Objective: To evaluate two debriefing strategies for the development of neonatal resuscitation skills in health professionals responsible for the critical newborn care in a high-complexity university Hospital. Results: A simple blind randomized clinical trial was conducted. Twenty-four professionals (pediatricians, nurses, and respiratory therapists) were randomly assigned for two interventions; one group received oral debriefing and the other oral debriefing assisted by video. Three standardized clinical scenarios that were recorded on video were executed. A checklist was applied for the evaluation, administered by a reviewer blinded to the assignment of the type of debriefing. The two debriefing strategies increased the technical and behavioral neonatal resuscitation skills of the participants, without one being superior to the other. The coefficient of the difference in the compliance percentage between the two types of debriefing was − 3.6% (95% CI − 13.77% to 6.47%). When comparing the development of technical and behavioral skills among the professionals evaluated, no significant differences were found between the types of debriefing. The two debriefing strategies increase compliance percentages, reaching or approaching 100%. Trial Registration ClinicalTrials.gov NCT03606278. July 30, 2018. Retrospectively registered

Exchange transfusion is a highly complex procedure that requires high levels of expertise. Trainee paediatricians do not have adequate training in exchange transfusion because opportunities to perform this procedure in practice are scarce. This protocol seeks to compare two educational interventions for exchange transfusion that allow students to develop competencies to perform the technique in an appropriate and safe way. This is a randomized parallel single-blind clinical trial with allocation by simple randomization to the educational intervention (simulation or a digital didactic environment). Students from the paediatric specialization who volunteer to participate will be included. A practical evaluation of the procedure will be performed through a simulated scenario using a standardized clinical case. The main outcome is defined as the result of evaluation using the Objective Structured Clinical Examination; superior performance will be defined when the percentage is greater than or equal to 85%, and non-superior performance will be defined when the result is less than 84%. The chi-square independence test or the Fisher exact test will be used to evaluate the effect of the interventions. Multivariate analysis will be performed using a non-conditional logistic regression model. Stata 15® software will be used. Exchange transfusion is a procedure that requires expertise to achieve adequate outcomes. The inclusion of new educational strategies, such as simulation and digital didactic environments, is seen as a training option that can improve performance in clinical skills, reduce adverse events and increase the level of trust. ClinicalTrials.gov: NCT04070066. Registered on 28 August 2019. https://clinicaltrials.gov.

Flipped classroom is an innovative teaching and learning methodology, that has demonstrated being effective in the health area. In the context of the actual confinement due to the Covid-19 Pandemic, it perfectly adapts to the new reality of medical teachers and students, as it substitutes face – to – face learning for online tutorials and telepresence meetings. The present study describes the medicine undergraduate student’s perception, in the Pediatrics course, with respect to inverted classroom classes performed during the COVID-19 Pandemic between June and November 2020. This study involved 93.3% of students enrolled in the university's paediatrics course, the sample consisted of 70 students, with an average age of 22, of whom 30% were men and 70% women, all respondent to the Flipped Classroom Perception Instrument survey. The results showed above 70 % positive perception on all the aspects that were evaluated among them. A positive perception of the inverted classroom is evidenced by the medical students who took the pediatrics course. It is suggested to perform another after study, to evaluate if this methodology impacts the academic results, compared with traditional learning methodologies.

Exchange transfusion is the treatment of choice for patients with severe hyperbilirubinemia who do not respond to phototherapy. This procedure is highly complex and requires substantial expertise to perform, however it´s not done frequently enough to guarantee adequate training. Traditional learning scenarios do not have a space reserved for teaching this procedure or an instrument that fully and objectively evaluates the skills that a professional must acquire. The purpose was to construct and evaluate the INEXTUS instrument´s validity evidence relevant to internal structure, in a simulated scenario through the performance of an objective structured clinical exam (OSCE). The Delphi consensus methodology was utilized to design the instrument; six experts participated through three rounds using the Google Forms platform. The categories and items previously obtained were subjected to validation by nine experts through a dichotomous survey. Prior to data collection, the evaluators were trained through a pilot test with 10 medical students. Subsequently, all residents of a paediatric programme were evaluated through the OSCE methodology in a simulated scenario, with 6 stations, of a clinical case of a new-born with an explicit need for exchange transfusion. During their participation in the scenario, the residents were first evaluated with the instrument developed. Additionally, audio and video filming of all students who participated was performed with the aim of conducting a second evaluation two weeks after the first four evaluators participated. The final INEXTUS instrument consists of 46 subitems grouped into 23 items divided into 6 categories, demonstrating an inter-rater intraclass correlation coefficient of 0.96 (95% CI 0.94, 0.98 p-value < 0.001). For the Fleiss Kappa of the 23 items evaluated, concordance was evaluated for 14 items but could not be determined for the 9 remaining items because all the ratings were equal, either because the items were not performed or they were all performed adequately. Of the 14 items, 9 good scores were obtained (95% CI 0.61 to 0.8; p value < 0.001), and 5 very good scores were obtained (95% CI 0.81 to 1; p value < 0.001). The INEXTUS instrument evaluates exchange transfusion skills in medical personnel in training in simulated scenarios using the OSCE methodology; it has high validity and reliability and is a high-impact educational tool.

La educación basada en la simulación en áreas de la salud ha sido ampliamente utilizada en los últimos años, al punto de constituir una forma de enseñanza y evaluación a la vanguardia de la tecnología, ya que permite el perfeccionamiento de habilidades, el desarrollo de competencias y la evaluación objetiva. De esa manera, esta se ha convertido en una estrategia de innovación educativa que permite afrontar algunos de los nuevos retos en la educación médica. Dentro de las estrategias de simulación se destacan la devolución constructiva inmediata y el examen clínico objetivo estructurado. En el presente trabajo se describen dos escenarios simulados pediátricos diseñados por los autores: uno aborda el manejo inmediato del recién nacido y otro el reconocimiento de signos de enfermedad respiratoria aguda en niños de dos meses a cinco años de edad, escenarios que pueden ser utilizados para la enseñanza y la evaluación tanto en programas de pregrado como de posgrado.