Since 2000, Brazil has transformed healthcare training through simulation-based education, embracing evidence-based practices despite challenges. Educators are increasingly participating in conferences and publishing research, marking a shift toward advanced studies and greater international recognition in medical education.
Simulation-based education (SBE) has changed the face of health professions education. Although SBE was initially implemented in the Global North, the adoption spread throughout Latin America, including Brazil, at the beginning of 2000. In the last 10 years, SBE has become a popular training method in Brazil. Nowadays, probably every medical school (and other courses also have their simulation centre) has a simulation centre that may differ in equipment quantity and size. This implementation of SBE has primarily happened in undergraduate training, which slightly differs from Global North. The reason is that health care professions are allowed to practice after completing undergraduate training, and often they work in emergency rooms or primary care. This led to the necessity of training complex skills such as advanced life support and orotracheal intubation, which mastery of these skills has a direct influence on patient care and safety.
The implementation of the best evidence
Surprisingly, the implementation of SBE in Brazil has always focused on the best evidence available. Several simulation centres have changed their practice according to current literature, such as implementing a rapid cycle of deliberate practice and mastery learning approach. This is also observed in the different conferences in Brazil. Health professions educators are more interested in learning new instructional methods and debriefing techniques and how they can be implemented in their daily practice. Conferences have helped disseminate the current practice since articles are often behind a paywall and are written in English. This is further supported by the increased number of attendees, as evidenced by the last Simulation User Network (SUN) with almost 500 attendees.
The effect of scientific inputs and outputs
Congress and conferences were critical in disseminating SBE to educators and stakeholders. I had the opportunity to give the first keynote lecture to the Brazilian Association of Health Simulation Congress in 2016. This event was a turning point in the simulation community in Brazil. After this first successful event with around 80 people around Brazil, several conferences have happened, and more participants have joined our community each year. Another significant milestone was the publication of the first special number on simulation in Scientia Medica, a Brazilian journal. Carolina Brandão and I had the pleasure of being the guest editors. Witnessing the growth of SBE research in Brazil is a great privilege. We moved from 2 published articles in 2002 to 27 in 2021 in journals indexed in Web of Science (Cecilio-Fernandes et al. 2024). Noteworthy, most articles are still published in international Brazilian journals instead of international journals based on Global North. This increase comes from overcoming significant challenges, such as barriers in language, lack of research training in health professions education, and lack of time and funding for research. Most research has focused on the perception of satisfaction, and knowledge, skills, and self-efficacy growth. Currently, research in Brazil has shifted to research focusing on experiments comparing two or more groups with different interventions, reviews and translational research.
Overcoming barriers to high-quality research
Most researchers in Brazil were trained in a different field from education. This transition is often full of challenges, ranging from writing to using the appropriate research method to answer the specific research question. Some courses are offered at conferences, but they are often too short. Other initiatives have been linked to research programmes but may be time-consuming. Ideally, researchers who would like to start a new research line in health professions education could try to find a mentor to help them navigate the literature and find a relevant research question for an international audience. Another crucial aspect is the writing of the paper. You may have the best research question and methods, but writing determines getting to international journals. As in any other field, there is a specific culture for writing in health professionals’ education research, and journal styles are pretty different. More importantly, the translation from Portuguese to English is often not precise because of grammatical and structural differences. Learning the structure is key to getting published in international journals. As all educators know, practice combined with feedback will lead to expertise. This is, of course, not an easy road, but everyone can achieve it.
References
Cecilio-Fernandes, D., Peccin, M. S., Sandars, J., Couto, T. B., & Mazzo, A. (2023). Advancing Simulation-Based Education in Brazil: Bridging Research and Practice for Healthcare Excellence. einstein (São Paulo), 21(Suppl 3), eEDS3.
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