Browsing by Author "Vicencio-Clarke, Scarlett"
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Publication Advancing the assessment of clinical competence in Latin America: a scoping review of OSCE implementation and challenges in resource-limited settings(2025) Armijo-Rivera, Soledad; Fuenzalida-Muñoz, Brenda; Bozzo-Navarrete, Sergio; Kunakov, Natasha; Sanhueza, Jacqueline; Cornejo, Carla; Vicencio-Clarke, Scarlett; Miranda-Hurtado, Cesar; Elbers-Arce, Alexandra; Shibao-Miyasato, Hector; Soublette, Alix; Sandoval, Ana María; Cicibel Casas-Bueno, Fresia; Delgado, XimenaBackground Objective Structured Clinical Examination (OSCE) is important to assess clinical competencies in health professions. However, in Latin America, a region with limited resources, the implementation and quality of OSCEs remain underexplored despite their increasing use. This study analyses how the OSCE has been applied and how its quality has evolved in Latin America. Methods A scoping review methodology was used, including a search across PubMed, Scopus, WOS, LILACS and Scielo, including studies on the implementation of OSCE in Latin America, written in English, French, Portuguese, or Spanish. Their quality was assessed using the AMEE guidelines 81 and 49 criteria and MMERSQI. Data were extracted regarding OSCE structure, evaluator training, validity, reliability, and the use of simulated patients. Results 365 articles were obtained, of which 69 met the inclusion criteria. The first report on OSCE implementation in the region dates back to 2000. Three countries accounted for 84.06% of the reports (Chile, Mexico, Brazil). 68.12% was applied in undergraduate programs. In this group, the implementation was mainly in Medicine (69.57%), with lesser use in physiotherapy (7.95%) and nursing (2.9%). The number of stations and duration of each varied, with 18-station circuits being the most common. Evidence of validity and reliability of the OSCE was reported in 26.09%, feedback to students in 33,33%, and simulated patient training in 37.68% of the reports. A notable trend in the quinquennial analysis is the increased use of high-fidelity simulations and the shift towards remote OSCEs during the pandemic. The inclusion of inactive stations, inadequate training for simulated patients, and the absence of evidence supporting instrument validation are recurrently reported challenges in OSCE studies. The overall methodological quality has improved, as evidenced by OSCE Committee and Blueprint in nearly 50% of the studies and rising MMERSQI scores, especially in recent years.Publication Educational research on medical residency programs in Chile: a scoping review and analysis of the impact of the new accreditation policy(2024) Marín Donato, Katherine; Armijo-Rivera, Soledad; Cantariño Pérez, René; Vicencio-Clarke, Scarlett; Ramírez-Delgado, Paulina; Triviño Bonifay, Ximena; Díaz-Guío, Diego Andrés; Acuña Mujica, CarolinaBackground Accrediting medical specialties programs are expected to influence and standardize training program quality, align curriculum with population needs, and improve learning environments. Despite global agreement on its necessity, methods vary widely. In the Chilean context, a recent new accreditation criteria includes research productivity in relation to educational research on resident programs, so we aimed to define it. What is the profile of publications in educational research produced by Chilean medical specialty residency programs in the last five years? Based on these results, we intend to analyze the potential impact of the new accreditation policy on medical specialty programs in Chile. Methods We performed a preliminary bibliometric search to identify the use of the term “resident” in literature. After that, we conducted a literature search, using a six-step approach to scoping reviews, including the appraisal of the methodological quality of the articles. Results Between 2019 and 2023, an average of 6.2 articles were published yearly (19%). The bibliometric analysis revealed that the dominant thematic area of the journals was clinical, accounting for 78.1%. Most articles focused on residents (84.38%), with only two articles including graduates as participants. One university was responsible for 62.50% of the articles and participated in all multicenter studies (9.38%). Surgical specialties produced 15 research articles focused on procedural training using simulation. Psychiatry was the second most productive specialty, with 5 articles (15.63%) covering standardized patients, well-being, and mental health assessment. The most frequent research focus within residency programs over the five-year period was teaching and learning methodologies, with 19 articles representing almost 60% of the total analyzed. Conclusions Research on medical education in Chile’s postgraduate residency programs is limited, with most studies concentrated in a few universities. The new accreditation criteria emphasize educational research, posing challenges for many institutions to meet higher standards. Understanding unexplored areas in educational research and learning from successful programs can enhance research productivity and align efforts with accreditation expectations. Continuous evaluation and new research on residents’ satisfaction, skills acquisition, and well-being are needed to ensure training quality and accountability.Publication Enhancing Disaster Preparedness and Community Safety Through Virtual Simulation: A Scoping Review in Undergraduate Health Education(2025) Torres-Agüero, Daniel; Armijo-Rivera, Soledad; Vicencio-Clarke, Scarlett; Norte, Gustavo; Herrera, Eduardo; Lagos Cordero, AndrésObjectives: Disaster medicine (DM) prepares health care professionals to manage emergencies caused by significant societal disruptions. Training recent graduates and final-year students is an essential element of disaster preparedness. This review aims to examine the use of Virtual Simulation (VS) in undergraduate students' DM training. Methods: The research team searched Scopus, PubMed, WOS, and Scielo. The team followed the 6-step approach described by Mak to conduct Scoping Reviews. We identified 262 reports, and 17 articles met the inclusion criteria. We extracted and analyzed data, focusing on educational settings, professions involved, and intervention characteristics. The report followed PRISMA guidelines. Results: The implementation of VS in DM training has been geographically concentrated, with most studies focused on nursing education. Most programs use virtual reality, with limited augmented or mixed reality integration, principally in nursing students. The training focused primarily on triage, disaster preparedness, evacuation, decontamination, improving knowledge retention, self-confidence, and decision-making. Conclusions: Although VS has effectively enhanced technical skills and disaster preparedness, its use remains limited in undergraduate health education. Further research is needed to expand its application in interprofessional and non-nursing contexts, with deliberate practice principles to maximize efficiency. Integrating VS into community training can reduce costs and enhance large-scale emergency response.Publication Evolución de la aplicación del concepto de integración curricular de simulación clínica: Una revisión con foco en el pregrado de carreras de salud(2025) Torres Suazo, Francisca; Bettancourt González, Marco; Atuez Araya, Catalina; Aravena González, Matías; Plaza Órdenes, Yenny; Vicencio-Clarke, Scarlett; Ramírez-Delgado, Paulina; Armijo-Rivera, SoledadDada la importancia que la simulación tiene en los pregrados de salud y a que la forma en qué entendemos los conceptos es un elemento esencial a la hora de implementar la simulación, el objetivo de esta revisión es contestar la siguiente pregunta: ¿Cómo se ha aplicado el concepto de integración curricular en simulación clínica de currículum de pregrado de salud? Material y Método: Se realizó una revisión con foco, con ayuda de una bibliotecaria. Se obtuvo 16 artículos, que fueron analizados in extenso dado su bajo número, usando como criterio de inclusión que tuvieran resultados de implementación en al menos dos niveles del curriculum. Resultados: Se incluyó 5 artículos en la síntesis conceptual. Todos los reportes analizados provienen de Norteamérica, tres de ellos corresponden a carreras de medicina, uno corresponde a formación de técnicos y el otro a formación de enfermería. Una similitud en los artículos analizados es que las integraciones curriculares reportadas comparten las competencias procedimentales o de habilidades clínicas básicas con el pensamiento crítico en todos los casos, y de manera indiferente a la profesión que se esté formando. La integración vertical, según el concepto de Brauer, es un enfoque dominante para planificar simulaciones complejas y progresivas en el plan de estudios de pregrado de salud. Discusión: La descripción y el análisis de los conceptos de integración curricular de simulación en carreras de salud, así como su evaluación y mejora continua a lo largo del tiempo son ámbitos de investigación educativa que requieren mayor información.Publication Exploring empathy in simulation-based health education: instructor profiles and training implications(2025) Armijo-Rivera, Soledad; Vicencio-Clarke, Scarlett; Riffo-Saldías, Nancy; Caamaño, Hernán; Díaz, Pía; Caldo, Francesca; Pino, CarlaIntroduction: Empathy has cognitive and emotional dimensions that healthcare professionals needEmpathy has cognitive and emotional dimensions that healthcare professionals need to develop. Empathy also influences the learning environment and student outcomes in simulation-to develop. Empathy also influences the learning environment and student outcomes in simulation-based education. This study explored the empathy profiles of simulation instructors and analyzedbased education. This study explored the empathy profiles of simulation instructors and analyzed how cognitive and affective dimensions correlate with demographic characteristics.how cognitive and affective dimensions correlate with demographic characteristics. Methods:Methods: Quantitative, observational, cross-sectional study conducted with 36 novice simulationQuantitative, observational, cross-sectional study conducted with 36 novice simulation instructors. Empathy was evaluated using the Test of Cognitive and Affective Empathy, whichinstructors. Empathy was evaluated using the Test of Cognitive and Affective Empathy, which assesses four dimensions of empathy: Perspective Adoption (PA), Emotional Understanding (EU),assesses four dimensions of empathy: Perspective Adoption (PA), Emotional Understanding (EU), Empathic Distress (ED), and Empathic Joy (EJ). Statistical analysis was conducted using Kruskal-Empathic Distress (ED), and Empathic Joy (EJ). Statistical analysis was conducted using Kruskal-Wallis and Spearman’s Rho tests in JASP (v0.19.1).Wallis and Spearman’s Rho tests in JASP (v0.19.1). Results:Results: Most participants were women (83.33%), aged 30–34 years (41.67%), and held a master’sMost participants were women (83.33%), aged 30–34 years (41.67%), and held a master’s degree (80.56%). One-third of the participants (33%) scoreddegree (80.56%). One-third of the participants (33%) scored ≥94th percentile on total empathy. PA94th percentile on total empathy. PA and EJ scores were consistently high, while EU and ED showed greater variability. Gender differencesand EJ scores were consistently high, while EU and ED showed greater variability. Gender differences were significant, with men scoring higher in total empathy, EU, and ED (pwere significant, with men scoring higher in total empathy, EU, and ED (p <0.05). Structured training0.05). Structured training correlated with higher ED; lack of conference attendance correlated with higher EU. There were nocorrelated with higher ED; lack of conference attendance correlated with higher EU. There were no associations between empathy scores and years of experience or academic qualifications.associations between empathy scores and years of experience or academic qualifications. Conclusions:Conclusions: Simulation instructors in this study exhibited high cognitive empathy, with variableSimulation instructors in this study exhibited high cognitive empathy, with variable levels of affective empathy. Empathy profiling can be an integral part of tailored instructor traininglevels of affective empathy. Empathy profiling can be an integral part of tailored instructor training that strikes a balance between emotional responsiveness and psychological safety. These resultsthat strikes a balance between emotional responsiveness and psychological safety. These results highlight the importance of including strategies to improve emotional resilience and promotehighlight the importance of including strategies to improve emotional resilience and promote effective educator-student interactions in simulation faculty development programs.effective educator-student interactions in simulation faculty development programs.Publication Good Treatment by Teachers as Perceived by Medical Students in Chile: A Survey-Based Study(2025) Vicencio-Clarke, Scarlett; Armijo-Rivera, Soledad; Pérez- Villalobos, Cristhian; Bastías-Vega, Nancy; Ortega-Bastidas, Javiera; Schilling- Norman, Mary Jane; Hechenleittner-Carvallo, Marcela; Soto-Faúndes, Catherine; Williams-Oyarce, Carolina; Peralta-Camposano, José; Ríos-Teillier, María IsabelThe perception of academic mistreatment among medical students is associated with burnout, emotional disorders, and poorer professional performance. Conversely, a positive environment that promotes respectful teaching can enhance empathy, reduce burnout, and increase student satisfaction. This study examines perceptions of respectful teaching and its associations with demographic and academic characteristics among medical students in Chile. Aim: To evaluate perceptions of respectful teaching among medical students in Chile and their relationship with sociodemographic, academic, and personal satisfaction factors. Methods: A cross-sectional study was conducted across six Chilean universities, involving 443 medical students. We used the Good Teaching Practices Questionnaire (40 items in 9 dimensions) and tools for sociodemographic characterization and academic satisfaction. Data were analyzed using descriptive statistics, reliability coefficients, Spearman correlations, and ANOVA, with significance set at p<0.05. Results: Younger students, those in earlier years, or those recently admitted reported better perceptions of respectful teaching (p<0.05). Men perceived greater support in flexible planning, feedback, and concern for students (p<0.01). Theoretical and synchronous courses were associated with better perceptions of class agility and teaching passion (p<0.001). The highest-rated dimension was subject mastery (Md= 4.00), while concern for students received the lowest score (Md= 3.00). Conclusion: Higher life satisfaction and work-life balance levels are related to respectful teaching. Differences between universities and demographic groups highlight the need for inclusive institutional policies and faculty training to foster equitable and empathetic environments in medical education.Publication Using the OSCE to assess medical students’ communication and clinical reasoning during five years of restricted clinical practice(2025) Armijo-Rivera, Soledad; Zamorano Saavedra, Catalina; Vicencio-Clarke, Scarlett; Behrens Pérez, Claudia; Pérez-Villalobos, CristhianBackground Objective and Structured Clinical Examination (OSCE) is a widely used evaluation method for health profession students. In Chile, physicians OSCEs have incorporated clinical reasoning and patient-centered communication assessment since 2015. The overall impact of the COVID-19 pandemic on undergraduate medical clinical practice remains unknown, in particular whether this context disproportionately affected lower-income regions, as was the case analysed in this study. Aim This research compares the OSCE patient-centered communication and clinical reasoning results among five cohorts of intermediate-level medical students with restricted clinical practice in Chile. Methods We designed an observational study analyzing five cohorts of fourth-year medical students with different clinical practice opportunities, with 3rd to 4th-year progression analysis in two cohorts. Adaptations to compensate lack of clinical practice hours include high-fidelity simulation and theoretical discussion of clinical cases, as well as formative OSCE at third-year level in two cohorts. Communication in OSCE was assessed using the Communication Assessment Tool (CAT) and Clinical Reasoning (CR) with a register form (that includes a global score, History Taking, Differential Diagnosis, and Therapeutic Plan subscores). Descriptive statistics and central tendency measurements were applied to analyze CAT and CR scores, along with Kruskal-Wallis tests and Wilcoxon’s test for paired sample analysis. Findings The 2018 cohort shows the lowest results in both variables although it was the cohort with more clinical practice opportunities. The higher CAT result was in the 2021 cohort, while the 2022 cohort exhibited a significantly higher CR score (p < 0.05). There is a linear tendency to grow over the years for both measures. The 2023 cohort shows significant improvement between third-year and fourth-year OSCEs in all items of CAT and a detriment in CR, while the 2022 cohort shows a significant increment in CR and four items of CAT (p < 0.05). Conclusion The students with fewer hours of clinical practice showed similar CR and communication results to the prepandemic group, probably because of the adaptations implemented. Simulation was an effective alternative.