<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2664-2891</journal-id>
<journal-title><![CDATA[Revista científica ciencias de la salud]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. cient. cienc. salud]]></abbrev-journal-title>
<issn>2664-2891</issn>
<publisher>
<publisher-name><![CDATA[Universidad del Pacífico]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2664-28912026000100510</article-id>
<article-id pub-id-type="doi">10.53732/rccsalud/2026.e81005</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Simulación clínica: el puente necesario para la práctica deliberada del razonamiento clínico]]></article-title>
<article-title xml:lang="en"><![CDATA[Clinical simulation: the necessary bridge for deliberate clinical reasoning practice]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ayala de Mendoza]]></surname>
<given-names><![CDATA[Fátima]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Canese Caballero]]></surname>
<given-names><![CDATA[Valentina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad del Norte Facultad de Postgrado ]]></institution>
<addr-line><![CDATA[Asunción ]]></addr-line>
<country>Paraguay</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2026</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2026</year>
</pub-date>
<volume>8</volume>
<fpage>510</fpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_arttext&amp;pid=S2664-28912026000100510&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_abstract&amp;pid=S2664-28912026000100510&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_pdf&amp;pid=S2664-28912026000100510&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN El Razonamiento Clínico (RC) es la competencia central de la medicina, definida como el procesamiento sistemático de datos clínicos bajo el Modelo de Doble Proceso para formular hipótesis y guiar decisiones. Su enseñanza explícita es un desafío persistente, siendo esencial la metacognición para mitigar sesgos. Esta Revisión Narrativa Conceptual de enfoque cualitativo sintetizó evidencia (2019&#8211;2025) de Scopus, Google Académico y SciELO para analizar la contribución de la simulación al aprendizaje del razonamiento clínico. La Simulación Clínica (SC) se valida como la estrategia más ventajosa, ya que su práctica deliberada con Pacientes Estandarizados (PE) garantiza la estandarización de la recopilación de datos y fomenta la Construcción de Representaciones Mentales. La SC es un catalizador cognitivo que fuerza la transición del RC de implícito a explícito, siendo el debriefing reflexivo el elemento crítico para activar la metacognición. Sin embargo, las barreras de alto costo y la escasez de capacitación docente comprometen la sistematización. La SC es esencial para el RC temprano y la mitigación de sesgos, pero se requiere soporte institucional y formación del profesorado para superar los obstáculos logísticos y optimizar la práctica deliberada a gran escala.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT Clinical Reasoning (CR) is the core competency of medicine, defined as the systematic processing of clinical data under the Dual Process Model to formulate hypotheses and guide decisions. Its explicit teaching is a persistent challenge, with metacognition being essential to mitigate biases. This qualitative Conceptual Narrative Review synthesized evidence (2019&#8211;2025) from Scopus, Google Scholar, and SciELO to analyze the contribution of simulation. Clinical Simulation (CS) is validated as the most advantageous strategy, since its deliberate practice with Standardized Patients (SP) guarantees the standardization of data collection and encourages the Construction of Mental Representations. CS is a cognitive catalyst that forces the transition of CR from implicit to explicit, with reflective debriefing being the critical element to activate metacognition. However, high cost barriers and a shortage of teacher training hinder systematization. SC is essential for early CR and bias mitigation, but institutional support and teacher training are required to overcome logistical obstacles and optimize large-scale deliberate practice.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[razonamiento clínico]]></kwd>
<kwd lng="es"><![CDATA[simulación]]></kwd>
<kwd lng="es"><![CDATA[metacognición]]></kwd>
<kwd lng="es"><![CDATA[pacientes estandarizados]]></kwd>
<kwd lng="es"><![CDATA[práctica deliberada]]></kwd>
<kwd lng="en"><![CDATA[clinical reasoning]]></kwd>
<kwd lng="en"><![CDATA[simulation]]></kwd>
<kwd lng="en"><![CDATA[metacognition]]></kwd>
<kwd lng="en"><![CDATA[standardized patients]]></kwd>
<kwd lng="en"><![CDATA[deliberate practice]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Amey]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Donald]]></surname>
<given-names><![CDATA[KJ]]></given-names>
</name>
<name>
<surname><![CDATA[Teodorczuk]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Teaching clinical reasoning to medical students]]></article-title>
<source><![CDATA[Br J Hosp Med (Lond)]]></source>
<year>2017</year>
<volume>78</volume>
<numero>7</numero>
<issue>7</issue>
<page-range>399-401</page-range></nlm-citation>
</ref>
<ref id="B2">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Brown Tyo]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[McCurry]]></surname>
<given-names><![CDATA[MK]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[An integrative review of clinical reasoning teaching strategies and outcome evaluation in nursing education]]></article-title>
<source><![CDATA[Nurs Educ Perspect]]></source>
<year>2019</year>
<volume>40</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>11-7</page-range></nlm-citation>
</ref>
<ref id="B3">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Young]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Thomas]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Gordon]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Gruppen]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Lubarsky]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Rencic]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The terminology of clinical reasoning in health professions education: Implications and considerations]]></article-title>
<source><![CDATA[Med Teach]]></source>
<year>2019</year>
<volume>41</volume>
<numero>11</numero>
<issue>11</issue>
<page-range>1277-84</page-range></nlm-citation>
</ref>
<ref id="B4">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Croskerry]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Clinical cognition and diagnostic error: applications of a dual process model of reasoning]]></article-title>
<source><![CDATA[Adv Health Sci Educ Theory Pract]]></source>
<year>2009</year>
<volume>14</volume>
<numero>Suppl 1</numero>
<issue>Suppl 1</issue>
<page-range>27-35</page-range></nlm-citation>
</ref>
<ref id="B5">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Croskerry]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[A universal model of diagnostic reasoning]]></article-title>
<source><![CDATA[Acad Med]]></source>
<year>2009</year>
<volume>84</volume>
<numero>8</numero>
<issue>8</issue>
<page-range>1022-8</page-range></nlm-citation>
</ref>
<ref id="B6">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[da Bove Rybertt]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Segue Palma]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Arteaga San Martín]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Antileo Pinto]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Carmona Maldonado]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Razonamiento clínico en carreras de la salud: percepción de estudiantes y docentes]]></article-title>
<source><![CDATA[Rev méd Chile]]></source>
<year>2022</year>
<volume>150</volume>
<numero>11</numero>
<issue>11</issue>
<page-range>1526-33</page-range></nlm-citation>
</ref>
<ref id="B7">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Alcalá Minagorre]]></surname>
<given-names><![CDATA[PJ]]></given-names>
</name>
<name>
<surname><![CDATA[Salmerón Fernández]]></surname>
<given-names><![CDATA[MJ]]></given-names>
</name>
<name>
<surname><![CDATA[Domingo Garau]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Díaz Pernas]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Nebot Marzal]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Pino Ramírez]]></surname>
<given-names><![CDATA[RM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Estrategias para la mejora de la seguridad diagnóstica y del razonamiento clínico]]></article-title>
<source><![CDATA[An Pediatr (Barc)]]></source>
<year>2025</year>
<volume>102</volume>
<numero>4</numero>
<issue>4</issue>
</nlm-citation>
</ref>
<ref id="B8">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Audétat]]></surname>
<given-names><![CDATA[MC]]></given-names>
</name>
<name>
<surname><![CDATA[Dory]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Nendaz]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Vanpee]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Pestiaux]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Junod Perron]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[What is so difficult about managing clinical reasoning difficulties?]]></article-title>
<source><![CDATA[Med Educ]]></source>
<year>2012</year>
<volume>46</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>216-27</page-range></nlm-citation>
</ref>
<ref id="B9">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Guamán]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Rivera]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Fomentando el pensamiento reflexivo: estrategias para mejorar las habilidades de metacognición]]></article-title>
<source><![CDATA[Esprint Investigación]]></source>
<year>2024</year>
<volume>3</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>28-38</page-range></nlm-citation>
</ref>
<ref id="B10">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rivera]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Behrens-Pérez]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Reyes-Aramburu]]></surname>
<given-names><![CDATA[EP]]></given-names>
</name>
<name>
<surname><![CDATA[Pérez-Villalobos]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Bastías-Vega]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Apoyos de la simulación al desarrollo del razonamiento clínico en estudiantes de pregrado de medicina]]></article-title>
<source><![CDATA[Simulación Clínica]]></source>
<year>2020</year>
<volume>2</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>19-25</page-range></nlm-citation>
</ref>
<ref id="B11">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Martindale]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Shah]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Gusic]]></surname>
<given-names><![CDATA[ME]]></given-names>
</name>
<name>
<surname><![CDATA[Wolf]]></surname>
<given-names><![CDATA[SJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Case-Based Teaching: Does the Addition of High-Fidelity Simulation Make a Difference in Medical Students' Clinical Reasoning Skills?]]></article-title>
<source><![CDATA[Med Sci Educ]]></source>
<year>2020</year>
<volume>30</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>307-13</page-range></nlm-citation>
</ref>
<ref id="B12">
<nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Pelaccia]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Jaffrelot]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Simulación para el aprendizaje del razonamiento clínico]]></article-title>
<source><![CDATA[Simulación clínica: Una herramienta para el desarrollo de competencias]]></source>
<year>2019</year>
<page-range>377-89</page-range><publisher-loc><![CDATA[Barcelona ]]></publisher-loc>
<publisher-name><![CDATA[Elsevier]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B13">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Serna Corredor]]></surname>
<given-names><![CDATA[DS]]></given-names>
</name>
<name>
<surname><![CDATA[Martínez Sánchez]]></surname>
<given-names><![CDATA[LM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[La simulación en la educación médica, una alternativa para facilitar el aprendizaje]]></article-title>
<source><![CDATA[Arch Med (Manizales)]]></source>
<year>2018</year>
<volume>18</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>447-54</page-range></nlm-citation>
</ref>
<ref id="B14">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cleland]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
<name>
<surname><![CDATA[Abe]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Rethans]]></surname>
<given-names><![CDATA[JJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The use of simulated patients in medical education: AMEE Guide No 42]]></article-title>
<source><![CDATA[Med Teach]]></source>
<year>2009</year>
<volume>31</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>477-86</page-range></nlm-citation>
</ref>
<ref id="B15">
<nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hernández-Sampieri]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Mendoza]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<source><![CDATA[Metodología de la investigación: las rutas cuantitativa, cualitativa y mixta]]></source>
<year>2018</year>
<publisher-loc><![CDATA[Ciudad de México ]]></publisher-loc>
<publisher-name><![CDATA[McGraw-Hill Education]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B16">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Amaya Afanador]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Simulación clínica: ¿pretende la educación médica basada en la simulación remplazar la formación tradicional en medicina y otras ciencias de la salud en cuanto a la experiencia actual con los pacientes?]]></article-title>
<source><![CDATA[Univ Méd]]></source>
<year>2008</year>
<volume>49</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>399-405</page-range></nlm-citation>
</ref>
<ref id="B17">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gaba]]></surname>
<given-names><![CDATA[DM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The future vision of simulation in health care]]></article-title>
<source><![CDATA[Qual Saf Health Care]]></source>
<year>2004</year>
<volume>13</volume>
<numero>Suppl 1</numero>
<issue>Suppl 1</issue>
<page-range>i2-i10</page-range></nlm-citation>
</ref>
<ref id="B18">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Farrar]]></surname>
<given-names><![CDATA[FC]]></given-names>
</name>
<name>
<surname><![CDATA[Suggs]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Potenciando el pensamiento crítico con simuladores computarizados de pacientes]]></article-title>
<source><![CDATA[J Coll Teach Learn (TLC)]]></source>
<year>2010</year>
<volume>7</volume>
<numero>5</numero>
<issue>5</issue>
</nlm-citation>
</ref>
<ref id="B19">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[De Visser]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Watson]]></surname>
<given-names><![CDATA[MO]]></given-names>
</name>
<name>
<surname><![CDATA[Salvado]]></surname>
<given-names><![CDATA[O]]></given-names>
</name>
<name>
<surname><![CDATA[Passenger]]></surname>
<given-names><![CDATA[JD]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Progress in virtual reality simulators for surgical training and certification]]></article-title>
<source><![CDATA[Med J Aust]]></source>
<year>2011</year>
<volume>194</volume>
<numero>S4</numero>
<issue>S4</issue>
<page-range>S38-40</page-range></nlm-citation>
</ref>
<ref id="B20">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kononowicz]]></surname>
<given-names><![CDATA[AA]]></given-names>
</name>
<name>
<surname><![CDATA[Hege]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Edelbring]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Sobocan]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Huwendiek]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Durning]]></surname>
<given-names><![CDATA[SJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The need for longitudinal clinical reasoning teaching and assessment: Results of an international survey]]></article-title>
<source><![CDATA[Med Teach]]></source>
<year>2020</year>
<volume>42</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>1-6</page-range></nlm-citation>
</ref>
<ref id="B21">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rudolph]]></surname>
<given-names><![CDATA[JW]]></given-names>
</name>
<name>
<surname><![CDATA[Simon]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Raemer]]></surname>
<given-names><![CDATA[DB]]></given-names>
</name>
<name>
<surname><![CDATA[Eppich]]></surname>
<given-names><![CDATA[WJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Debriefing as Formative Assessment: Closing Performance Gaps in Medical Education]]></article-title>
<source><![CDATA[Acad Emerg Med]]></source>
<year>2008</year>
<volume>15</volume>
<numero>11</numero>
<issue>11</issue>
<page-range>1010-6</page-range></nlm-citation>
</ref>
<ref id="B22">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[McGaghie]]></surname>
<given-names><![CDATA[WC]]></given-names>
</name>
<name>
<surname><![CDATA[Issenberg]]></surname>
<given-names><![CDATA[SB]]></given-names>
</name>
<name>
<surname><![CDATA[Petrusa]]></surname>
<given-names><![CDATA[ER]]></given-names>
</name>
<name>
<surname><![CDATA[Scalese]]></surname>
<given-names><![CDATA[RJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[A critical review of simulation-based medical education research: 2003-2009]]></article-title>
<source><![CDATA[Med Educ]]></source>
<year>2010</year>
<volume>44</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>50-63</page-range></nlm-citation>
</ref>
<ref id="B23">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Muñoz Gualan]]></surname>
<given-names><![CDATA[GG]]></given-names>
</name>
<name>
<surname><![CDATA[Elías Sierra]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[La simulación clínica en la educación médica moderna: revisión de revisiones]]></article-title>
<source><![CDATA[Rev Enferm Vanguard]]></source>
<year>2025</year>
<volume>19</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>102-16</page-range></nlm-citation>
</ref>
<ref id="B24">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Segura-Azuara]]></surname>
<given-names><![CDATA[NdlÁ]]></given-names>
</name>
<name>
<surname><![CDATA[Valencia Castro]]></surname>
<given-names><![CDATA[JL]]></given-names>
</name>
<name>
<surname><![CDATA[López Cabrera]]></surname>
<given-names><![CDATA[MV]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Desarrollo del pensamiento crítico mediante la simulación de alta fidelidad con estudiantes de medicina]]></article-title>
<source><![CDATA[Investigación en educación médica]]></source>
<year>2018</year>
<volume>7</volume>
<numero>28</numero>
<issue>28</issue>
<page-range>55-63</page-range></nlm-citation>
</ref>
<ref id="B25">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Tormo Calandín]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Ruiz López]]></surname>
<given-names><![CDATA[JL]]></given-names>
</name>
<name>
<surname><![CDATA[Casaña Mohedo]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Casal Angulo]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Adánez Martínez]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[García Bermejo]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Aprendizaje de las habilidades psicomotoras en simulación clínica: Metodología docente y resultados preliminares]]></article-title>
<source><![CDATA[Libro de actas: IX Congreso de Innovación Educativa y Docencia en Red]]></source>
<year>2023</year>
<publisher-loc><![CDATA[Valencia ]]></publisher-loc>
<publisher-name><![CDATA[Editorial Universitat Politècnica de València]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B26">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hornos]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Pleguezuelos]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Bala]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Collares]]></surname>
<given-names><![CDATA[CF]]></given-names>
</name>
<name>
<surname><![CDATA[Freeman]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[van der Vleuten]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Reliability, validity and acceptability of an online clinical reasoning simulator for medical students: An international pilot]]></article-title>
<source><![CDATA[Med Teach]]></source>
<year>2024</year>
<volume>46</volume>
<numero>9</numero>
<issue>9</issue>
<page-range>1220-7</page-range></nlm-citation>
</ref>
<ref id="B27">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Brentnall]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Thackray]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Judd]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Evaluating the clinical reasoning of student health professionals in placement and simulation settings: A systematic review]]></article-title>
<source><![CDATA[Int J Environ Res Public Health]]></source>
<year>2022</year>
<volume>19</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>936</page-range></nlm-citation>
</ref>
<ref id="B28">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Issenberg]]></surname>
<given-names><![CDATA[SB]]></given-names>
</name>
<name>
<surname><![CDATA[McGaghie]]></surname>
<given-names><![CDATA[WC]]></given-names>
</name>
<name>
<surname><![CDATA[Petrusa]]></surname>
<given-names><![CDATA[ER]]></given-names>
</name>
<name>
<surname><![CDATA[Lee Gordon]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Scalese]]></surname>
<given-names><![CDATA[RJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Features and uses of high-fidelity medical simulations that lead to effective learning: a BEME systematic review]]></article-title>
<source><![CDATA[Med Teach]]></source>
<year>2005</year>
<volume>27</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>10-28</page-range></nlm-citation>
</ref>
<ref id="B29">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cant]]></surname>
<given-names><![CDATA[RP]]></given-names>
</name>
<name>
<surname><![CDATA[Cooper]]></surname>
<given-names><![CDATA[SJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Use of simulation-based learning in undergraduate nurse education: An umbrella systematic review]]></article-title>
<source><![CDATA[Nurse Educ Today]]></source>
<year>2017</year>
<volume>49</volume>
<page-range>63-71</page-range></nlm-citation>
</ref>
<ref id="B30">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bernita Zamora]]></surname>
<given-names><![CDATA[MM]]></given-names>
</name>
<name>
<surname><![CDATA[Sevillano Paredes]]></surname>
<given-names><![CDATA[EP]]></given-names>
</name>
<name>
<surname><![CDATA[Zambrano Torres]]></surname>
<given-names><![CDATA[DM]]></given-names>
</name>
<name>
<surname><![CDATA[Montaño Quiñonez]]></surname>
<given-names><![CDATA[ML]]></given-names>
</name>
<name>
<surname><![CDATA[Velez Zambrano]]></surname>
<given-names><![CDATA[AM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[El enfoque socio-constructivista y su relación con los estilos de aprendizaje en la educación secundaria en Ecuador]]></article-title>
<source><![CDATA[Arandu UTIC]]></source>
<year>2025</year>
<volume>12</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>1019-32</page-range></nlm-citation>
</ref>
<ref id="B31">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[McGraw]]></surname>
<given-names><![CDATA[RC]]></given-names>
</name>
<name>
<surname><![CDATA[O'Connor]]></surname>
<given-names><![CDATA[HM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Standardized patients in the early acquisition of clinical skills]]></article-title>
<source><![CDATA[Med Educ]]></source>
<year>1999</year>
<volume>33</volume>
<numero>8</numero>
<issue>8</issue>
<page-range>572-8</page-range></nlm-citation>
</ref>
<ref id="B32">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ayala de Mendoza]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[López Esquivel]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Pacientes estandarizados: clave para el aprendizaje clínico]]></article-title>
<source><![CDATA[Rev cient cienc salud]]></source>
<year>2025</year>
<volume>7</volume>
<page-range>01-7</page-range></nlm-citation>
</ref>
<ref id="B33">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Fida]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Kassab]]></surname>
<given-names><![CDATA[SE]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Do medical students' scores using different assessment instruments predict their scores in clinical reasoning using a computer-based simulation?]]></article-title>
<source><![CDATA[Adv Med Educ Pract]]></source>
<year>2015</year>
<volume>6</volume>
<page-range>135-41</page-range></nlm-citation>
</ref>
<ref id="B34">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cook]]></surname>
<given-names><![CDATA[DA]]></given-names>
</name>
<name>
<surname><![CDATA[Hatala]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Brydges]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Zendejas]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Szostek]]></surname>
<given-names><![CDATA[JH]]></given-names>
</name>
<name>
<surname><![CDATA[Wang]]></surname>
<given-names><![CDATA[AT]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Technology-enhanced simulation for health professions education: a systematic review and meta-analysis]]></article-title>
<source><![CDATA[JAMA]]></source>
<year>2011</year>
<volume>306</volume>
<numero>9</numero>
<issue>9</issue>
<page-range>978-88</page-range></nlm-citation>
</ref>
<ref id="B35">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Giraldo Echeverri]]></surname>
<given-names><![CDATA[LM]]></given-names>
</name>
<name>
<surname><![CDATA[Gómez]]></surname>
<given-names><![CDATA[AM]]></given-names>
</name>
<name>
<surname><![CDATA[Buitrago Bach]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Luna]]></surname>
<given-names><![CDATA[IF]]></given-names>
</name>
<name>
<surname><![CDATA[Royeth Pérez]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Rodríguez Padilla]]></surname>
<given-names><![CDATA[LM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Percepción de estudiantes de medicina sobre la simulación presencial y virtual durante la pandemia: estudio transversal analítico]]></article-title>
<source><![CDATA[Iatreia]]></source>
<year>2024</year>
<volume>37</volume>
<numero>3</numero>
<issue>3</issue>
</nlm-citation>
</ref>
<ref id="B36">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rodríguez-Díez]]></surname>
<given-names><![CDATA[MC]]></given-names>
</name>
<name>
<surname><![CDATA[Beunza]]></surname>
<given-names><![CDATA[JJ]]></given-names>
</name>
<name>
<surname><![CDATA[López-Del Burgo]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Hyder]]></surname>
<given-names><![CDATA[O]]></given-names>
</name>
<name>
<surname><![CDATA[Civeira-Murillo]]></surname>
<given-names><![CDATA[MP]]></given-names>
</name>
<name>
<surname><![CDATA[Díez]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Aprendizaje de la historia clínica con pacientes simulados en el grado de Medicina]]></article-title>
<source><![CDATA[Educ Méd]]></source>
<year>2012</year>
<volume>15</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>47-52</page-range></nlm-citation>
</ref>
<ref id="B37">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Makransky]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Bonde]]></surname>
<given-names><![CDATA[MT]]></given-names>
</name>
<name>
<surname><![CDATA[Wulff]]></surname>
<given-names><![CDATA[JS]]></given-names>
</name>
<name>
<surname><![CDATA[Wandall]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Hood]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Creed]]></surname>
<given-names><![CDATA[PA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Simulation based virtual learning environment in medical genetics counseling: an example of bridging the gap between theory and practice in medical education]]></article-title>
<source><![CDATA[BMC Med Educ]]></source>
<year>2016</year>
<volume>16</volume>
<page-range>98</page-range></nlm-citation>
</ref>
<ref id="B38">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Plackett]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Kassianos]]></surname>
<given-names><![CDATA[AP]]></given-names>
</name>
<name>
<surname><![CDATA[Kambouri]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Kay]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Mylan]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Hopwood]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Online patient simulation training to improve clinical reasoning: a feasibility randomised controlled trial]]></article-title>
<source><![CDATA[BMC Med Educ]]></source>
<year>2020</year>
<volume>20</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>245</page-range></nlm-citation>
</ref>
<ref id="B39">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Genes]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[González]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Navarro]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Osorio]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Ocampos]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Contribución de la Didáctica y Evaluación para la Construcción del Razonamiento Clínico en Estudiantes de Medicina]]></article-title>
<source><![CDATA[An Fac Cienc Méd (Asunción)]]></source>
<year>2025</year>
<volume>58</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>25-32</page-range></nlm-citation>
</ref>
<ref id="B40">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Elendu]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Amaechi]]></surname>
<given-names><![CDATA[DC]]></given-names>
</name>
<name>
<surname><![CDATA[Okatta]]></surname>
<given-names><![CDATA[AU]]></given-names>
</name>
<name>
<surname><![CDATA[Amaechi]]></surname>
<given-names><![CDATA[EC]]></given-names>
</name>
<name>
<surname><![CDATA[Elendu]]></surname>
<given-names><![CDATA[TC]]></given-names>
</name>
<name>
<surname><![CDATA[Ezeh]]></surname>
<given-names><![CDATA[CP]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The impact of simulation-based training in medical education: A review]]></article-title>
<source><![CDATA[Medicine (Baltimore)]]></source>
<year>2024</year>
<volume>103</volume>
<numero>27</numero>
<issue>27</issue>
</nlm-citation>
</ref>
<ref id="B41">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rognoni Amrein]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Benet Bertran]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Castro Salomó]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Gomar Sancho]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Villalonga Vadell]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Zorrilla Riveiro]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[La simulación clínica en la educación médica: Ventajas e inconvenientes del aprendizaje al lado del paciente y en entorno simulado]]></article-title>
<source><![CDATA[Med Clin Pract]]></source>
<year>2024</year>
<volume>7</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>100459</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
