Face-to-face clinical simulation has been a powerful methodology for teaching, learning, and research, and has positioned itself in health science education. However, due to the COVID-19 pandemic, social distancing has forced universities to abandon simulation centers and make use of alternatives that allow the continuation of educational programs safely for students and teachers through virtual environments such as distance simulation. In Latin America, before the pandemic, the use of non-presential simulation was very limited and anecdotal. This article has three main objectives: to establish the efficacy of online-synchronized clinical simulation in the learning and performance of medical students on the management of patients with COVID-19 in simulation centers of three Latin American countries, to determine the quality of the online debriefing from the students’ perspective, and to deepen the understanding of how learning is generated with this methodology.

Introduction: A powerful methodology for teaching, learning, and researching is clinical simulation, which has positioned itself in recent decades in health science education. However, due to the COVID-19 pandemic, social distancing has forced institutions to leave simulation centers and make use of new alternatives that allow the continuation of educational programs through virtual environments.Methods: We carried out a before-and-after design study that used online-synchronized clinical simulation (OSCSim) in three Latin American clinical simulation centers (Colombia, Ecuador, and Mexico). The educational intervention included briefing, COVID-19 simulated cases, and structured debriefing through a meeting platform. We assessed the participants' learning and performance in diagnosis, treatment, and nontechnical skills for the management of patients with COVID-19. Satisfaction and learning perception were measured. The debriefing quality was evaluated from the student's perspective.Results: We had 106 participants. 46.2% from Colombia, 31.1% from Mexico, and 22.6% from Ecuador. A total of 51.9% were men, and the median age was 23 years (IQR: 22-26). A total of 34.9% were fourth-year students of medicine, 38% were fifth-year students, and 21.7% were anesthesia residents. Fourteen OSCSim sessions were performed; cognitive engagement was 43.4%, mainly interactive. A relationship was found between cognitive engagement, learning, situational awareness, and realism in the simulation. The quality of debriefing was ranked high by the participants, and they also agreed with the OSCSim methodology.Conclusion: OSCSim is an active and social learning activity that enables training and improvement of nontechnical skills and declarative knowledge about COVID-19 management. Nevertheless, it needs to be complemented in the procedural aspect in simulation centers.

Valdez-Garcia et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Factores humanos y seguridad del personal de salud en tiempos de pandemiaHuman factors and healthcare personnel safety in times of pandemic

During the pandemic, postgraduate medical programs were affected by the closure of clinics, which reduced the surgical procedures that the students performed. To continue offering these practical experiences, many educational programs turned to simulation activities where students could practice, engage in assessment, and receive feedback to guarantee skill development. The objective of this study was to analyze the training experience of ophthalmology residents based on a simulation that emerged in the pandemic. The study considered a mixed-method approach with parallel quantitativequalitative phases. The sample consisted of 21 residents from different stages in their training in a multicentric postgraduate medical program in Mexico. As an instrument, a 10-item online survey focused on the elements of simulation practice, such as the type of procedures, frequency of participation, and their perspectives on skills development and how closely their mastery could be translated to professional practice. The results show that students practiced nine different types of procedures. First-year residents used simulators the most (40%), and 65% performed animal model practices. Regarding students' perception of skill development, 70% of them valued their performance on a competent level, and 75% of students consider these skills are transferable to a professional practice setting. Even 31% of participants consider this experience comparable to what they would have done without the restrictions of the pandemic. The model can be transferred to other postgraduate medical or health-focused programs, even after the pandemic simulation can foster a safe learning environment for students to master complex procedures. Other disciplines can incorporate these lessons in preparing contextrich educational experiences to prepare graduates for a competitive professional environment. Keywords: Educational innovation, Higher education, Simulation, Medical education, Residency programs