Papers by Salvador Espinosa-Ramirez
European Review for Medical and Pharmacological Sciences, Jul 1, 2022
Revista Española de Urgencias y Emergencias, 2023
OBJETIVO. Conocer la percepción sobre la influencia del factor humano en urgencias que adquieren ... more OBJETIVO. Conocer la percepción sobre la influencia del factor humano en urgencias que adquieren los alumnos trasla realización
de un curso E-CRM (Emergency Crisis Resource Management) de la Sociedad Española de Urgencias y Emergencias (SEMES) basado
en simulación
clínica.
MATERIAL Y MÉTODO. Se analizaron las respuestas a un cuestionario ad hoc administrado a los 3 meses de las ediciones de los
cursos E-CRM SEMES realizados entre 2017-19. El cuestionario valoraba la autopercepción sobre la influencia que ha tenido el curso
en su desarrollo personal y profesional.
RESULTADOS. Se recogieron las encuestas de 147 participantes (73,5% médicos, 20,4% enfermeras, 5,4% TES (Técnico en Emergencias
Sanitarias) y 1,4% otras profesiones. El 65% de los profesionales tenía una antigüedad de más de 10 años. Existieron diferencias
significativas entre las diferentes profesiones y servicios en los 5 ejes E-CRM (petición de ayuda, claridad de papeles, comunicación
eficaz, uso de recursos y evaluación global). Se destacó el uso de ayudas cognitivas, la escucha activa y la planificación
previa al inicio del turno.
CONCLUSIONES. Tras la realización de un curso E-CRM basado en simulación, los participantes son conscientes de cómo el factor
humano influye en el desempeño de su trabajo en los servicios de urgencias y emergencias, lo que pueder llevar a introducir cambios
en su quehacer profesional y personal.
Palabras clave: Medicina de emergencia. Educación médica basada en simulación. Interprofesional. Educación y entrenamiento médico.
OBJECTIVE. To know the perception of the influence of the human factor in emergencies, acquired by students after completing an
E-CRM (Emergency Crisis Resource Management) course of the Spanish Society of Emergency Medicine and Emergency Medicine
(SEMES) based on clinical simulation. E-CRM (Emergency Crisis Resource Management) course of the Spanish Society of Emergency
Medicine (SEMES) based on clinical simulation.
METHODS. We analyzed responses to an ad hoc survey sent to participants 3 months after they completed the E-CRM course
between 2017 and 2019. We analyzed their views of the influence the course had on their personal and professional development.
RESULTS. Responses were received from 147 course participants (73.5%, physicians; 20.4%, nurses; 5.4%, emergency medical
technicians; and 1.4%, other). Sixty-five percent had more than 10 years of experience. The different groups of participants gave
significantly different responses for the 5 question categories: seeking help, role clarification, effective communication, resource use,
and overall evaluation. Respondents emphasized their use of cognitive aids, active listening, and team planning prior to starting a
shift.
CONCLUSIONS. After the E-CRM clinical simulation course, respondents reported being more aware of how human factors
influence their personal and professional approaches to carrying out their emergency service work.
Keywords: Emergency medicine. Educational activities, simulation. Multidisciplinary training. Training programs.
Fundación Educación Médica, 2022
Introducción. La autopercepción que tienen los estudiantes para desarrollar su práctica clínica e... more Introducción. La autopercepción que tienen los estudiantes para desarrollar su práctica clínica es la manera más acertada de evaluar cuán preparados se sienten y cuáles son sus habilidades. La universidad desarrolla un programa de simulación que permite a los alumnos potenciar su propio aprendizaje, con situaciones de feedback de los instructores de simulación. Sujetos y métodos. El estudio tuvo lugar en el curso académico 2019-2020. Los estudiantes de tercer año completaron tres escenarios de simulación; los de cuarto año, cuatro; y los de quinto año, tres. Antes y después de cada sesión de simulación, completaron un cuestionario electrónico de autopercepción de competencias técnicas y no técnicas. Resultados. De los 121 estudiantes de tercer curso, 79 (65,3%) contestaron a la encuesta inicial y 68 (61,2%) a la encuesta final. En cuarto curso participaron 111 alumnos, y contestaron la encuesta inicial 63 alumnos (56,8%) y 68 la final (61,2%). El quinto curso estuvo compuesto por 97 estudiantes, de los cuales 94 (96,9%) contestaron la encuesta inicial y 69 (71,1%) la final. Todos los ítems de la encuesta de autopercepción mejoraron de forma estadísticamente significativa (p < 0,001) en la encuesta final. Las puntuaciones iniciales medias en la dimensión no técnica fueron más altas que las puntuaciones medias en la dimensión técnica para todos los cursos de estudio. Conclusiones. Los resultados que obtuvimos mostraron una mejora en la autopercepción de las habilidades de los estudiantes y en su confianza para realizar las tareas de las simulaciones. Los alumnos de cursos superiores se sienten más seguros tanto en habilidades técnicas como en no técnicas, como la comunicación. Palabras clave. Autoevaluación. Estudiantes. Grado de Medicina. Habilidades no técnicas. Habilidades técnicas. Simulación clínica.
European Review for Medical and Pharmacological Sciences, 2022
Objective
Our aim was to reach expert consensus on specific learning outcomes (LOs) that can be... more Objective
Our aim was to reach expert consensus on specific learning outcomes (LOs) that can be achieved through clinical simulation aimed at developing the competencies that medical students need to be able to successfully manage patients and assume general clinical responsibilities.
Materials and Methods
The six-member scientific committee peer-reviewed Spanish reference documentation (in line with the Bologna Process) on required competencies in medical undergraduate students to select an initial set of 16 competencies that could feasibly be developed through simulation and a corresponding set of 75 LOs. Snowball sampling was used to identify candidates for an international panel of simulation experts. Applying a set of pre-defined criteria, 19 panellists from seven Spanish-speaking regions were recruited to participate in a modified two-round Delphi procedure based on electronic questionnaires and aimed at reaching formal consensus on appropriate LOs for simulated medical training.
Results
Final agreement between the panellists was high: no mean score fell below 7.26 of a maximum of 9, and all 75 LOs were agreed on, 74 in the first round and only one requiring the second round. The 16 LOs with mean scores in the top 25th percentile were selected as a set of core LOs to attain via simulation.
Conclusions
This Ibero-American consensus on observable and measurable LOs, reflecting competencies that can feasibly be developed via clinical simulation, is a framework that aims to help medical schools plan and deliver specific kinds of undergraduate medical training through simulation. Also proposed in a set of core LOs as a starting point for less experienced schools to design a simulated training programme.
La realizacion de este articulo surge a raiz del trabajo que esta desarrollando el Grupo de Simul... more La realizacion de este articulo surge a raiz del trabajo que esta desarrollando el Grupo de Simulacion Clinica de la SEMES desde enero de 2017. El objetivo que tiene este grupo de trabajo es concienciar al personal sanitario sobre la importancia del factor humano en la atencion al paciente con patologia urgente con el fin de minimizar el numero y las consecuencias de los eventos adversos. Para ello se ha disenado, en base a la bibliografia existente, el modelo E-CRM de SEMES basado en 15 puntos siendo estos agrupados en 5 ejes: claridad de papeles, comunicacion, ayuda y su gestion, conocimiento y uso de recursos y vision global.
Simulación clínica, 2020
Introduction: Simulated clinical experience allows to asses response of pre-hospital care, emerge... more Introduction: Simulated clinical experience allows to asses response of pre-hospital care, emergencies and critical care teams to a suspected case of COVID-19. Case report: A multiple environment was set, beginning at patient’s home and continued in hospital. During the analysis, a self-assessment exercise was carried out on emotions, cognitive load and self-perception of efficacy. A difference was found in the cognitive load in favor of the critical care and emergencies groups compared to pre-hospital care. All three groups expressed high self-perception of efficacy; however, a performance gap was observed in terms of prevention and control of the infection and nontechnical skills. Conclusions: We highlight the need to take cognitive load and non-technical skills into account in the design of simulated clinical experience, their role in self-perception of efficacy, and the value of translational simulation in the continuous improvement of processes for the care of COVID-19.
Revista Española de Cardiología, 2011
Coronary heart disease, and acute myocardial infarction in particular, is the primary cause of de... more Coronary heart disease, and acute myocardial infarction in particular, is the primary cause of death in Spain, resulting in more deaths than cancer. Where available, primary percutaneous coronary intervention is the treatment of choice in the first 12 hours after an acute myocardial infarction. The universalization of percutaneous revascularization to all patients with myocardial infarctions necessitates the creation of wellorganized networks. The participation of health-care professionals and coordination with local health-care authorities are essential. This article describes the CORECAM protocol of the primary percutaneous coronary intervention program in Castile-La Mancha, Spain, thereby providing a summary of the treatment initiative for patients with acute myocardial infarction.
Emergencias, 2020
Emergencias 2020;32:135-137 terna en relación al presente artículo.
Emergencias, 2020
A 29 de mayo de 2020, la Red Nacional de Vigilancia epidemiológica (RENAVE), contabilizaba 40.961... more A 29 de mayo de 2020, la Red Nacional de Vigilancia epidemiológica (RENAVE), contabilizaba 40.961 sanitarios contagiados en España por COVID-19, la cuarta parte de la población española afectada por la pandemia (24,1%) 1,2 . El 10,5% de nuestros colegas ha precisado hospitalización (4.188), 310 casos (1,1%) ingreso en unidades de cuidados intensivos y 211 de ellos necesitaron ventilación mecánica. No obstante, los datos de gravedad (entendida como ingreso hospitalario o nivel de tratamiento intensivo) solo están disponibles en el 31,7% de los casos registrados en RENAVE. El dato más duro de este informe es, lógicamente, los 52 compañeros fallecidos, 61 si usamos otra fuente oficial, la cual además eleva hasta los 51.482 los casos de sanitarios afectados 3 .
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Papers by Salvador Espinosa-Ramirez
de un curso E-CRM (Emergency Crisis Resource Management) de la Sociedad Española de Urgencias y Emergencias (SEMES) basado
en simulación
clínica.
MATERIAL Y MÉTODO. Se analizaron las respuestas a un cuestionario ad hoc administrado a los 3 meses de las ediciones de los
cursos E-CRM SEMES realizados entre 2017-19. El cuestionario valoraba la autopercepción sobre la influencia que ha tenido el curso
en su desarrollo personal y profesional.
RESULTADOS. Se recogieron las encuestas de 147 participantes (73,5% médicos, 20,4% enfermeras, 5,4% TES (Técnico en Emergencias
Sanitarias) y 1,4% otras profesiones. El 65% de los profesionales tenía una antigüedad de más de 10 años. Existieron diferencias
significativas entre las diferentes profesiones y servicios en los 5 ejes E-CRM (petición de ayuda, claridad de papeles, comunicación
eficaz, uso de recursos y evaluación global). Se destacó el uso de ayudas cognitivas, la escucha activa y la planificación
previa al inicio del turno.
CONCLUSIONES. Tras la realización de un curso E-CRM basado en simulación, los participantes son conscientes de cómo el factor
humano influye en el desempeño de su trabajo en los servicios de urgencias y emergencias, lo que pueder llevar a introducir cambios
en su quehacer profesional y personal.
Palabras clave: Medicina de emergencia. Educación médica basada en simulación. Interprofesional. Educación y entrenamiento médico.
OBJECTIVE. To know the perception of the influence of the human factor in emergencies, acquired by students after completing an
E-CRM (Emergency Crisis Resource Management) course of the Spanish Society of Emergency Medicine and Emergency Medicine
(SEMES) based on clinical simulation. E-CRM (Emergency Crisis Resource Management) course of the Spanish Society of Emergency
Medicine (SEMES) based on clinical simulation.
METHODS. We analyzed responses to an ad hoc survey sent to participants 3 months after they completed the E-CRM course
between 2017 and 2019. We analyzed their views of the influence the course had on their personal and professional development.
RESULTS. Responses were received from 147 course participants (73.5%, physicians; 20.4%, nurses; 5.4%, emergency medical
technicians; and 1.4%, other). Sixty-five percent had more than 10 years of experience. The different groups of participants gave
significantly different responses for the 5 question categories: seeking help, role clarification, effective communication, resource use,
and overall evaluation. Respondents emphasized their use of cognitive aids, active listening, and team planning prior to starting a
shift.
CONCLUSIONS. After the E-CRM clinical simulation course, respondents reported being more aware of how human factors
influence their personal and professional approaches to carrying out their emergency service work.
Keywords: Emergency medicine. Educational activities, simulation. Multidisciplinary training. Training programs.
Our aim was to reach expert consensus on specific learning outcomes (LOs) that can be achieved through clinical simulation aimed at developing the competencies that medical students need to be able to successfully manage patients and assume general clinical responsibilities.
Materials and Methods
The six-member scientific committee peer-reviewed Spanish reference documentation (in line with the Bologna Process) on required competencies in medical undergraduate students to select an initial set of 16 competencies that could feasibly be developed through simulation and a corresponding set of 75 LOs. Snowball sampling was used to identify candidates for an international panel of simulation experts. Applying a set of pre-defined criteria, 19 panellists from seven Spanish-speaking regions were recruited to participate in a modified two-round Delphi procedure based on electronic questionnaires and aimed at reaching formal consensus on appropriate LOs for simulated medical training.
Results
Final agreement between the panellists was high: no mean score fell below 7.26 of a maximum of 9, and all 75 LOs were agreed on, 74 in the first round and only one requiring the second round. The 16 LOs with mean scores in the top 25th percentile were selected as a set of core LOs to attain via simulation.
Conclusions
This Ibero-American consensus on observable and measurable LOs, reflecting competencies that can feasibly be developed via clinical simulation, is a framework that aims to help medical schools plan and deliver specific kinds of undergraduate medical training through simulation. Also proposed in a set of core LOs as a starting point for less experienced schools to design a simulated training programme.
de un curso E-CRM (Emergency Crisis Resource Management) de la Sociedad Española de Urgencias y Emergencias (SEMES) basado
en simulación
clínica.
MATERIAL Y MÉTODO. Se analizaron las respuestas a un cuestionario ad hoc administrado a los 3 meses de las ediciones de los
cursos E-CRM SEMES realizados entre 2017-19. El cuestionario valoraba la autopercepción sobre la influencia que ha tenido el curso
en su desarrollo personal y profesional.
RESULTADOS. Se recogieron las encuestas de 147 participantes (73,5% médicos, 20,4% enfermeras, 5,4% TES (Técnico en Emergencias
Sanitarias) y 1,4% otras profesiones. El 65% de los profesionales tenía una antigüedad de más de 10 años. Existieron diferencias
significativas entre las diferentes profesiones y servicios en los 5 ejes E-CRM (petición de ayuda, claridad de papeles, comunicación
eficaz, uso de recursos y evaluación global). Se destacó el uso de ayudas cognitivas, la escucha activa y la planificación
previa al inicio del turno.
CONCLUSIONES. Tras la realización de un curso E-CRM basado en simulación, los participantes son conscientes de cómo el factor
humano influye en el desempeño de su trabajo en los servicios de urgencias y emergencias, lo que pueder llevar a introducir cambios
en su quehacer profesional y personal.
Palabras clave: Medicina de emergencia. Educación médica basada en simulación. Interprofesional. Educación y entrenamiento médico.
OBJECTIVE. To know the perception of the influence of the human factor in emergencies, acquired by students after completing an
E-CRM (Emergency Crisis Resource Management) course of the Spanish Society of Emergency Medicine and Emergency Medicine
(SEMES) based on clinical simulation. E-CRM (Emergency Crisis Resource Management) course of the Spanish Society of Emergency
Medicine (SEMES) based on clinical simulation.
METHODS. We analyzed responses to an ad hoc survey sent to participants 3 months after they completed the E-CRM course
between 2017 and 2019. We analyzed their views of the influence the course had on their personal and professional development.
RESULTS. Responses were received from 147 course participants (73.5%, physicians; 20.4%, nurses; 5.4%, emergency medical
technicians; and 1.4%, other). Sixty-five percent had more than 10 years of experience. The different groups of participants gave
significantly different responses for the 5 question categories: seeking help, role clarification, effective communication, resource use,
and overall evaluation. Respondents emphasized their use of cognitive aids, active listening, and team planning prior to starting a
shift.
CONCLUSIONS. After the E-CRM clinical simulation course, respondents reported being more aware of how human factors
influence their personal and professional approaches to carrying out their emergency service work.
Keywords: Emergency medicine. Educational activities, simulation. Multidisciplinary training. Training programs.
Our aim was to reach expert consensus on specific learning outcomes (LOs) that can be achieved through clinical simulation aimed at developing the competencies that medical students need to be able to successfully manage patients and assume general clinical responsibilities.
Materials and Methods
The six-member scientific committee peer-reviewed Spanish reference documentation (in line with the Bologna Process) on required competencies in medical undergraduate students to select an initial set of 16 competencies that could feasibly be developed through simulation and a corresponding set of 75 LOs. Snowball sampling was used to identify candidates for an international panel of simulation experts. Applying a set of pre-defined criteria, 19 panellists from seven Spanish-speaking regions were recruited to participate in a modified two-round Delphi procedure based on electronic questionnaires and aimed at reaching formal consensus on appropriate LOs for simulated medical training.
Results
Final agreement between the panellists was high: no mean score fell below 7.26 of a maximum of 9, and all 75 LOs were agreed on, 74 in the first round and only one requiring the second round. The 16 LOs with mean scores in the top 25th percentile were selected as a set of core LOs to attain via simulation.
Conclusions
This Ibero-American consensus on observable and measurable LOs, reflecting competencies that can feasibly be developed via clinical simulation, is a framework that aims to help medical schools plan and deliver specific kinds of undergraduate medical training through simulation. Also proposed in a set of core LOs as a starting point for less experienced schools to design a simulated training programme.