Browsing by Author "Corvetto Aqueveque, Marcia Antonia"
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- ItemAcquiring skills in malignant hyperthermia crisis management: comparison of high-fidelity simulation versus computer-based case study(2018) Mejia, Vilma; Gonzalez, Carlos; Delfino, Alejandro; Altermatt, Fernando; Corvetto Aqueveque, Marcia Antonia; Mejia, Vilma; Gonzalez, Carlos; Delfino, Alejandro; Altermatt, Fernando; Corvetto Aqueveque, Marcia Antonia
- ItemActualización en el manejo de intoxicación sistémica por anestésicos locales(2020) Miranda Hiriart, Pablo; Coloma, R.; Rueda, F.; Corvetto Aqueveque, Marcia Antonia
- ItemAssessment of central venous catheterization in a simulated model using a motion-tracking device: an experimental validation study(2016) Varas, Julián; Achurra Tirado, Pablo; León, Felipe.; Castillo, Richard.; De La Fuente, Natalia.; Aggarwal, Rajesh.; Clede, Leticia.; Bravo, María P.; Corvetto Aqueveque, Marcia Antonia; Montaña Rodríguez, RodrigoAbstract Background Central venous catheterization (CVC) is a basic requirement for many medical specialties. Simulated training in CVC may allow the acquisition of this competency but few reports have established a valid methodology for learning and acquiring procedural skills for CVC. This study aims to validate the use of a tracking motion device, the imperial college surgical assessment device (ICSAD), by comparing it with validated global rating scales (GRS) to measure CVC performance in a simulated torso. Methods Senior year medical students, first and last year residents (PGY1, LYR), and expert anesthesiologists performed a jugular CVC assessment in a simulated model (Laerdal IV Torso). A validated GRS for objective assessment of technical skills and motion analysis by ICSAD was used. Statistical analysis was performed through Mann–Whitney and Kruskal–Wallis tests for construct validity and Spearman correlation coefficients between the ICSAD and GRS scores for concurrent validity between both. Results 32 subjects were recruited (10 medical students, 8 PGY1, 8 LYR and 8 experts). Total path length measured with ICSAD and GRS scores were significantly different between all groups, except for LYR compared to experts (p = 0.664 for GRS and p = 0.72 for ICSAD). Regarding jugular CVC procedural time, LYR and experts were faster than PGY1 and MS (p < 0.05). Spearman correlation coefficient was −0.684 (p < 0.001) between ICSAD and GRS scores. Conclusions ICSAD is a valid tool for assessment of jugular CVC since it differentiates between expert and novice subjects, and correlates with a validated GRS for jugular CVC in a simulated torso.Abstract Background Central venous catheterization (CVC) is a basic requirement for many medical specialties. Simulated training in CVC may allow the acquisition of this competency but few reports have established a valid methodology for learning and acquiring procedural skills for CVC. This study aims to validate the use of a tracking motion device, the imperial college surgical assessment device (ICSAD), by comparing it with validated global rating scales (GRS) to measure CVC performance in a simulated torso. Methods Senior year medical students, first and last year residents (PGY1, LYR), and expert anesthesiologists performed a jugular CVC assessment in a simulated model (Laerdal IV Torso). A validated GRS for objective assessment of technical skills and motion analysis by ICSAD was used. Statistical analysis was performed through Mann–Whitney and Kruskal–Wallis tests for construct validity and Spearman correlation coefficients between the ICSAD and GRS scores for concurrent validity between both. Results 32 subjects were recruited (10 medical students, 8 PGY1, 8 LYR and 8 experts). Total path length measured with ICSAD and GRS scores were significantly different between all groups, except for LYR compared to experts (p = 0.664 for GRS and p = 0.72 for ICSAD). Regarding jugular CVC procedural time, LYR and experts were faster than PGY1 and MS (p < 0.05). Spearman correlation coefficient was −0.684 (p < 0.001) between ICSAD and GRS scores. Conclusions ICSAD is a valid tool for assessment of jugular CVC since it differentiates between expert and novice subjects, and correlates with a validated GRS for jugular CVC in a simulated torso.
- ItemBloqueos continuos de nervio periférico ambulatorios en pediatría: dos casos clínicos(2010) Corvetto Aqueveque, Marcia Antonia; Ratallino, Marcos; Altermann, Fernando
- ItemBringing clinical simulation into an Anesthesia residency training program in a university hospital. Participants' acceptability assessment(2013) Corvetto Aqueveque, Marcia Antonia; Bravo, M. P.; Montana, R. A.; Altermatt, Fernando; Delfino, Alejandro; Corvetto Aqueveque, Marcia Antonia; Bravo, M. P.; Montana, R. A.; Altermatt, Fernando; Delfino, AlejandroIntroduction Clinical simulation is currently an integral part of the curriculum of the Anesthesiology residency programs in other countries. We aimed to describe and evaluate the insertion of simulation in an anesthesia residency training program. Methods Activities feasible to be used for training in a simulated environment were classified into 2 modules: workshops for technical skills conducted with first year residents, and high fidelity simulation scenarios performed with second and third year residents. After each activity, and using an anonymous questionnaire, residents assessed their satisfaction and objectives accomplished. Results A total of 18 activities: 6 skills workshops and 12 high fidelity scenarios were assessed. A total of 206 questionnaires were analyzed, corresponding to 41 residents. Almost all (96%) of respondents agreed or strongly agreed that workshops met the objectives and should be mandatory in the anesthesia curriculum; however, 11% agreed that the activity caused anxiety and/or nervousness. The high fidelity scenarios were considered realistic and consistent with the objectives by 97% of residents, and 42% felt that workshops caused anxiety and/or nervousness. Conclusions The inclusion of simulation has been well accepted by the residents. The activities have been described as realistic, and limited to the objectives, essential points in adult education, as according to Kolb's learning model this is associated with profound, useful and long lasting knowledge.Introduction Clinical simulation is currently an integral part of the curriculum of the Anesthesiology residency programs in other countries. We aimed to describe and evaluate the insertion of simulation in an anesthesia residency training program. Methods Activities feasible to be used for training in a simulated environment were classified into 2 modules: workshops for technical skills conducted with first year residents, and high fidelity simulation scenarios performed with second and third year residents. After each activity, and using an anonymous questionnaire, residents assessed their satisfaction and objectives accomplished. Results A total of 18 activities: 6 skills workshops and 12 high fidelity scenarios were assessed. A total of 206 questionnaires were analyzed, corresponding to 41 residents. Almost all (96%) of respondents agreed or strongly agreed that workshops met the objectives and should be mandatory in the anesthesia curriculum; however, 11% agreed that the activity caused anxiety and/or nervousness. The high fidelity scenarios were considered realistic and consistent with the objectives by 97% of residents, and 42% felt that workshops caused anxiety and/or nervousness. Conclusions The inclusion of simulation has been well accepted by the residents. The activities have been described as realistic, and limited to the objectives, essential points in adult education, as according to Kolb's learning model this is associated with profound, useful and long lasting knowledge.
- ItemComparison of Continuous Popliteal Nerve Blocks Using Lidocaine versus Bupivacaine Infusions for Ambulatory Foot Surgery: A Randomized, Double-blind, Noninferiority Trial(2023) Echevarría, Ghislaine; Altermatt Couratier, Fernando René; Miranda Hiriart, Pablo; Araneda Vilches, Andrea Lucía; Corvetto Aqueveque, Marcia Antonia; De La Fuente Sanhueza, René Francisco; Cuadra F., Juan Carlos de laBackground and objectives: Continuous sciatic popliteal nerve block effectivelymanages pain after ankle and foot surgery. Most studies on continuous infusionof local anesthetics by perineural catheters have been made with bupivacaine,levobupivacaine, and ropivacaine, but lidocaine has not been used. The mainobjective of this study was to compare the quality of analgesia, motor function,and side effects between lidocaine and bupivacaine infusions in bilateralcontinuous popliteal nerve blocks for foot surgery.Methods: This was a prospective, double-blind, randomized, parallel-group,noninferiority study. We enrolled 70 patients undergoing bilateral foot or anklesurgery that could be performed under general anesthesia and continuous regionalanalgesia using sciatic popliteal nerve blocks. During their postoperative care, theywere randomized into 2 groups: group lidocaine (lidocaine 0.5%, 5 ml/h) or groupbupivacaine (bupivacaine 0.1%, 5 ml/h), administered through elastomeric pumps.The primary outcome was pain at 24 h after surgery, assessed by a verbal numericrating scale (ranging from 0 to 10). A pre-specified non-inferiority margin of 1.5 wasdefined. Secondary outcomes were the degree of motor and sensitive block, totalopioid use, and difficulties with pump or catheter management.Results: The mean postoperative pain at 24 h of surgery was 2.06 (95% bootstrapconfidence interval bCI 1.29, 2.83) and 1.82 (95% bCI 1.02, 2.62) in the lidocaineand bupivacaine group, respectively. The upper limit of the 95% bCI for the meandifference between lidocaine and bupivacaine was 0.82, declaring non-inferiority.No differences in the postoperative rescue analgesia use and satisfaction withcare were found. No differences in postoperative NRS, sensory block and motorblock were seen between groups.Conclusions: Lidocaine 0.5% and bupivacaine 0.1% provide similar postoperativeanalgesia through a sciatic popliteal catheter in ambulatory bilateral foot surgery patients.
- ItemControl-flow analysis of procedural skills competencies in medical training through process mining(2020) Fuente Sanhueza, René Francisco de la; Fuentes Henríquez, Ricardo Sergio; Muñoz Gama, Jorge; Riquelme Pérez, Arnoldo; Altermatt, Fernando; Pedemonte Trewhela, Juan Cristóbal; Corvetto Aqueveque, Marcia Antonia; Sepúlveda Fernández, Marcos Ernesto
- ItemDesign and Evaluation of a Low-Cost Bronchoscopy-Guided Percutaneous Dilatational Tracheostomy Simulator(2019) Kattan Tala, Eduardo José; Vera Alarcón, María Magdalena; Putz de la Fuente, Francisca Carolina; Corvetto Aqueveque, Marcia Antonia; De la Fuente Sanhueza, René; Bravo Grau, Sebastián
- ItemDiseño curricular en Anestesiología utilizando la simulación como herramienta docente (réplica)(2014) Corvetto Aqueveque, Marcia Antonia; Altermatt, Fernando; Delfino, Alejandro
- ItemLevobupivacaine absorption pharmacokinetics with and without epinephrine during TAP block : analysis of doses based on the associated risk of local anaesthetic toxicity(2016) Miranda Hiriart, Pablo; Corvetto Aqueveque, Marcia Antonia; Altermatt, Fernando; Araneda Levy, Ana María; Echevarria, G.; Cortínez Fernández, Luis Ignacio
- ItemPerioperative lumbar plexus block and cardiac ischemia in patients with hip fracture : randomized clinical trial(2018) Altermatt, Fernando; Echevarría, Ghislaine C.; Cuadra F., Juan Carlos de la; Baeza Vergara, Ricardo Gabriel; Ferrada, Marcela; De La Cuadra Fontaine, Juan Carlos; Corvetto Aqueveque, Marcia Antonia
- ItemPharmacokinetics of levobupivacaine with epinephrine in transversus abdominis plane block for postoperative analgesia after caesarean section(2018) Lacassie Quiroga, Héctor; Rolle, A.; Cortínez Fernández, Luis Ignacio; Solari Gajardo, Sandra; Corvetto Aqueveque, Marcia Antonia; Altermatt, Fernando
- ItemPráctica actual de la anestesia regional en América del Sur: encuesta en línea. Current practice in regional anaesthesia in South America: An online survey(2017) Corvetto Aqueveque, Marcia Antonia; Carmona, J.; Vásquez, M. I.; Salgueiro, C.; Crostón, J.; Sosa, R.; Folle, V.; Altermatt, Fernando
- ItemProtective intraoperative ventilation with higher versus lower levels of positive end-expiratory pressure in obese patients (PROBESE): Study protocol for a randomized controlled trial(2017) Bluth, T.; Teichmann, R.; Kiss, T.; Bobek, I.; |Canet J.; Cinnella, G.; Pedemonte Trewhela, Juan Cristóbal; Altermatt, Fernando; Corvetto Aqueveque, Marcia Antonia; Paredes, Sebastián; De Baerdemaeker, L.; Gregoretti, C.; Hedenstierna, G.; Hemmes, S. N.; Carmona, Javiera; Rolle, Augusto
- ItemRemote, asynchronous training and feedback enables development of neurodynamic skills in physiotherapy students(2023) Villagrán Gutiérrez, Ignacio Andrés; Rammsy, Francisca; Del Valle, Javiera; Gregorio De Las Heras Moreau, Sofia Ignacia; Pozo, Liliana; García, Patricio; Torres, Gustavo; Varas Cohen, Julián; Mandrusiak, Allison; Corvetto Aqueveque, Marcia Antonia; Fuentes-Cimma, JavieraDuring the COVID-19 pandemic, face-to-face teaching and learning of physiotherapy practical skills was limited. Asynchronous, remote training has been effective in development of clinical skills in some health professions. This study aimed to determine the effect of remote, asynchronous training and feedback on development of neurodynamic skills in physiotherapy students. Methods Longitudinal repeated measurements study, across four training sessions. Participants engaged in a remote training program for development of upper limb neurodynamic techniques. In this sequential training, participants viewed the online tutorial, practiced independently, and uploaded a video of their performance for formative assessment and feedback from a trained instructor via a checklist and rubric. Results Intra-subject analyses of 60 third-year physiotherapy students showed that the target standard of performance, with no further significant change in scores, was attained following session 2 for the checklist and session 3 for the rubric. This shows that two sessions are required to learn the procedures, and three sessions yield further improvements in performance quality. Conclusion The remote, asynchronous training and feedback model proved to be an effective strategy for students’ development of neurodynamic testing skills and forms a viable alternative to in-person training. This study contributes to the future of acquiring physiotherapy clinical competencies when distance or hybrid practice is required.
- ItemSimulación en anestesia : la importancia del debriefing(2014) García Soto, Nicolás; Nazar Jara, Claudio; Corvetto Aqueveque, Marcia Antonia
- ItemSimulación en Anestesiología(2013) Clede-Belforti, L.; Nazar Jara, Claudio; Montaña Rodríguez, Rodrigo; Corvetto Aqueveque, Marcia AntoniaTraining in anaesthesia relies on the duration and quality of clinical experience. It involves exposure to a range of interventions. This works well in routine cases, but when an uncommon and life-threatening event occurs, the anaesthetist needs to carry out multiple tasks simultaneously. Aviation has remarkable similarities with the practice of anaesthesia. Over the years, the aviation industry has used simulation to train and assess individuals very effectively. Anaesthetists face rapidly evolving clinical situations. This needs appropriate decision-making and communication with others in the theatre team. Simulation, using current technology, offers innovative and reproducible training experience. It enables standardised scenario building and reflective learning. Various non-technical aspects of an anaesthetist's day-to-day work could also be addressed to during such training. The technology could be used very effectively for the assessment of competence too. Simulation has been used for technology development and appraisal over the years.
- ItemLa simulación puede mejorar la seguridad de los pacientes sometidos a procedimientos endoscópicos gastrointestinales bajo sedación(2017) Delfino, Alejandro; Carmona, J.; Paredes, S.; Riquelme Pérez, Arnoldo; Corvetto Aqueveque, Marcia Antonia; Altermatt, Fernando; Echevarria, G.
- ItemSimulation-based mastery learning of bronchoscopy-guided percutaneous dilatational tracheostomy competency acquisition and skills transfer to a cadaveric model(2021) Kattan Tala, Eduardo José; De la Fuente Sanhueza, René; Putz de la Fuente, Francisca Carolina; Vera Alarcón, María Magdalena; Corvetto Aqueveque, Marcia Antonia; Inzunza, Oscar; Achurra Tirado, Pablo; Inzunza Agüero, Martín Alejandro; Muñoz Gama, Jorge; Sepúlveda Fernández, Marcos Ernesto; Gálvez Yanjarí, Víctor Andrés; Pavez, Nicolás; Retamal Montes, Jaime; Bravo Morales, SebastiánIntroduction: Although simulation-based training has demonstrated improvement of procedural skills and clinical outcomes in different procedures, there are no published training protocols for bronchoscopy-guided percutaneous dilatational tracheostomy (BG-PDT). The objective of this study was to assess the acquisition of BG-PDT procedural competency with a simulation-based mastery learning training program, and skills transfer into cadaveric models. Methods: Using a prospective interventional design, 8 trainees naive to the procedure were trained in a simulation-based mastery learning BG-PDT program. Students were assessed using a multimodal approach, including blind global rating scale (GRS) scores of video-recorded executions, total procedural time, and hand-motion tracking–derived parameters. The BG-PDT mastery was defined as proficient tracheostomy (successful procedural performance, with less than 3 puncture attempts, and no complications) with GRS scores higher than 21 points (of 25). After mastery was achieved in the simulator, residents performed 1 BG-PDT execution in a cadaveric model. Results: Compared with baseline, in the final training session, residents presented a higher procedural proficiency (0% vs. 100%, P < 0.001), with higher GRS scores [8 (6–8) vs. 25 (24–25), P = 0.01] performed in less time [563 (408–600) vs. 246 (214–267), P = 0.01] and with higher movement economy. Procedural skills were further transferred to the cadaveric model. Conclusions: Residents successfully acquired BG-PDT procedural skills with a simulation-based mastery learning training program, and skills were effectively transferred to a cadaveric model. This easily replicable program is the first simulation-based BG-PDT training experience reported in the literature, enhancing safe competency acquisition, to further improve patient care.
- ItemSimulation-based training program with deliberate practice for ultrasound-guided jugular central venous catheter placement(2017) Corvetto Aqueveque, Marcia Antonia; Pedemonte Trewhela, Juan Cristóbal; Varas, Diego; Fuentes, C.; Altermatt, Fernando