Objetivo. Conocer la valoración de los estudiantes respecto a la simulación como herramienta de formación y la opinión sobre la figura del alumno instructor. Sujetos y métodos. El taller se realizó en el Centro de Simulación y tuvo una duración aproximada de 90 minutos. En cada sesión estaba el alumno instructor con diez compañeros. Los alumnos instructores fueron formados previamente por un profesor de cardiología. Al finalizar la sesión, los estudiantes cumplimentaron un cuestionario de satisfacción anónimo que contenía preguntas relacionadas con el aprendizaje basado en la simulación y sobre la capacidad de sus compañeros para actuar como formadores. Resultados. Se obtuvieron encuestas de 291 estudiantes: 150 de quinto y 141 de sexto curso (82,4% y 71,2% de los matri - culados, respectivamente). Los datos obtenidos del cuestionario de satisfacción respecto a la metodología de aprendizaje obtuvieron puntuaciones entre 3,64 y 4,75 sobre 5. Las preguntas que valoraban la opinión acerca de los alumnos forma - dores obtuvieron valores entre 4,88 y 4,93 sobre 5. Conclusiones. La simulación es una herramienta docente complementaria muy valiosa. La participación de alumnos ins - tructores podría ser una ayuda adicional en los talleres de simulación de exploración cardiológica.

Introduction: Simulation enables medical students to practice clinical skills in a safe environment. Graduates in medicine must be able to correctly perform an examination on a pregnant woman using Leopold maneuvers. Learning curves-cumulative summation (LC-CUSUM) may help determine when the student has achieved a specific skill. Our objective was to perform the LC-CUSUM test regarding the ability of students to correctly carry out Leopold maneuvers; a pregnancy simulator was used, transferring the results to a clinical setting. Methods: Five medical students were trained to carry out Leopold maneuvers using the simulator. Each student performed maneuvers for 50 cases of different fetus positions; a LC-CUSUM was plotted for each student. Afterward, the students performed the Leopold maneuvers on 5 pregnant women. Results: Of the 5 students, 3 achieved a level of proficiency; the attempts needed for reaching this level were 13, 13, and 37, respectively. The other 2 students did not reach proficiency level. Of the students who became successfully proficient with the simulator, one of them attained a 100% success rate in pregnant patients, whereas the other two had success rates of 80%. The students who did not achieve a level of competency with the simulator had only a 60% success rate with patients. Conclusions: Because of the differences observed between students in the number of attempts needed for achieving proficiency in Leopold maneuvers, we believe that each student should build his/her own learning curve. Achieving competency in carrying out Leopold maneuvers using the simulator could be transferable to patients. Copyright © 2015 by the Society for Simulation in Healthcare.

Objective: To know the level of confidence of fifth year medical students in order to perform maneuvers in bladder catheterization and rectal examination before and after training with simulators. To be able to assess student satisfaction regarding the use of the simulation as a learning method. Material and Methods: The study was conducted in the Simulation Center of the Faculty of Medicine. A total of 173 students who completed a practical workshop on the subject of Urology participated. The students were asked to answer anonymous questionnaires on their level of confidence in performing a bladder catheterization and rectal examination before and after the workshop as well as their satisfaction in using the simulation as a training tool. The workshops were organized using groups of 10 students. A teacher or a resident in that area of expertise supervised each student individually, resolving their doubts and teaching them the proper technique. Results: All the evaluations made on the different abilities were significantly higher after training (P<.001). Significant differences were found in the confidence level between men and women before the training regarding male urethral catheterization maneuvers and recognition of normal or pathological prostate, The confidence level was lower in women (P<.05). These differences disappeared after training. The level of overall satisfaction with the workshop was high, going from 4.47 ± 0.9 to a maximum score of 5. Conclusions: Simulation is a training method that helps improve the confidence of the medical student in performing a bladder catheterization and digital rectal examination.

Introduction: Current European Resuscitation Guidelines 2010 recommend the use of prompt/feedback devices when training for cardiopulmonary resuscitation (CPR). We aimed to assess the quality of CPR training among second-year medical students with a voice advisory mannequin (VAM) compared to guidance provided by an instructor. Methods: Forty-three students received a theoretical reminder about CPR followed by a 2-minute pretest on CPR (compressions/ventilations cycle) with Resusci Anne SkillReporter (Laerdal Medical). They were then randomized into a control group (n = 22), trained by an instructor for 4 minutes per student, and an intervention group (n = 21) trained individually with VAM CPR mannequin for 4 minutes. After training, the students performed a 2-minute posttest, with the same method as the pretest. Results: Participants in the intervention group (VAM) performed more correct hand position (73% vs. 37%; P = 0.014) and tended to display better compression rate (124 min-1 vs. 135 min-1; P = 0.089). In a stratified analyses by sex we found that only among women trained with VAM was there a significant improvement in compression depth before and after training (36 mm vs. 46 mm, P = 0.018) and in the percentage of insufficient compressions before and after training (56% vs. 15%; P = 0.021). Conclusions: In comparison to the traditional training method involving an instructor, training medical students in CPR with VAM improves the quality of chest compressions in hand position and in compression rate applied to mannequins. Only among women was VAM shown to be superior in compression depth training. This technology reduces costs in 14% in our setup and might potentially release instructors' time for other activities.

To determine the degree of confidence of students regarding obstetric examination before and after training with simulators, and assess their satisfaction with the use of simulation as a tool for acquiring skills. METHODS:Training groups involved 10 students per lecturer. Students learned how to perform Leopold's manoeuvres and measure uterine height with a simulator. The instructor supervised each physical exam. Surveys by those students who had previously done an internship at the Department of Obstetric & Gynecology were not taken into account. RESULTS:Students' confidence in performing the procedures improved significantly (p¿0.001) after the intervention.

MMP-10 is involved in the development of microvascular complications in type 1 diabetes and emerges as a potential therapeutic target for slowing down the evolution of diabetic nephropathy and retinopathy.

Objetivos. La utilización de la simulación es habitual en medicina para mejorar el conocimiento y habilidades de competencias. Se pueden utilizar pacientes virtuales, simuladores y pacientes simulados. Nosotros planteamos que alumnos de quinto y sexto curso actúen como pacientes simulados para que sus compañeros de primero aprendan la anamnesis de la historia clínica. Sujetos y métodos. Un total de 207 alumnos de primer curso de grado aprendieron a realizar la historia clínica en una sala de urgencias del centro de simulación entrevistando a pacientes simulados, que eran sus compañeros de quinto y sexto curso. Se evaluaron las historias clínicas realizadas, y para conocer el grado de satisfacción de los estudiantes se pidió que cumplimentasen un cuestionario anónimo tanto a los alumnos de primer curso como a los de cursos superiores. Resultados. La valoración de la calidad de las historias clínicas fue de 8,2 sobre 10. Esta metodología ha sido muy bien valorada. A la pregunta "¿el entrenamiento con pacientes simulados ayuda al aprendizaje para la realización de la historia clínica?", los alumnos de primero puntuaron 9, y los de quinto y sexto, 9,2. Al ítem "¿trabajar con pacientes simulados mejora sus habilidades de comunicación?", ambos grupos puntuaron 8,6. Y para "¿es adecuado el aprendizaje de la historia clínica mediante pacientes simulados previo a su aprendizaje con pacientes reales?", ambos grupos puntuaron 9,3. La valoración de la experiencia como paciente simulado fue de 9,3. Conclusión. El aprendizaje de la historia clínica en primer curso del grado de Medicina mediante pacientes simulados resulta beneficioso para los alumnos. Un contacto temprano con la clínica a partir del aprendizaje basado en la simulación podría mejorar la formación de los estudiantes.

Background. Type 1 diabetes is associated with vascular morbidity. The aim of this study was to evaluate the role of polymorphisms rs1410996 CFH and rs10490924 ARMS2 with proliferative diabetic retinopathy and coronary disease in type 1 diabetes patients. Material and methods. We present a retrospective study that analyses the clinical characteristics and the polymorphisms rs1410996 CFH and rs10490924 ARMS2 of 147 type 1 diabetes patients. Results. The patients who developed proliferative diabetic retinopathy in the first 20 years carried the rs1410996 CFH polymorphism. The overall risk-allele frequency was significantly higher among patients with coronary artery disease than in those without it (75 vs. 53%, p<0.001). Conclusions. rs1410996 CFH polymorphism could be associated with both proliferative diabetic retinopathy and coronary artery disease in type 1 diabetes patients. However, rs10490924 ARMS2 does not seem to be associated either with retinopathy or coronary artery disease.

BACKGROUND: Type 1 diabetes is associated with vascular morbidity. The aim of this study was to evaluate the role of polymorphisms rs1410996 CFH and rs10490924 ARMS2 with proliferative diabetic retinopathy and coronary disease in type 1 diabetes patients. MATERIAL AND METHODS: We present a retrospective study that analyses the clinical characteristics and the polymorphisms rs1410996 CFH and rs10490924 ARMS2 of 147 type 1 diabetes patients. RESULTS: The patients who developed proliferative diabetic retinopathy in the first 20 years carried the rs1410996 CFH polymorphism. The overall risk-allele frequency was significantly higher among patients with coronary artery disease than in those without it (75 vs. 53%, p<0.001). CONCLUSIONS: rs1410996 CFH polymorphism could be associated with both proliferative diabetic retinopathy and coronary artery disease in type 1 diabetes patients. However, rs10490924 ARMS2 does not seem to be associated either with retinopathy or coronary artery disease.