National survey: how do we approach the patient at risk of clinical deterioration outside the ICU in the spanish context?

Background: Anticipating and avoiding preventable intrahospital cardiac arrest and clinical deterioration are important priorities for international healthcare systems and institutions. One of the internationally followed strategies to improve this matter is the introduction of the Rapid Response Systems (RRS). Although there is vast evidence from the international community, the evidence reported in a Spanish context is scarce. Methods: A nationwide cross-sectional research consisting of a voluntary 31-question online survey was performed. The Spanish Society of Intensive, Critical and Coronary Care Medicine (SEMICYUC) supported the research. Results: We received 62 fully completed surveys distributed within 13 of the 17 regions and two autonomous cities of Spain. Thirty-two of the participants had an established Rapid Response Team (RRT). Common frequency on measuring vital signs was at least once per shift but other frequencies were contemplated (48.4%), usually based on professional criteria (69.4%), as only 12 (19.4%) centers used Early Warning Scores (EWS) or automated alarms on abnormal parameters. In the sample, doctors, nurses (55%), and other healthcare professionals (39%) could activate the RRT via telephone, but only 11.3% of the sample enacted this at early signs of deterioration. The responders on the RRT are the Intensive Care Unit (ICU), doctors, and nurses, who are available 24/7 most of the time. Concerning the education and training of general ward staff and RRT members, this varies from basic to advanced and specific-specialized level, simulating a growing educational methodology among participants. A great number of participants have emergency resuscitation equipment (drugs, airway adjuncts, and defibrillators) in their general wards. In terms of quality improvement, only half of the sample registered RRT activity indicators. In terms of the use of communication and teamwork techniques, the most used is clinical debriefing in 29 centers. Conclusions: In terms of the concept of RRS, we found in our context that we are in the early stages of the establishment process, as it is not yet a generalized concept in most of our hospitals. The centers that have it are in still in the process of maturing the system and adapting themselves to our context

Plan de contingencia para los servicios de medicina intensiva frente a la pandemia COVID-19

In January 2020, the Chinese authorities identified a new virus of the Coronaviridae family as the cause of several cases of pneumonia of unknown aetiology. The outbreak was initially confined to Wuhan City, but then spread outside Chinese borders. On 31 January 2020, the first case was declared in Spain. On 11 March 2020, The World Health Organization (WHO) declared the coronavirus outbreak a pandemic. On 16 March 2020, there were 139 countries affected. In this situation, the Scientific Societies SEMICYUC and SEEIUC, have decided to draw up this Contingency Plan to guide the response of the Intensive Care Services. The objectives of this plan are to estimate the magnitude of the problem and identify the necessary human and material resources. This is to provide the Spanish Intensive Medicine Services with a tool to programme optimal response strategies

Effects of intubation timing in patients with COVID-19 throughout the four waves of the pandemic : a matched analysis

The primary aim of our study was to investigate the association between intubation timing and hospital mortality in critically ill patients with COVID-19-associated respiratory failure. We also analysed both the impact of such timing throughout the first four pandemic waves and the influence of prior non-invasive respiratory support on outcomes. This is a secondary analysis of a multicentre, observational and prospective cohort study that included all consecutive patients undergoing invasive mechanical ventilation due to COVID-19 from across 58 Spanish intensive care units (ICU) participating in the CIBERESUCICOVID project. The study period was between 29 February 2020 and 31 August 2021. Early intubation was defined as that occurring within the first 24 h of intensive care unit (ICU) admission. Propensity score (PS) matching was used to achieve balance across baseline variables between the early intubation cohort and those patients who were intubated after the first 24 h of ICU admission. Differences in outcomes between early and delayed intubation were also assessed. We performed sensitivity analyses to consider a different timepoint (48 h from ICU admission) for early and delayed intubation. Of the 2725 patients who received invasive mechanical ventilation, a total of 614 matched patients were included in the analysis (307 for each group). In the unmatched population, there were no differences in mortality between the early and delayed groups. After PS matching, patients with delayed intubation presented higher hospital mortality (27.3% versus 37.1%, p =0.01), ICU mortality (25.7% versus 36.1%, p=0.007) and 90-day mortality (30.9% versus 40.2%, p=0.02) when compared to the early intubation group. Very similar findings were observed when we used a 48-hour timepoint for early or delayed intubation. The use of early intubation decreased after the first wave of the pandemic (72%, 49%, 46% and 45% in the first, second, third and fourth wave, respectively; first versus second, third and fourth waves p<0.001). In both the main and sensitivity analyses, hospital mortality was lower in patients receiving high-flow nasal cannula (n=294) who were intubated earlier. The subgroup of patients undergoing NIV (n=214) before intubation showed higher mortality when delayed intubation was set as that occurring after 48 h from ICU admission, but not when after 24 h. In patients with COVID-19 requiring invasive mechanical ventilation, delayed intubation was associated with a higher risk of hospital mortality. The use of early intubation significantly decreased throughout the course of the pandemic. Benefits of such an approach occurred more notably in patients who had received high-flow nasal cannul

The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients

Background: Mortality due to COVID-19 is high, especially in patients requiring mechanical ventilation. The purpose of the study is to investigate associations between mortality and variables measured during the first three days of mechanical ventilation in patients with COVID-19 intubated at ICU admission. Methods: Multicenter, observational, cohort study includes consecutive patients with COVID-19 admitted to 44 Spanish ICUs between February 25 and July 31, 2020, who required intubation at ICU admission and mechanical ventilation for more than three days. We collected demographic and clinical data prior to admission; information about clinical evolution at days 1 and 3 of mechanical ventilation; and outcomes. Results: Of the 2,095 patients with COVID-19 admitted to the ICU, 1,118 (53.3%) were intubated at day 1 and remained under mechanical ventilation at day three. From days 1 to 3, PaO2/FiO2 increased from 115.6 [80.0-171.2] to 180.0 [135.4-227.9] mmHg and the ventilatory ratio from 1.73 [1.33-2.25] to 1.96 [1.61-2.40]. In-hospital mortality was 38.7%. A higher increase between ICU admission and day 3 in the ventilatory ratio (OR 1.04 [CI 1.01-1.07], p = 0.030) and creatinine levels (OR 1.05 [CI 1.01-1.09], p = 0.005) and a lower increase in platelet counts (OR 0.96 [CI 0.93-1.00], p = 0.037) were independently associated with a higher risk of death. No association between mortality and the PaO2/FiO2 variation was observed (OR 0.99 [CI 0.95 to 1.02], p = 0.47). Conclusions: Higher ventilatory ratio and its increase at day 3 is associated with mortality in patients with COVID-19 receiving mechanical ventilation at ICU admission. No association was found in the PaO2/FiO2 variation

Variables psicológicas implicadas en la actitud e iniciativa emprendedora (II): personalidad, cognición y emoción

El proyecto titulado: Variables implicadas en la actitud e iniciativa emprendedora (II): personalidad, cognición y emoción, es la continuidad de otro presentado en la convocatoria anterior (2016-2017) cuyo objetivo era evaluar variables psicológicas en la actitud emprendedora de los estudiantes universitarios de la Universidad Complutense de Madrid (UCM). Este segundo proyecto ha tenido por objetivo principal ampliar la evaluación a otras facultades y áreas de conocimiento de nuestra universidad a fin de obtener el mapa y perfil de la iniciativa emprendedora del universitario UCM

Implantación de un protocolo y trayectoria clínica para la reperfusión cerebral del ictus isquémico hiperagudo. Una visión multidisciplinar

El ictus es una emergencia médica, igual que otras patologías tiempo dependiente. Hasta el estudio NINDS, el único tratamiento era el de soporte, pero éste y posteriores estudios (ECASS-III), mostraron que el tratamiento con activador tisular del plasminógeno recombinante (rt-PA) es beneficioso en pacientes con un ictus isquémico agudo en las primeras 4,5h desde el inicio de los síntomas. Hasta el estudio SITS-MOST, este tratamiento sólo se administraba en grandes centros experimentados con unidades de ictus. En nuestro centro, sin experiencia previa en el tratamiento de esta patología, planteamos el tratamiento con rt-PA en la fase hiperaguda de un ictus isquémico, en el ámbito del Servicio de Medicina Intensiva, mediante un protocolo a través de una trayectoria clínica, previamente elaborada con la colaboración de todos los servicios implicados. OBJETIVO: 1) Describir la población afecta de un ictus isquémico tratada con rt-PA en las primeras 3-4.5 horas del inicio de los síntomas. 2) Analizar los factores que influyen en los tiempos de latencia y las variables de eficacia y seguridad.3) Describir y comparar las poblaciones tratadas con rtPA en los periodos pre y post ECAS III 4) Comparar la población de nuestro centro tratada en las primeras 4.5 horas y las variables de eficacia y seguridad con las del registro SITS-MOST. MÉTODO: Se incluyeron todos los pacientes entre Marzo-2006 y Diciembre-2015 que tratados con rt-PA. Se recogieron características demográficas, comorbilidades, situación basal, intensidad del déficit neurológico pre-tratamiento, clasificación clínica de los ictus, medios de traslado, forma de activación del código ictus, tiempos de latencia y variables de eficacia y seguridad. RESULTADOS: Se realizó tratamiento fibrinolítico a un total de 493 pacientes con ictus isquémico; 52,1% hombres, edad media: 75 años; el 95,5% eran independientes previamente. La puntuación NIHSS era 10,86 (DE 6,55). El 48% de los pacientes accedieron al hospital mediante medios propios, y la activación fue intrahospitalaria en el 52.3%. Los tiempos de latencia fueron: inicio-puerta 81,56 min, puerta-TC 25,11 min, puerta-aguja 48,28 min y el tiempo inicio-aguja 129,22 min. El tiempo puerta-aguja descendió a partir del año 2010 (p<0,001). El tiempo inicio síntomas-puerta fue menor en los pacientes intrahospitalarios y en aquéllos trasladados con SEM primario y con mayor dèficit neurológico (p<0,05). Los tiempos puerta-aguja fueron menores (p<0,05) en periodo de estudio más reciente y en horario laboral. El 52,4% presentaron una mejoría clínica precoz, la mortalidad a los 3 y los 12 meses fue del 13,2 y 16,5%, respectivamente. La transformación hemorrágica sintomática fue del 3,9%, asociándose con esta, sólo la presentación clínica en forma de TACI (p<0,001). Al comparar los periodos pre y post ECASS III, en el periodo 2010-2015, los pacientes eran de mayor edad (72,78 años vs 66,39 años). Disminuyeron los tiempos de latencia, inicio-activación y puerta-aguja (p<0,01), sin diferencias en las variables de eficacia y seguridad. Nuestros pacientes eran de mayor edad que los del registro SITS (67 vs 77 años), con peor situación funcional previa. Nuestros tiempos puerta-aguja e inicio-aguja fueron muy inferiores (65 vs. 36 min y 140 vs 105 min, respectivamente). Aunque el número de hemorragias intracraneales sintomáticas fue ligeramente superior (1,7% vs 3,6%), no presentaron mayor mortalidad y su pronóstico funcional fue mejor (mRS 0-1 40,8% vs 51,2%). CONCLUSIONES: 1) Nuestros tiempos de latencia fueron cortos; y la evolución clínica y funcional fue buena 2) El inicio intrahospitalario y el traslado mediante SEM se asociaron a tiempos cortos de latencia 3) El tratamiento en las primeras 4,5 horas fue igual de seguro y eficaz que el realizado en menos de 3 horas.4) En comparación con el registro SITS-MOST, nuestros tiempos de latencia fueron más cortos y el pronóstico funcional mejor.Stroke is a real medical emergency, as they are other time-dependent pathologies. NINDS and subsequent studies (ECASS-III), showed that treatment with recombinant plasminogen activator (rt-PA) within the first 4.5 hours from the onset of the symptoms is beneficial in patients affected by an acute ischemic stroke. Until the development of the SITS-MOST study, this treatment was only given in large centers with experienced and specialized stroke units. In our center, with no previous experience in the treatment of this pathology, we propose the treatment of intravenous cerebral reperfusion in the hyperacute phase of ischemic stroke, in the scope of the Intensive Care Unit, through a protocol based on a clinical pathway done with the collaboration of all the departments involved. OBJECTIVE: 1) To describe the population affected by an ischemic stroke and treated with intravenous fibrinolysis within the first 3-4.5 hours of the onset of the symptoms. 2) To analyze the factors that influence the latency times and the variables of efficacy and safety. 3) To describe and compare the populations affected by ischemic stroke treated with rtPA i.v. in the pre and post periods ECAS III 4) To compare the population treated in our center in the first 4.5 hours with those of the SITS-MOST registry. METHOD: All patients between March 2006 and December 2015 who had received fibrinolytic treatment were included. Demographic data, basal characteristics, comorbidities, baseline status, intensity of pre-treatment neurological deficit, clinical classification of stroke, times of transfer and activation of stroke code, latency times, efficacy and safety variables were collected. RESULTS: Fibrinolysis was performed in 493 patients; 52.1% were male, mean age 75 years old; 95.5% were independent prior to the stroke episode. They presented NIHSS score of 10.86 (SD 6.55). The 48% of patients arrived to the hospital by their own means and the activation was intrahospitalary in the 52.3%. Latency times were as follows: start-ED 81.56 min, ED-CT 25.11 min, ED-needle 48.28 min and start-needle time 129.22 min. The ED-needle time decreased from the year 2010 (p <0.001). The onset of symptoms-ED was lower in the in-hospital patients group and in those who arrived through the EMs with higher neurological impairments (p <0.05). ED-needle times were lower (p <0.05) in the most recent study period and during working hours. 52.4% of the patients presented early clinical improvement, and mortality at 3 and 12 months was of 13.2 and 16.5%, respectively. The hemorrhagic transformation was symptomathic in the 3.9%, and the clinical presentation associated was TACI form (p <0.001). When the pre and post ECASS III periods were compared, in 2010-2015 period, the patients were older (72.78 vs 66.39 years old), with no other differences. Time of latency, start-activation and ED-needle times decreased (p <0.01). No differences were detected between the two periods in the efficacy and safety variables. Patients at our center were older than the SITS registry (67 vs 77 years old) and they had worse previous functional status. ED-needle and onset of simptoms-needle times were much lower in our patients (36 vs. 65 min and 105 vs 140 min, respectively). Although the number of symptomatic intracraneal haemorrhages was slightly higher (1.7% vs 3.6%), they did not present higher mortality and their functional prognosis was better (mRS 0-1 40.8% vs 51.2%). CONCLUSIONS: 1) Our latency times were short; and clinical and functional outcome were good. 2) In-hospital activation and transfer through EMS were associated with short latency times. 3) Treatment in the first 4.5 hours was as safe and effective as in less than 3 hours.4) Compared to the SITS-MOST register, our latency times were shorter and the functional prognosis was better

Implantación de un protocolo y trayectoria clínica para la reperfusión cerebral del ictus isquémico hiperagudo : Una visión multidisciplinar /

El ictus es una emergencia médica, igual que otras patologías tiempo dependiente. Hasta el estudio NINDS, el único tratamiento era el de soporte, pero éste y posteriores estudios (ECASS-III), mostraron que el tratamiento con activador tisular del plasminógeno recombinante (rt-PA) es beneficioso en pacientes con un ictus isquémico agudo en las primeras 4,5h desde el inicio de los síntomas. Hasta el estudio SITS-MOST, este tratamiento sólo se administraba en grandes centros experimentados con unidades de ictus. En nuestro centro, sin experiencia previa en el tratamiento de esta patología, planteamos el tratamiento con rt-PA en la fase hiperaguda de un ictus isquémico, en el ámbito del Servicio de Medicina Intensiva, mediante un protocolo a través de una trayectoria clínica, previamente elaborada con la colaboración de todos los servicios implicados. OBJETIVO: 1) Describir la población afecta de un ictus isquémico tratada con rt-PA en las primeras 3-4.5 horas del inicio de los síntomas. 2) Analizar los factores que influyen en los tiempos de latencia y las variables de eficacia y seguridad.3) Describir y comparar las poblaciones tratadas con rtPA en los periodos pre y post ECAS III 4) Comparar la población de nuestro centro tratada en las primeras 4.5 horas y las variables de eficacia y seguridad con las del registro SITS-MOST. MÉTODO: Se incluyeron todos los pacientes entre Marzo-2006 y Diciembre-2015 que tratados con rt-PA. Se recogieron características demográficas, comorbilidades, situación basal, intensidad del déficit neurológico pre-tratamiento, clasificación clínica de los ictus, medios de traslado, forma de activación del código ictus, tiempos de latencia y variables de eficacia y seguridad. RESULTADOS: Se realizó tratamiento fibrinolítico a un total de 493 pacientes con ictus isquémico; 52,1% hombres, edad media: 75 años; el 95,5% eran independientes previamente. La puntuación NIHSS era 10,86 (DE 6,55). El 48% de los pacientes accedieron al hospital mediante medios propios, y la activación fue intrahospitalaria en el 52.3%. Los tiempos de latencia fueron: inicio-puerta 81,56 min, puerta-TC 25,11 min, puerta-aguja 48,28 min y el tiempo inicio-aguja 129,22 min. El tiempo puerta-aguja descendió a partir del año 2010 (p 0,001). El tiempo inicio síntomas-puerta fue menor en los pacientes intrahospitalarios y en aquéllos trasladados con SEM primario y con mayor dèficit neurológico (p 0,05). Los tiempos puerta-aguja fueron menores (p 0,05) en periodo de estudio más reciente y en horario laboral. El 52,4% presentaron una mejoría clínica precoz, la mortalidad a los 3 y los 12 meses fue del 13,2 y 16,5%, respectivamente. La transformación hemorrágica sintomática fue del 3,9%, asociándose con esta, sólo la presentación clínica en forma de TACI (p 0,001). Al comparar los periodos pre y post ECASS III, en el periodo 2010-2015, los pacientes eran de mayor edad (72,78 años vs 66,39 años). Disminuyeron los tiempos de latencia, inicio-activación y puerta-aguja (p 0,01), sin diferencias en las variables de eficacia y seguridad. Nuestros pacientes eran de mayor edad que los del registro SITS (67 vs 77 años), con peor situación funcional previa. Nuestros tiempos puerta-aguja e inicio-aguja fueron muy inferiores (65 vs. 36 min y 140 vs 105 min, respectivamente). Aunque el número de hemorragias intracraneales sintomáticas fue ligeramente superior (1,7% vs 3,6%), no presentaron mayor mortalidad y su pronóstico funcional fue mejor (mRS 0-1 40,8% vs 51,2%). CONCLUSIONES: 1) Nuestros tiempos de latencia fueron cortos; y la evolución clínica y funcional fue buena 2) El inicio intrahospitalario y el traslado mediante SEM se asociaron a tiempos cortos de latencia 3) El tratamiento en las primeras 4,5 horas fue igual de seguro y eficaz que el realizado en menos de 3 horas.4) En comparación con el registro SITS-MOST, nuestros tiempos de latencia fueron más cortos y el pronóstico funcional mejor.Stroke is a real medical emergency, as they are other time-dependent pathologies. NINDS and subsequent studies (ECASS-III), showed that treatment with recombinant plasminogen activator (rt-PA) within the first 4.5 hours from the onset of the symptoms is beneficial in patients affected by an acute ischemic stroke. Until the development of the SITS-MOST study, this treatment was only given in large centers with experienced and specialized stroke units. In our center, with no previous experience in the treatment of this pathology, we propose the treatment of intravenous cerebral reperfusion in the hyperacute phase of ischemic stroke, in the scope of the Intensive Care Unit, through a protocol based on a clinical pathway done with the collaboration of all the departments involved. OBJECTIVE: 1) To describe the population affected by an ischemic stroke and treated with intravenous fibrinolysis within the first 3-4.5 hours of the onset of the symptoms. 2) To analyze the factors that influence the latency times and the variables of efficacy and safety. 3) To describe and compare the populations affected by ischemic stroke treated with rtPA i.v. in the pre and post periods ECAS III 4) To compare the population treated in our center in the first 4.5 hours with those of the SITS-MOST registry. METHOD: All patients between March 2006 and December 2015 who had received fibrinolytic treatment were included. Demographic data, basal characteristics, comorbidities, baseline status, intensity of pre-treatment neurological deficit, clinical classification of stroke, times of transfer and activation of stroke code, latency times, efficacy and safety variables were collected. RESULTS: Fibrinolysis was performed in 493 patients; 52.1% were male, mean age 75 years old; 95.5% were independent prior to the stroke episode. They presented NIHSS score of 10.86 (SD 6.55). The 48% of patients arrived to the hospital by their own means and the activation was intrahospitalary in the 52.3%. Latency times were as follows: start-ED 81.56 min, ED-CT 25.11 min, ED-needle 48.28 min and start-needle time 129.22 min. The ED-needle time decreased from the year 2010 (p 0.001). The onset of symptoms-ED was lower in the in-hospital patients group and in those who arrived through the EMs with higher neurological impairments (p 0.05). ED-needle times were lower (p 0.05) in the most recent study period and during working hours. 52.4% of the patients presented early clinical improvement, and mortality at 3 and 12 months was of 13.2 and 16.5%, respectively. The hemorrhagic transformation was symptomathic in the 3.9%, and the clinical presentation associated was TACI form (p 0.001). When the pre and post ECASS III periods were compared, in 2010-2015 period, the patients were older (72.78 vs 66.39 years old), with no other differences. Time of latency, start-activation and ED-needle times decreased (p 0.01). No differences were detected between the two periods in the efficacy and safety variables. Patients at our center were older than the SITS registry (67 vs 77 years old) and they had worse previous functional status. ED-needle and onset of simptoms-needle times were much lower in our patients (36 vs. 65 min and 105 vs 140 min, respectively). Although the number of symptomatic intracraneal haemorrhages was slightly higher (1.7% vs 3.6%), they did not present higher mortality and their functional prognosis was better (mRS 0-1 40.8% vs 51.2%). CONCLUSIONS: 1) Our latency times were short; and clinical and functional outcome were good. 2) In-hospital activation and transfer through EMS were associated with short latency times. 3) Treatment in the first 4.5 hours was as safe and effective as in less than 3 hours.4) Compared to the SITS-MOST register, our latency times were shorter and the functional prognosis was better

Non-invasive oxygenation support in acutely hypoxemic COVID-19 patients admitted to the ICU: a multicenter observational retrospective study

Background: Non-invasive oxygenation strategies have a prominent role in the treatment of acute hypoxemic respiratory failure during the coronavirus disease 2019 (COVID-19). While the efcacy of these therapies has been studied in hospitalized patients with COVID-19, the clinical outcomes associated with oxygen masks, high-fow oxy‑ gen therapy by nasal cannula and non-invasive mechanical ventilation in critically ill intensive care unit (ICU) patients remain unclear. Methods: In this retrospective study, we used the best of nine covariate balancing algorithms on all baseline covari‑ ates in critically ill COVID-19 patients supported with>10 L of supplemental oxygen at one of the 26 participating ICUs in Catalonia, Spain, between March 14 and April 15, 2020. Results: Of the 1093 non-invasively oxygenated patients at ICU admission treated with one of the three stand-alone non-invasive oxygenation strategies, 897 (82%) required endotracheal intubation and 310 (28%) died during the ICU stay. High-fow oxygen therapy by nasal cannula (n=439) and non-invasive mechanical ventilation (n=101) were associated with a lower rate of endotracheal intubation (70% and 88%, respectively) than oxygen masks (n=553 and 91% intubated), p<0.001. Compared to oxygen masks, high-fow oxygen therapy by nasal cannula was associated with lower ICU mortality (hazard ratio 0.75 [95% CI 0.58-0.98), and the hazard ratio for ICU mortality was 1.21 [95% CI 0.80-1.83] for non-invasive mechanical ventilation. Conclusion: In critically ill COVID-19 ICU patients and, in the absence of conclusive data, high-fow oxygen therapy by nasal cannula may be the approach of choice as the primary non-invasive oxygenation support strateg

I Feria BarbarArte : Leonardo da Vinci (1519-2019)

El trabajo obtuvo un Premio Tomás García Verdejo a las buenas prácticas educativas en la Comunidad Autónoma de Extremadura para el curso 2018/2019. Modalidad BSe describe un proyecto llevado a cabo en el IES Sierra de Santa Bárbara (Plasencia, Cáceres) promovido desde la biblioteca y en el que se involucró a los distintos departamentos del centro, que consistió en organizar una feria en torno a la figura de Leonardo da Vinci. Los objetivos de la actividad fueron: celebrar el V centenario de la muerte de Leonardo da Vinci como una efeméride de 2019; conocer el trabajo del artista, valorar su espíritu humanista y emprendedor; relacionar todas las materias curriculares con un fin común de estudio para la elaboración de formatos de aprendizaje basado en proyectos que fomenten el aprendizaje autónomo y activo del alumno; fomentar el trabajo colaborativo y en grupo así como concienciar al alumnado de la importancia de comunicar y transmitir los conocimientos adquiridos; implicar a la comunidad educativa para facilitar el trabajo de la biblioteca como eje difusor de ideas; utilizar metodologías activas, usar los dispositivos móviles, la gamificación y las nuevas tecnologías; concienciar de la necesidad de realizar actividades que cohesionen al alumnado; elaborar instrumentos de evaluación acordes a las metodologías empleadas que garanticen la objetividad, sean acordes al currículo y permitan evaluar el grado de adquisición de las competencias claveExtremaduraES

La esclavitud en el siglo XXI. Solidaridad y voluntariado

Convocatoria Proyectos de innovación de Extremadura 2018/2019Se describe un proyecto llevado a cabo en el IES Zurbarán (Badajoz) en el que se reflexiona sobre las distintas formas de explotación que se dan en la sociedad actual y la respuesta que puede dar la solidaridad y el voluntariado a estas situaciones. El tema se aborda desde distintas áreas convirtiéndolo en un proyecto transversal. Los objetivos principales del proyecto fueron: conocer la realidad para crear una ciudadanía consciente, crítica y comprometida; fomentar la participación para crear iniciativas de cambio y alternativas para un mundo más justo e igualitario; desarrollar la empatía; favorecer el pensamiento crítico; mejorar la inteligencia emocional y social; fomentar el respeto a los demás valorando la identidad propia y posibilitar la transformación personalExtremaduraES