02.04.01. Investigación y comunicación científica

Structured Plus/Delta Debriefing with Graphical Feedback Versus Conversational Debriefing and Chest Compression Quality in Simulated Cardiopulmonary Resuscitation Among Nursing Students: A Quasi-Experimental Study

2026-09-11T00:00:00Z

Structured Plus/Delta Debriefing with Graphical Feedback Versus Conversational Debriefing and Chest Compression Quality in Simulated Cardiopulmonary Resuscitation Among Nursing Students: A Quasi-Experimental Study García-Álvarez, José-Manuel; García-Sánchez, Alfonso Background/Objectives: Chest compression quality is a key determinant of survival after cardiac arrest. Debriefing is an essential educational tool in cardiopulmonary resuscitation training; however, limited evidence exists regarding the comparative effectiveness of specific debriefing approaches incorporating objective feedback. The objective of this study was to evaluate whether a structured Plus/Delta debriefing approach incorporating graphical performance feedback was associated with greater improvements in chest compression quality parameters than unstructured conversational debriefing in nursing students. Methods: A pre-post quasi-experimental study with a control group was conducted in nursing students. Participants were assigned to experimental or control groups at the academic subgroup level. The experimental group received a structured Plus/Delta debriefing approach incorporating graphical performance feedback, whereas the control group received conversational debriefing. Performance outcomes were assessed before and after the intervention. The primary outcome was the time spent with compression rate, compression depth, and residual leaning simultaneously within their recommended ranges, expressed in seconds. Data were primarily analyzed using linear mixed-effects models to account for repeated measures and clustering. Sensitivity analyses using ANCOVA models adjusted for baseline values and age were performed to assess the robustness of the findings. Results: A total of 112 participants were included (n = 56 per group), with no baseline differences between groups. Improvements were observed in both groups, although they were larger in the experimental group. Mixed-effects models showed significant group × time interactions, with the experimental group showing greater improvements in the primary outcome (? = 91.40 s, 95% CI 82.51-100.28; p < 0.001). Significant group × time interactions were also observed for the secondary compression-quality outcomes. The percentage of total test duration during which all three parameters were simultaneously within the recommended ranges increased in both groups and showed a greater improvement in the experimental group. A complementary analysis using a fixed 120 s observation period showed a greater proportion of time with all three parameters simultaneously within the recommended ranges in the experimental group (50.7% ± 24.8% vs. 42.8% ± 11.0%; p = 0.042). ANCOVA sensitivity analyses adjusted for baseline values and age yielded results consistent with the primary analysis. Conclusions: A structured Plus/Delta debriefing approach incorporating graphical performance feedback was associated with greater improvements in the consistency of guideline-compliant chest compression performance than unstructured conversational debriefing in undergraduate nursing students during simulated CPR training. However, given the quasi-experimental design, group-level allocation, potential practice effects, residual confounding, and the inability to isolate the independent contributions of structured debriefing and graphical feedback, causal inference should be made with caution. Randomized controlled studies are needed to confirm these findings, evaluate their long-term effects, and determine whether similar findings are observed in other populations and settings.

Searching for the Ideal Selection of Cognitive Screening Tasks for Early Detection of Cognitive Decline in Older Individuals With Low Literacy.

2026-11-01T00:00:00Z

Searching for the Ideal Selection of Cognitive Screening Tasks for Early Detection of Cognitive Decline in Older Individuals With Low Literacy. Pellicer-Espinosa, Isabel; de-Andrade-Moral, Rafael; Diaz-Orueta, Unai BACKGROUND: Tests for detecting neurocognitive disorders may not be suitable for individuals with low educational levels. This study presents a battery of cognitive tests and tasks to improve the detection of cognitive decline in older adults with different literacy levels. METHOD: 78 older adults attending primary care services were classified in four groups based on their educational level (low versus high) and cognitive status (healthy versus decline). The evaluation included a selection of cognitive tests and tasks administered in two orders to each half of the sample to reduce sequence of administration bias. RESULTS: Most tests (MMSE, Stroop, Five Digit Test, and BNT-15, as well as many individual tasks) could not differentiate properly between low-educated healthy individuals and highly educated individuals with decline, with the latter even showing better performance despite the decline in some selected tasks. The Phototest emerged as the only effective tool where healthy individuals with low education outperformed highly educated individuals with cognitive decline. A separate comparison of low versus high education groups (healthy versus decline) raised the need for differentiated tasks, based on the education level, to specifically discriminate between healthy individuals and individuals with decline. CONCLUSIONS: Educational level (EL) significantly impacts cognitive performance. High EL individuals show better results and even compensate for cognitive decline when screened with a range of widely used cognitive tasks. Tasks must be adapted to EL to avoid biases and improve accuracy in detecting cognitive decline. Careful selection of tools based on EL is recommended to optimise cognitive assessment.

Spontaneous rupture of a liver hemangioma. A case report.

2016-07-01T00:00:00Z

Spontaneous rupture of a liver hemangioma. A case report. Guillén-Paredes, Maria-Pilar; Martínez-Fernández, Josefa; Morales-González, Alvaro; Pardo-García, José-Luis Spontaneous rupture of a liver hemangioma is a very uncommon disease, but extremely seriousness because it is associated to a 75% of mortality caused by hipovolemic shock. A case of an spontaneous rupture of liver hemangioma, which was previously unknow, is presented.

Acute gastric volvulus. A case report

2015-03-01T00:00:00Z

Acute gastric volvulus. A case report Guillén-Paredes, María-Pilar; Pardo-García, José-Luis