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fective way to evaluate EM examinees medical knowledge, communication, and procedural skills. Technology issues was a limitation of our telesimulation experience. Future studies on telesimulation use in global EM training would be useful.Cerebrospinal fluid flows around and into the brain, driven by intricate mechanisms, with profound implications for human health. According to the glymphatic hypothesis, in physiological conditions, cerebrospinal fluid flows primarily during sleep and serves to remove metabolic was