knowledge improvement over the Residency years, as well as students’ satisfaction about progress test. Finally, to describe the implementation of the online progress test in some Ophthalmological Residency programs in Brazil. Methods It was an observational cross-section study. The participants were all Ophthalmology residents who accepted to join the study. They did an online test and answered demographic and satisfaction questionnaires. Results Two hundred and fifty-nine residents joined the study. 42,86% of the residents answered the demographic questionnaire and 6,95% answered the satisfaction questionnaire. In general, the residents approved the website as a tool for self-learning and to improve residency programs. Conclusion Over the years, the residents acquired knowledge during the residency program. In general, residents were satisfied with the test. The implementation of the online progress test system in the Ophthalmological Residency schools in Brazil was successful.

There has been little information about how the COVID-19 pandemic has impacted medical students’ knowledge acquisition. The aim of the study was to identify the impact of the COVID-19 pandemic on medical students’ knowledge acquisition by comparing the students’ performance on two Progress Test exams administered in 2019 (pre-pandemic) and 2020 (during the pandemic). We included data from 1,491 students at two medical schools in Brazil. Both schools had experienced interrupted preclinical classes and clinical clerkship rotations in March 2020 but had resumed remote preclinical classes with online activities within 1 month after the interruption and clerkship rotations within five to 6 months after the interruption. We analyzed the data with the Rasch model from Item Response Theory to calibrate the difficulty of the two exams and calculated the performance of the students, with comparison of the differences of mean knowledge for each year and between the two cohorts. We found that the students’ knowledge in the cohort of 2019 was higher than those in the cohort of 2020, except in the second year. Also, the students did not show any increase in knowledge between 2019 and 2020 in the clerkship years. It appears that the pandemic significantly impaired the knowledge acquisition of medical students, mainly in the clerkship years, where practical activities are the central part of training. This is of special concern in low- and middle-income countries where graduated medical doctors are allowed to practice without further training or are required to have continuing professional development.

ABSTRACT BACKGROUND: Coronavirus disease-19 (COVID-19) has imposed a new reality that presents several challenges for healthcare professionals. The main challenge has been the lack of proper training in relation to an unknown disease. OBJECTIVE: To investigate healthcare professionals’ acquisition of knowledge of a new airway management protocol for COVID-19 through their participation in simulation training. DESIGN AND SETTING: Pre and post-test study with purpose sampling, carried out in a tertiary-level hospital in the city of Campinas, state of São Paulo, Brazil. METHODS: This was a cross-sectional pre and post-test intervention among healthcare professionals working in the intensive care unit and emergency department of a large hospital. The training was carried out using an in situ simulation scenario and the participants answered pre and post-tests consisting of a 20-item questionnaire about the new protocol. RESULTS: The paired-sample t test demonstrated that there was a significant increase in test score (t = −19.06; P < 0.001), from before the training (M = 8.62; standard deviation, SD = 3.53) to after the simulation training (M = 17.02; SD = 1.76). CONCLUSIONS: The simulated training had a positive impact on the healthcare professionals’ acquisition of the COVID-19 protocol. We also demonstrated that in situ simulation training was an efficient tool for implementing new protocols, thus bringing benefits to healthcare systems, professionals and patients.

ABSTRACT BACKGROUND: The longitudinal evaluation of students seems to be a better way to assess their knowledge compared with that of the traditional methods of evaluation, such as modular and final tests. Currently, progress testing is the most consolidated type of longitudinal testing method. However, despite being well consolidated as an assessment tool in medical education, the use of this type of test in residency programs is scarce. OBJECTIVES: This study aimed to investigate residents’ knowledge growth regarding residency training and to describe the implementation of a longitudinal evaluation test in ophthalmological residency training across several medical schools in Brazil. Finally, the study aimed to check whether performance in the tests can be used as a predictor of the results of the specialist title test. DESIGN AND SETTING: This was a prospective observational study. This study was conducted using an online platform. METHODS: Online tests were developed following the same pattern as the Brazilian Ophthalmology Council specialist tests. All the residents performed the test simultaneously. The tests were conducted once a year at the end of the school year. RESULTS: A progress test was conducted across 13 services with 259 residents. Our results demonstrated that resident scores improved over the years (P < 0.0001) and had a moderate correlation with the Brazilian Opthalmology Council specialist test (P = 0.0156). CONCLUSION: The progress test can be considered a valuable tool to assess knowledge, meaning their knowledge increased over residency training. In addition, it can be used as a predictor of the result in the specialist title test.

Abstract Background Students require feedback on their self-regulated learning (SRL) processes to improve the performance of clinical examinations. The key SRL processes used by students can be identified by SRL-micro-analysis but, this method has not been previously applied to physiotherapy students. The aim of this pilot study was to test a research design that might allow the evaluation of the potential usefulness of SRL microanalysis for the identification of key SRL processes used by physiotherapy students during the performance of a clinical examination skill. The objectives of the pilot study were: 1) to evaluate whether SRL-microanalysis could identify differences in the use of SRL processes between successful and unsuccessful students; 2) to evaluate the reliability of SRL microanalysis ratings produced by different assessors. Methods SRL-microanalysis was used with second year physiotherapy students of a Spanish university (n = 26) as they performed a goniometric task. The task required students to obtain a goniometric measurement of the shoulder joint of a peer. Two assessors evaluated student performance and conducted the SRL- microanalysis with all students. An analysis of inter-rater reliability was performed to evaluate the degree of agreement between assessors. Results The SRL-microanalysis revealed differences in the use of key SRL processes between successful (n = 15: 57.0%) and unsuccessful performers (n = 11: 43.0%): The differences were particularly evident in strategic planning and self-monitoring skills. There was good inter-rater reliability for scoring of strategic planning (k = 0.792), self-monitoring (k = 0.946) and self-evaluation (k = 0.846). Conclusion The use of SRL microanalysis characterized the key SRL processes of physiotherapy students performing a clinical skill with reliability between the assessors. This pilot study supports the potential usefulness of SRL-microanalysis for the identification of key SRL processes in physiotherapy education. Therefore, this study paves the way to the development of a full study, with a larger number of students and more diverse clinical tasks, to evaluate the SRL processes in successful and unsuccessful students.

ABSTRACT BACKGROUND: Progress tests are longitudinal assessments of students’ knowledge based on successive tests. Calibration of the test difficulty is challenging, especially because of the tendency of item-writers to overestimate students’ performance. The relationships between the levels of Bloom’s taxonomy, the ability of test judges to predict the difficulty of test items and the real psychometric properties of test items have been insufficiently studied. OBJECTIVE: To investigate the psychometric properties of items according to their classification in Bloom’s taxonomy and judges’ estimates, through an adaptation of the Angoff method. DESIGN AND SETTING: Prospective observational study using secondary data from students’ performance in a progress test applied to ten medical schools, mainly in the state of São Paulo, Brazil. METHODS: We compared the expected and real difficulty of items used in a progress test. The items were classified according to Bloom’s taxonomy. Psychometric properties were assessed based on their taxonomy and fields of knowledge. RESULTS: There was a 54% match between the panel of experts’ expectations and the real difficulty of items. Items that were expected to be easy had mean difficulty that was significantly lower than that of items that were expected to be medium (P < 0.05) or difficult (P < 0.01). Items with high-level taxonomy had higher discrimination indices than low-level items (P = 0.026). We did not find any significant differences between the fields in terms of difficulty and discrimination. CONCLUSIONS: Our study demonstrated that items with high-level taxonomy performed better in discrimination indices and that a panel of experts may develop coherent reasoning regarding the difficulty of items.

ABSTRACT BACKGROUND: Because of the social isolation and distancing measures that were imposed to stop the spread of coronavirus disease 19 (COVID-19), new ways of teaching were implemented. OBJECTIVES: To describe the implementation of telesimulation and seek to assess students’ perceptions regarding telesimulation. DESIGN AND SETTING: Retrospective quantitative study conducted within the hospital simulation at a private medical school in São Paulo, Brazil. METHODS: After telesimulation training, students answered a questionnaire that provided an overall assessment of this activity, self-assessment and assessments of the facilitators and infrastructure provided by the University. RESULTS: Among the students, 50% reported that the activity was below expectations and 45% reported that it was in line with their expectations. The strong points of the activity were the clinical cases, workload and teachers. The main challenge was students’ difficulty in reflecting on their learning and the infrastructure. CONCLUSIONS: Since students have less experience and fewer clinical encounters than residents or professionals, they also face more difficulty. Although telesimulation may have provided a valid alternative to replace simulation training during the COVID-19 pandemic, more face-to-face activities should be offered to students, when possible.

Purpose Assessment in different languages should measure the same construct. However, item characteristics, such as item flaws and content, may favor one test-taker group over another. This is known as item bias. Although some studies have focused on item bias, little is known about item bias and its association with items characteristics. Therefore, this study investigated the association between item characteristics and bias. Methods The University of Groningen offers both an international and a national bachelor’s program in medicine. Students in both programs take the same progress test, but the international progress test is literally translated into English from the Dutch version. Differential item functioning was calculated to analyze item bias in four subsequent progress tests. Items were also classified by their categories, number of alternatives, item flaw, item length, and whether it was a case-based question. Results The proportion of items with bias ranged from 34% to 36% for the various tests. The number of items and the size of their bias was very similar in both programmes. We have identified that the more complex items with more alternatives favored the national students, whereas shorter items and fewer alternatives favored the international students. Conclusion Although nearly 35% of all items contain bias, the distribution and the size of the bias were similar for both groups. The findings of this paper may be used to improve the writing process of the items, by avoiding some characteristics that may benefit one group whilst being a disadvantage for others.

Progress test has been created with the necessity of an assessment method align with problem-based learning. Although it was specifically created to overcome the limitations of traditional assessment for problem-based learning, nowadays is used by different type of curricula. In this paper, we first present the basic assumptions, the history, benefit and challenges of the progress test. Progress test overcomes many limitations of traditional assessment, such as validity and reliability. However, the implementation of progress test is a logistical challenge. In addition, we discuss the limitation of progress test when used as summative assessment, which may not always be aligned with constructivist theory. When adding feedback and methods of analysis that considers multiple testing, progress test is then align with constructivist theory. Finally, the use of progress test’s sub scores may lack validity because of the low number of items; thus, pass/fail decision should not be based on the sub scores, but only on general scores.

Introduction Including palliative care (PC) in overloaded medical curricula is a challenge, especially where there is a lack of PC specialists. We hypothesised that non-specialised rotations could provide meaningful PC learning when there are enough clinical experiences, with adequate feedback.Objective Observe the effects of including PC topics in non-specialised placements for undergraduate medical students in two different medical schools.Design Observational prospective study.Setting Medical schools in Brazil.Participants 134 sixth-year medical students of two medical schools.Methods This was a longitudinal study that observed the development of Self-efficacy in Palliative Care (SEPC) and Thanatophobia (TS) in sixth-year medical students in different non-specialised clinical rotations in two Brazilian medical schools (MS1 and MS2). We enrolled 78 students in MS1 during the Emergency and Critical Care rotation and 56 students in MS2 during the rotation in Anaesthesiology. Both schools provide PC discussions with different learning environment and approaches.Primary outcomes SEPC and TS Scales were used to assess students at the beginning and the end of the rotations.Results In both schools’ students had an increase in SEPC and a decrease in TS scores.Conclusion Non-specialised rotations that consider PC competencies as core aspects of being a doctor can be effective to develop SEPC and decrease TS levels.

Objectives This study describes the development and implementation of a model to assess students’ communication skills highlighting the use of reflective writing. We aimed to evaluate the usefulness of the students’ reflections in the assessment of communication skills.Design Third-year and fourth-year medical students enrolled in an elective course on clinical communication skills development were assessed using different assessment methods.Setting and participants The communication skills course was offered at four universities (three in Brazil and one in Portugal) and included 69 students.Outcome measures The students were assessed by a Multiple-Choice Questionnaire (MCQ), an objective structured clinical examination (OSCE) and reflective writing narratives. The Cronbach’s alpha, dimensionality and the person’s correlation were applied to evaluate the reliability of the assessment methods and their correlations. Reflective witting was assessed by applying the Reflection Evaluation for Enhanced Competencies Tool Rubric (Reflect Score (RS)) to measure reflections’ depth, and the Thematic Score (TS) to map and grade reflections’ themes.Results The Cronbach alpha for the MCQ, OSCE global score, TS and RS were, respectively, 0.697, 0.633, 0.784 and 0.850. The interobserver correlation for the TS and RS were, respectively, 0.907 and 0.816. The assessment of reflection using the TS was significantly correlated with the MCQ (r=0.412; p=0.019), OSCE (0.439; p=0.012) and RS (0.410; p=0.020). The RS did not correlate with the MCQ and OSCE.Conclusions Assessing reflection through mapping the themes and analysing the depth of reflective writing expands the assessment of communication skills. While the assessment of reflective themes is related to the cognitive and behavioural domains of learning, the reflective depth seems to be a specific competence, not correlated with other assessment methods—possibly a metacognitive domain.

Background As the global population ages, palliative care is ever more essential to provide care for patients with incurable chronic conditions. However, in many countries, doctors are not prepared to care for dying patients. Palliative care education should be an urgent concern for all medical schools all around the world, including Latin America and Brazil. Advances in palliative care education require robust assessment tools for constant evaluation and improvement of educational programmes. Bandura’s social cognitive theory proposes that active learning processes are mediated by self-efficacy and associated outcome expectancies, both crucial elements of developing new behaviour. The Self-Efficacy in Palliative Care (SEPC) and Thanatophobia Scales were developed using Bandura’s theory to assess the outcomes of palliative care training.Objectives We aimed to translate and validate these scales for Brazilian Portuguese to generate data on how well doctors are being prepared to meet the needs of their patients.Design Cross-sectional study.Setting One Brazilian medical school.Participants Third-year medical students.Methods The authors translated the scales following the European Organisation for Research and Treatment of Cancer’s recommendations and examined their psychometric properties using data collected from a sample of 111 students in a Brazilian medical school in 2017.Results The Brazilian versions of SEPC and Thanatophobia Scales showed good psychometric properties, including confirmatory factor analysis, replicating the original factors (factor range: 0.51–0.90), and acceptable values of reliability (Cronbach’s alpha: 0.82–0.97 and composite reliability: 0.82–0.96). Additionally, the Brazilian versions of the scales showed concurrent validity, demonstrated through a significant negative correlation.Conclusions The Brazilian version of the scales may be used to assess the impact of current undergraduate training and identify areas for improvement within palliative care educational programmes. The data generated allow Brazilian researchers to join international conversations on this topic and educators to develop tailored pedagogical approaches.

The current use of technology for medical education in low and middle income countries (LMIC) during the COVID-19 pandemic is not yet reaching its potential. We provide recommendations for LMIC that has focus on a systematic framework that considers both faculty development and developing the skills of students. An enormous challenge for all medical educators, but especially in LMIC, continues to be how to maintain clinical teaching in these extraordinary times.

Abstract Background Progress testing is an assessment tool used to periodically assess all students at the end-of-curriculum level. Because students cannot know everything, it is important that they recognize their lack of knowledge. For that reason, the formula-scoring method has usually been used. However, where partial knowledge needs to be taken into account, the number-right scoring method is used. Research comparing both methods has yielded conflicting results. As far as we know, in all these studies, Classical Test Theory or Generalizability Theory was used to analyze the data. In contrast to these studies, we will explore the use of the Rasch model to compare both methods. Methods A 2 × 2 crossover design was used in a study where 298 students from four medical schools participated. A sample of 200 previously used questions from the progress tests was selected. The data were analyzed using the Rasch model, which provides fit parameters, reliability coefficients, and response option analysis. Results The fit parameters were in the optimal interval ranging from 0.50 to 1.50, and the means were around 1.00. The person and item reliability coefficients were higher in the number-right condition than in the formula-scoring condition. The response option analysis showed that the majority of dysfunctional items emerged in the formula-scoring condition. Conclusions The findings of this study support the use of number-right scoring over formula scoring. Rasch model analyses showed that tests with number-right scoring have better psychometric properties than formula scoring. However, choosing the appropriate scoring method should depend not only on psychometric properties but also on self-directed test-taking strategies and metacognitive skills.

ObjectivesThis study investigated the associations between self-assessed empathy levels by physicians in training and empathy levels as perceived by their patients after clinical encounters. The authors also examined whether patient assessments were valid and reliable tools to measure empathy in physicians in training.DesignA multicentric, observational, cross-sectional study.SettingThis study was conducted in three public teaching hospitals in Brazil.ParticipantsFrom the 668 patients invited to participate in this research, 566 (84.7%) agreed. Of these, 238 (42%) were male and 328 (58%) were female. From the invited 112 physicians in training, 86 (76.8%) agreed. Of the 86 physicians in training, 35 (41%) were final-year medical students and 51 (59%) were residents from clinical and surgical specialties. The gender distribution was 39 (45%) males and 47 (51%) females.Primary and secondary outcome measuresPhysicians in training filled the Jefferson Scale of Physician Empathy (JSE) and the Interpersonal Reactivity Index. Patients answered the Jefferson Scale of Patient’s Perceptions of Physician Empathy (JSPPPE) and the Consultation and Relational Empathy Scale (CARE).ResultsThis study found non-significant correlations between patient and physicians-in-training self-assessments, except for a weak correlation (0.241, p

Purpose It is assumed that case-based questions require higher-order cognitive processing, whereas questions that are not case-based require lower-order cognitive processing. In this study, we investigated to what extent case-based and non-case-based questions followed this assumption based on Bloom’s taxonomy. Methods In this article, 4,800 questions from the Interuniversity Progress Test of Medicine were classified based on whether they were case-based and on the level of Bloom’s taxonomy that they involved. Lower-order questions require students to remember or/and have a basic understanding of knowledge. Higher-order questions require students to apply, analyze, or/and evaluate. The phi coefficient was calculated to investigate the relationship between whether questions were case-based and the required level of cognitive processing. Results Our results demonstrated that 98.1% of case-based questions required higher-level cognitive processing. Of the non-case-based questions, 33.7% required higher-level cognitive processing. The phi coefficient demonstrated a significant, but moderate correlation between the presence of a patient case in a question and its required level of cognitive processing (phi coefficient= 0.55, P< 0.001). Conclusion Medical instructors should be aware of the association between item format (case-based versus non-case-based) and the cognitive processes they elicit in order to meet the desired balance in a test, taking the learning objectives and the test difficulty into account.

The aim of this study was to compare the original version of Escala de Competência de Estudo – ECE (C&T), with the reduced one by using the Item Response Theory. A sample of 126 college students, male and female, between 17 and 48 years old (M = 24.65, SD = 6.54) answered the test. The precision coefficients obtained were .91 for the original scale and .90 for the reduced one, indicating a good level of precision for both. The scale’s adjustment to the Rasch Model was analyzed, resulting an average error of 0.11 (SD = 0.02). The scale with 54 items presents an item’s infit mean of 1.00 (SD = .18), and the reduced scale presents an item’s infit mean of 1.01 (SD = .20), and the outfit’s mean value is 1,02 (SD = 0.41). The difficulty of the items was similar in the two scales. The results presented a better adjustment for the reduced scale, seeing that there were less misfit items, in terms of quantity and value.

La investigación tuvo como objetivo analizar la dimensionalidad de la escala de compromiso organizacional. Participaron 184 trabajadores, 91 (49,5%) eran hombres de edades comprendidas entre los 18 y 61 años ( M = 27,44, DP = 7,12). La media del infit fue de 1,04 ( DP = 0,19) que van desde 0,72 hasta 1,53. El outfit promedio fue de 1,03 ( DP = 0,24), y los valores oscilaron entre 0,67 y 1,90. En cuanto a los parámetros de ajuste de personas los valores medios de infit (1,02, DP = 0,49) y outfit (1,03, DP = 0,54). Se seleccionaron ítens con mayor carga en la dimensión positiva y negativa. El análisis de correlación entre los elementos positivos y negativos corregidas por Spearman ‑Brown formulario fue de r = 0,68. Después de ensayos de asociación de las categorías de respuesta y análisis, se decidió llevar a cabo una agrupación de categorías disfuncionales, lo que reduce siete para tres opciones de respuesta. Por lo tanto, se concluye que la escala presenta evidencia que apoya la hipótesis de escala unidimensionalidad.

Este artigo teve como objetivo verificar as diferenças de condutas agressivas entre um grupo de pessoas que cometeram delitos (grupo 1) e um grupo de universitários com as maiores pontuações na Escala de Avaliação de Tendência a Agressividade (grupo 2). O grupo 1 foi constituído por 41 jovens com idades entre 18 e 19 anos, enquanto o grupo 2 foi composto por 42 participantes universitários com idades entre 18-29 anos. Os resultados mostraram o grupo 1 caracterizou-se por condutas relacionadas a enganar para prejudicar, obter sexo ou não perceberem minha culpa; desafiar pessoas, descarregar a raiva em alguém e andar armado, enquanto o grupo 2 apresentou apenas o fato falar alto quando não atendido ou entendido.Este artículo tiene como objetivo verificar las diferencias de conductas agresivas entre un grupo de personas que cometieron delitos (grupo 1) y un grupo de universitarios con los más altos puntajes en la Escala de Avaliação de Tendência a Agressividade (grupo 2). El grupo fue compuesto por 41 jóvenes de edades comprendidas entre 18 y 19 años, mientras que el grupo 2 fue compuesto por 42 universitarios de edades entre 18-29 años. Los resultados mostraron que el grupo 1 se caracterizó por conductas relacionadas a engañar para perjudicar, tener sexo, o no darse cuenta de mi culpa; desafiar a la gente; descargar la ira en alguien y estar armado, mientras que el grupo 2 presentó solamente el facto de hablar alto cuando no atendidos o entendidos.This article aims to verify the differences in aggressive behaviors in a group of people who committed crimes (group 1) and a group of college students with the highest scores on the Escala de Avaliação de Tendência a Agressividade (group 2). Group 1 consisted of 41 18-19 years persons, while Group 2 was composed of 42 18-29 year-old participating students. The results showed that group 1 was characterized by conduct related to injury, sex, or it is not my fault; defying people, raging at someone and carrying a gun. Group 2 showed only the fact "speak loud" when misunderstood.

Esta pesquisa teve como objetivo verificar o funcionamento diferencial dos itens de uma Escala de Avaliação de Tendência à Agressividade, comparando pessoas infratoras, e pessoas estudantes sem histórico conhecido de delinqüência. O primeiro grupo foi constituído por 41 jovens infratores, enquanto o grupo dois foi composto por 42 jovens universitários que obtiveram as mais altas pontuações na escala. Primeiramente, foi analisado o ajuste da escala ao modelo Rasch, sendo que as médias do infit e do outfit sugeriram boa adequação. O resultado da análise do funcionamento diferencial dos itens resultou em 24 itens, com funcionamento diferencial, sendo 10 favorecendo o primeiro grupo e 14 favorecendo o grupo de universitários. Concluiu-se que os comportamentos agressivos exclusivos dos infratores foram o de intimidação física, intimidação e vingança, e para o segundo grupo o comportamento de irritar as pessoas.

O objetivo do presente estudo foi procurar evidências de validade concorrente e por grupos extremos para o Teste Pictórico de Memória. Participaram 204 estudantes universitários do Estado de Minas Gerais, sendo 39,2% homens e 60,8% mulheres, com idades variando de 17 a 56 anos. Foram aplicados de forma coletiva o Teste Pictórico de Memória e o Teste de Raciocínio Inferencial. Quanto à validade concorrente, os resultados revelaram correlações positivas e significativas, variando de 0,34 até 0,56, sem o controle da idade, e de 0,31 a 0,54 controlando tal efeito. Em relação aos grupos extremos, os estudantes com alta e baixa pontuação no Teste de Raciocínio Inferencial apresentaram maiores e menores pontuações no Teste Pictórico de Memória respectivamente. Com base nisso, concluiu-se que foram constatadas evidências de validade concorrente e por grupos extremos para o Teste Pictórico de Memória.