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This survey provides a brief and selective overview of research in the philosophy of mathematics education. It asks what makes up the philosophy of mathematics education, what it means, what questions it asks and answers, and what is its overall importance and use? It provides overviews of critical mathematics education, and the most relevant modern movements in the philosophy of mathematics. A case study is provided of an emerging research tradition in one country. This is the Hermeneutic strand of research in the philosophy of mathematics education in Brazil. This illustrates one orientation towards research inquiry in the philosophy of mathematics education. It is part of a broader practice of 'philosophical archaeology': the uncovering of hidden assumptions and buried ideologies within the concepts and methods of research and practice in mathematics education. An extensive bibliography is also included.

It has been proposed that the school origin of items for cross-institutional Progress Tests (PTs) may introduce a bias in favour of students from the same school, posing a potential threat to the validity and reliability of PT results and cross-institutional comparisons. The aim of this study was to examine whether origin bias is present in a Brazilian cross-institutional PT examination. This study conducted a cross-sectional analysis of seven schools affiliated with the oldest PT consortium in Brazil, utilising a pooled analysis of differences in students' performance concerning self and non-self items. A proportional meta-analysis of the items' rate differences and confidence intervals with random effects was performed, providing an odds ratio (OR) for self and non-self items. Differences between the two groups of items were assessed by scrutinising whether the OR and 95% confidence intervals overlapped. The findings indicated no discernible differences in psychometric indices based on the school responsible for item creation. Three schools consistently demonstrate superior performance on items authored by their faculty, however, these they also excelled on non-self items. Furthermore, an overlap in the 95% confidence intervals for both self and non-self items was observed across all seven schools. In contrast to prior reports, this study revealed the absence of origin bias, suggesting that adoption of best practices in blueprinting, item writing, and editing may have played a role in mitigating such bias.

Several methods have been proposed for analyzing differences between test scores, such as using mean scores, cumulative deviation, and mixed-effect models. Here, we explore the pooled analysis of retested Progress Test items to monitor the performance of first-year medical students who were exposed to a new curriculum design. This was a cross-sectional study of students in their first year of a medical program who participated in the annual interinstitutional Progress Tests from 2013 to 2019. We analyzed the performance of first-year students in the 2019 test and compared it with that of first-year students taking the test from 2013 to 2018 and encountering the same items. For each item, we calculated odds ratios with 95% confidence intervals; we also performed meta-analyses with fixed effects for each content area in the pooled analysis and presented the odds ratio (OR) with a 95% confidence interval (CI). In all, we used 63 items, which were divided into basic sciences, internal medicine, pediatrics, surgery, obstetrics and gynecology, and public health. Significant differences were found between groups in basic sciences (OR = 1.172 [CI95% 1.005 CI 1.366], p = 0.043) and public health (OR = 1.54 [CI95% CI 1.25–1.897], p < 0.001), which may reflect the characteristics of the new curriculum. Thus, pooled analysis of pretested items may provide indicators of different performance. This method may complement analysis of score differences on benchmark assessments.

Congenital heart diseases (CHDs) constitute the most prevalent congenital pathology, and they are a consequence of structural and functional abnormalities during fetal development. The etiology of CHD involves the interaction of genetic and environmental factors. Fetal cardiac surgery aims at preventing natural pathways of CHD in utero, mitigating progression to more complex abnormalities. The goal of this review was to demonstrate the benefits and risks of fetal interventions in the two most prevalent CHDs, pulmonary stenosis and pulmonary atresia with an intact ventricular septum, but also critical aortic stenosis and hypoplastic left heart syndrome. Original and relevant articles were selected by meta-aggregation to perform a qualitative analysis of fetal cardiac interventions for pulmonary stenosis and critical aortic stenosis. The Joanna Briggs Institute's Qualitative Assessment and Review Instrument (or JBI-QARI) was used for data quality appraisal. Of 61 potential articles, 13 were selected, and nine were finally included. Discussion: The present review demonstrated that fetal cardiac surgery increases right ventricular growth and hemodynamic flow in pulmonary stenosis, whereas in critical aortic stenosis it enables growth of the left ventricle and increases left ventricular pressure. However, it has a high complication rate, along with considerable morbidity and mortality. The benefits of fetal cardiac surgery for pulmonary stenosis and critical aortic stenosis are well-described in the literature; however, there is a significant risk of complications which can be reduced by the surgeon's technical expertise and well-structured hospital facilities.

Background Congenital Anomalies were responsible for 303,000 deaths in the neonatal period, according to the WHO, they are among the world’s top 20 causes of morbidity and mortality. Expensive simulators demonstrate several diseases, but few are related to congenital anomalies. This study aims to develop, validate, and evaluate low-cost simulator models (WALL-GO) of the most common abdominal wall defects, gastroschisis, and omphalocele, to enable diagnosis through an accessible tool with study value and amenable to replication. Methods Market research was conducted to find materials to build low-cost models. The researchers built the model and underwent validation assessment of the selected experts who scored five or more in the adapted Fehring criteria. The experts were assessed through a 5-point Likert scale to 7 statements (S1-7). Statements were assigned values according to relevance in face and transfer validities. Concomitantly, the model was also evaluated by students from 1st to 5th year with the same instruments. Content Validity Indexes (CVIs) were considered validated between groups with concordance greater than 90%. Text feedback was also collected. Each statement was subjected to Fisher’s Exact Test. Results Gastroschisis and omphalocele model costs were US $15 and US $27, respectively. In total, there were 105 simulator evaluators. 15 experts were selected. Of the 90 students, there were 16 (1st year), 22 (2nd), 16 (3rd), 22 (4th), and 14 (5th). Students and experts obtained CVI = 96.4% and 94.6%, respectively. The CVIs of each statement were not significantly different between groups ( p  < 0,05). Conclusions The WALL-GO models are suitable for use and replicable at a manufacturable low cost. Mannequins with abdominal wall defects are helpful in learning to diagnose and can be applied in teaching and training health professionals in developing and low-income countries.

Correspondence to Luiza Telles; lulustelles21@gmail.com Pediatric trauma is a leading cause of death in children and a significant global health concern, with 95% of all childhood injury deaths occurring in low- and middle-income countries (LMICs).1 Approximately 10–15% of pediatric trauma patients suffer blunt abdominal injuries, with the spleen being commonly injured.2 Over the last three decades, based on a series of high-income country (HIC) generated research publications and disseminated English language care guidelines, the management of blunt splenic injury in children in HICs has changed dramatically, from frequent splenectomy to successful non-operative management in more than 90% of patients.2 In Brazil, an LMIC, where only four publications touched on this area in the past 40 years, the splenectomy rate following blunt splenic injury has remained well over 50%, reaching 70% in some regions,2 3 and appropriate Brazilian clinical care guidelines for this condition are lacking. Enhancing research in LMICs with a focus on equity to reduce medical research colonialism involves a multifaceted approach (figure 1), adapting surgical systems and implementing changes into surgical training curricula to advance the implementation of evidence-based medicine. A multifaceted approach to enhance research capacity and equity in global surgery, focusing on financial support, empowerment of local researchers, academic inclusion, research protection, and the development of collaborative research networks.

The history of Emergency Pediatrics at the University of Campinas (Unicamp of the Portuguese ) began in 1986, with the creation of the Discipline of Emergency Pediatrics in the Department of Pediatrics. This development was driven by the growing need for specialization in childcare, given the physiological differences and the specific attention required in emergencies. In the 1980s, the Pediatric Advanced Life Support (PALS) program played a crucial role in improving pediatric emergency care. Training in the area was formally regulated in 2016, after a period of interruption in the 2000s. This informative article was designed with the objective of underscoring the importance of establishing a skills laboratory within a university hospital center. To achieve this, we reviewed institutional records, the history of residency programs, and national and international initiatives that supported the inclusion of simulation in medical education. Special attention was given to the evolution of medical simulation, its integration into the Unicamp curriculum, and its application in pediatric emergency training. Unicamp pioneered the creating of a residency program in Pediatric Emergency, consolidating its training with internships in Intensive Care Units and Anesthesiology. Since 1986, the Pediatric Emergency Room has been coordinated by institutional professionals and was strengthened with the start of the residency program in 1991. Training expanded with the creation of an outpatient clinic for graduates, and in 2018, 24 professionals were awarded the title of Pediatric Emergency Physician, three of them from Unicamp. Currently, 12 graduates are working in different regions of Brazil. Regarding simulation, Brazil began using this educational technique in the 1990s, initially in nursing courses. Following the World Health Organization's recognition in 2009 of its importance in controlled training environments, and subsequent initiatives by the Ministry of Health and the Pan American Health Organization in 2014, medical simulation was progressively incorporated into Brazilian medical schools. At Unicamp, the implementation began in 2007 with the construction of the Center for Realistic Simulation, inaugurated in 2009. Since then, medical students and pediatric residents have participated in high-fidelity simulation sessions, strengthening both technical and non-technical skills such as communication and teamwork. The experience of Unicamp demonstrates that the establishment of a skills laboratory within a university hospital contributes significantly to the advancement of medical education, the consolidation of pediatric emergency residency training, and the improvement of healthcare delivery. Medical simulation, fully integrated into the curriculum, has proven to be an essential tool not only for developing clinical competencies but also for fostering professional collaboration, thereby strengthening the overall quality of pediatric emergency care.

AI chatbots have demonstrated variable performances across biological disciplines in medical education, particularly in multiple-choice and image-based assessments. However, their performance in addressing discipline-specific and image-based questions in biology remains unexamined. This study evaluated the accuracy and reliability of chatbots in answering biological questions from the Progress Test, a medical assessment applied across ten universities. We conducted an observational cross-sectional study by inputting 180 questions into the chatbots and categorising them according to morphology, function, and aggression. Each question was assessed for correctness across multiple chatbot attempts, and logistic regression and hierarchical clustering were applied to identify performance patterns. Although the chatbots answered functional and morphological questions accurately (from 85% (Gemini) to 91.7% (ChatGPT-4)), their accuracy decreased significantly for questions involving biological aggression and visual content. The agreement between chatbot responses remained weak, and Co-pilot displayed the lowest concordance. Chatbot accuracy decreased significantly in aggression-related disciplines and image-based questions. Logistic regression confirmed that the presence of images reduced the odds of correct answers by up to 17.6% (ChatGPT-4). Hierarchical clustering distinguished the two distinct response patterns, further validating these findings. These results highlight the potential of chatbots in medical education while emphasising their limitations in handling image-based and aggression-related content.

PurposeTrauma leagues (TLs) are extracurricular programs that offer medical students supervised exposure to trauma and acute care surgery, mentorship, and participation in other academic activities. TLs are fully approved medical schools, and currently, over 100 TLs exist in Brazil. We hypothesized that the performance/competence of medical students who participated in TLs was superior compared to non-participants. This study evaluated and compared the cognitive performance and technical skills of the two groups.MethodsThis retrospective cohort study evaluated the performance of TL medical students to non-TL alumni from 2005 to 2017, using the students’ academic performance coefficient, Clinical Competence Assessment, and Progress Test results. SigmaPlot 12.0 software was used to perform statistical analyses, including Mann–Whitney comparison tests and the Kruskal–Wallis test to confirm the data.ResultsOf the 1366 medical students who graduated from a Brazilian university, 966 were included, with 17.9% having participated in TL. Compared to non-TL participants, TL students demonstrated better cognitive performance according to the performance coefficient (p = 0.017) and Progress Test result (p < 0.001), and higher achievement in the Clinical Competence Assessment (p < 0.001).ConclusionThe academic performance of TL students was superior to that of non-TL students at the University of Campinas (Unicamp), suggesting a positive impact of TL in the preparation of future doctors. The study findings suggest that participation in TL at Unicamp was beneficial in preparing better doctors and should be considered by medical schools worldwide.Evidence level: II (Retrospective cohort).

This study addresses aspects that should be considered in every investigation concerning the reality of the subject being investigated, which in turn provide the basis for the procedures adopted to carry out the research. It speaks about the analysis of the procedures chosen to carry out the research. It is assumed that this care should be taken by the researcher at the moment the research procedures are being defined and made explicit. It is argued that the consonance between the ontological and epistemological dimensions of “what” and “how” to investigate the subject of investigation confers a degree of confidence to the research findings. The search for that confidence transcends analyses based only on calculations and explanations of methodological procedures, regardless of how well founded they are. This study addresses mathematics education specifically, adopting a phenomenological perspective. It is focused on the constitution of mathematical idealities and of mathematics as a science under the perspective of the Husserlian phenomenological conception of reality and knowledge. Characteristics of a phenomenological pedagogy are presented, which is carried out through work that is always intentional, with the educator taking account of what occurs with himself/herself, with the life world of the school, and with the student. The student is seen as a person and as being with others, his/her classmates, and the theme is addressed in the context of the field of inquiry under focus, with the teacher and with his/her “surroundings”.