• 의학교육논단
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• 제12권1호
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• pp.9-22
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• 2010

It is the most important thing at present for physicians to posses the qualification of medical professionalism. A lot of medical schools have made all-out efforts to develop leaders of medicine, who will be able to meet the needs of medical professionalism in this complex medical environment. The purpose of this study is to review the cognitive base of medical professionalism leading the curriculum development of medical professionalism. The discussion of medical professionalism started in the 20th century. During the 1960s, there were attempts to reshape the concepts and attributes of medical professionalism. The government began to intervene in the autonomy of physician and the self regulation policy of medical society in 1970s. Physician may be asked to play as a healer and professional (what?) during their medical practice. The fundamental role of healer such as care, compassion, honesty, integrity, confidentiality, ethical behaviors, and respect with patients were nothing fresh to tell even though the age was changed. The attributes of professional which are physician's autonomy, self regulation, teamwork, and responsibility to society has been changed dramatically over the past five decades. In general, medical educators agreed that professionalism is demonstrated through a foundation of clinical competence, communication skills, and ethical and legal understanding, upon which is built application of the principles of professionalism: excellence, accountability, altruism, and humanism. If physicians fail to show professionalism in society, they will confront the crisis which can be under the government control. The only way to keep their autonomy is to practice medical professionalism. So far today, medical schools have laid more stress on competence than value standards in educational systems and it was restricted for medical students to learn the value standards for medical practice. To understand and practice the medical professionalism, it is the most realistic way to solve the complicated medical problems.

• 의학교육논단
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• 제12권1호
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• pp.23-31
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• 2010

Medical humanities has become a third area of medical education following basic and clinical medicine. Also, in the national evaluation of medical schools, medical humanities education is an important factor. However, there are many difficulties in teaching medical humanities in medical schools. First, it is still an unfamiliar education area to medical schools and professors. Second, still, there is no consensus on the definition and contents of this education. Third, it is usually very difficult to find professors who have interest and the ability to teach medical humanities. Fourth, even medical students do not understand why they should study medical humanities and sometimes do not eagerly participate in class. This paper suggests some solutions for these problems. First, medical humanities need to be divided into sections according to how easily the contents can be accepted by existing medical education system and apply these sections in the introduction of this education gradually and in stage. One example of the division can be as follows: Group 1) medical ethics and medical law which can be most easily accepted. Group 2) medical communication skills which can be relatively easily accepted. Group 3) medical history and medical professionalism which is relatively difficult to accept, and Group 4) medical philosophy, medicine and music, medicine and literature, medicine and art, medicine and religion, etc. which is the most difficult to accept. In this paper, four things are suggested. Second, divide the contents into mendatory courses and elective courses. Third, allocate the contents throughout the four years from the first year though the fourth year according to the spiral curriculum model. This paper reports some new ideas and methods for medical humanities education. First, to stimulate students' participation, several methods were applied in a large size lecture and student projects. Second, the emphasis of writing in class and evaluation were discussed. Third, the provision of hands on experience is more emphasized than lectures. Fourth, inviting some doctors who work in non-medical areas such as journalism, pharmaceutical industry, etc is suggested. Trial and error is inevitable in this education, but it is essential in molding a good doctor, so medical professors who are interested or in charge of this medical humanities education need to share their ideas and experiences.

• 의학교육논단
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• 제22권1호
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• pp.46-54
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• 2020

The purpose of this study was to examine professors' and students' perceptions of curriculum that fosters character in medical school. 'Character' can be defined as a desirable personality and the ability to be a good person. A total of 264 subjects (professors=131, students=133) participated in the study. Survey questions were divided into the three parts (education needs, factors of character, and curriculum management strategy). Data were analyzed by using t-test and one-way analysis of variance. Both professors and students recognized the need for character education. Professors were more aware of the need for education than students (t=4.35, p<0.01), and clinical professors were more aware of the need for education than basic medical science professors (t=3.48, p<0.01). Premedical students were more aware of the need for character-centered education than medical students in the later stages of their education (t=3.41, p<0.01). Professors and students commonly referred to 'consideration and communication' as the most important factor in building character. Professors considered 'self-regulation' more important than the students recognized, while students perceived 'wisdom' as more important than the professors did. There was a difference in preference for curriculum development (creating new subjects vs. revising existing subjects) between the two groups. However, both groups agreed on the teaching and evaluation methods. In conclusion, both groups acknowledged the need for character education. However, there were differences in perception on the major factors of character and preference for curriculum development. The results of this study may assist in designing character education in medical education.

• 의학교육논단
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• 제14권1호
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• pp.51-56
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• 2012

Purpose: Precepted video review (PVR) has been considered one of the methods for the remediation of clinical performance examinations (CPX). This study quantified the effect of brief PVR on CPX scores. Methods: For two years, final-year students (61 students in the 1st year's cohort and 54 in the 2nd year's cohort) participated in CPXs. The scores on the initial CPX were announced to the students shortly after that CPX administration. There was no PVR after the initial CPX in the 1st year. All participants of the 2nd year were notified of the opportunity to voluntarily receive brief PVR after the initial CPX. Several months after the initial CPX, the students took the latter CPX in both years. The differences of scores between initial and latter CPX were compared in good performers and poor performers of the initial CPX. Results: Thirteen poor performers and 8 good performers received PVR in the 2nd year. In the 1st year, history taking (Hx), physical examination, and patient physician interaction (PPI) scores of the good performers of the initial CPX were significantly decreased on the latter CPX. In the 2nd year, the Hx and PPI scores of the good performers of the initial CPX, who received PVR, were significantly decreased at the latter CPX. The Hx and PPI scores of the poor performers of the initial CPX were significantly increased at the latter CPX in both years regardless of PVR. Conclusion: The changes in CPX scores according to PVR did not show any consistent trend. Brief PVR appears to be not sufficient for improving CPX scores.

• 의학교육논단
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• 제14권1호
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• pp.25-36
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• 2012

For decades medical educators have continually emphasized medical professionalism, which is reflective response to the challenges of a rapidly changing medical environment. This study aimed to review the experience of implementing medical professionalism education at Yonsei University College of Medicine (YUCM). YUCM introduced a new curriculum in 2004 designed by Curriculum Development Project 2004 (CDP2004), a project that was launched in 2001. CDP2004 reorganized lectures as organ-based integrated lectures, introduced an introductory course for clinical medicine and medical humanities courses for premedical and medical students. Problem-based learning (PBL), elective courses, and self-study sessions in the afternoon were implemented in order to equip students with a self-directed learning attitude as medical professionals. Professors were asked by the CDP2004 curriculum to spend more time on student education and to adopt new teaching methods. Experiences of the CDP2004 curriculum reveals 1) difficulty of motivating professors to be PBL tutors 2) students' dissatisfaction with the medical humanities course (major critique was that the course was impractical and unrealistic), and 3) students' optimistic understanding about their future role as medical professionals in influencing and helping people in spite of their perception of the general medical environment not as promising. To foster professionalism, the following are necessary in our experiences: 1) faculty development of medical humanities and medical professionalism, 2) establishment of an environment throughout the whole institution to support medical professionalism education and to integrate the concept into praxis, 3) emphasis on the fact that medical professionalism education is not contradictory to biophysical medical education.

• 의학교육논단
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• 제14권1호
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• pp.37-49
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• 2012

The main purpose of this study is to examine the improvement and discourse of the medical education system in Korea since 1990. In particular, this study, focusing on the graduate medical education system initiated in 2002, has explored the discussions that led to the system's establishment and what the context of those discussions. To meet this objective, this study analyzed research report related to the medical education system authored by members of the government and medical community, suggestions to the government, discussion materials, and data with regard to the Medical (Dental) Education Eligibility Test. The improvement of the medical education system in Korea has been an important issue in education reform by the expansion of the number of years of higher education, the requirements for increased levels of professional knowledge by improving public educational standards, and the basic formation policy of higher education consisting of graduate school, special graduate school, and professional graduate school. Nevertheless, the views of the government and the medical community on improving medical education system have made an obvious difference. This was due to different aims about how to improve the medical education system and different perception of the degree and medical education system. The medical community at least tended to prefer the status of academic positions over professional positions. The policy of medical education for people with a bachelor's degree which was introduced in 2002 spread to many colleges of medicine based on the government's administrative and financial support policy. Even so, the absence of accompanying policy by the relevant government agencies and department of education, which could have ensured the success of the system, has led to continued debate. In conclusion, without a consistent and persistent government policy, the graduate medical education system has led to confusion in many medical institutions. Above all, an evidence-based policy decision and policy approach based on a long-term perspective are necessary in order to improve the medical education system.

• 의학교육논단
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• 제16권3호
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• pp.111-118
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• 2014

Over the last century, medical education in North America has evolved by identifying educational challenges within its own socio-cultural context and by appropriately responding to these challenges. A discipline-based curriculum, organ-system or integrated curriculum, problem-based curriculum, and competency-based curriculum are historical examples of the educational solutions that have been developed and refined to address specific educational challenges, such as students' lack of basic scientific knowledge, lack of integration between scientific knowledge and clinical practice, and lack of clinical practice. In contrast, Korean medical education has evolved with the influence of two forces: (1) the adoption of educational solutions developed in North America by pioneers who have identified urgent needs for medical education reform in Korea over the last three decades, and (2) the revitalization of Korean medical schools' curricula through medical education accreditation and national medical licensing examination. Despite this progressive evolution in Korean medical education, we contend that it faces two major challenges in order to advance to the next level. First, Korean medical education should identify its own problems in medical education and iteratively develop educational solutions within its own socio-cultural context. Secondly, to raise reflective doctors who have scientific knowledge and professional commitment to deal with different types of medical problems within a continuum from well-defined to ill-defined, medical education should develop innovative ways to provide students with a balanced spectrum of clinical problems, including uncertain, ill-defined problems.

• 의학교육논단
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• 제16권3호
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• pp.126-131
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• 2014

The purpose of this study is to analyze the medical education system of Korea and to propose a method of curriculum redesign. Although there have been many attempts by medical educators to improve the quality of medical education, the results have not been fruitful. First, there exists a limitation to the dualistic curriculum design based on Flexnerianism, and thus, this model does not provide an integrated experience to medical students. Therefore, we propose a unidimensional model for curriculum redesign. Second, it is impossible to promote excellence in medical education without solving the structural problems of teaching and learning, such as the teaching competency of the faculty, large-scale lectures, and team teaching systems. A curricular strategy that emphasizes mutual interaction and teaching accountability is necessary to promote meaningful learning. Third, the current clinical training system, the circulation model, provides incomplete training as well as a lack of sequence and articulation experiences. This system needs to be redesigned in a way that allows only those students who have mastered both the knowledge and the application of medical education to advance to the next step. Fourth, norm-referenced assessments of a medical college distort the learning process and create unconstructive system energy. A criterion-referenced assessment that values cooperation, independent study, and intrinsic motivation is more important for the reliability and validity of the assessment. Medical students should not focus on formative and informative learning. Medical colleges should investigate the multifaceted potential of the students and provide transformative learning to grow students into change agents. For this to take place, curriculum redesign-not new methods of medical education-is required.

• 의학교육논단
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• 제15권2호
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• pp.87-92
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• 2013

The purpose of this study was to assess third-year medical students' competency for development or revision of the undergraduate curriculum and assessments. One hundred and twenty-seven third-year medical students at the Pusan National University were included in the study. After third- and fourth-year students took a common written examination, clinical performance examination (CPX), and objective structured clinical examination (OSCE) with common items as a summative assessment, the third-year students' competency was compared with 132 forth-year students' results. The correlation of the written examination and CPX/OSCE was analysed, and the summative results were compared with the grade point average (GPA) through the second year, CPX/ OSCE in the second year, and GPA in the clerkship. On the written examination, the third-year students' mean score was lower than the fourth-year students' by over 11 points, whereas the gap in the CPX/OSCE was 4 points and there was no difference in the OSCE. There was a moderate correlation between the written examination and the CPX/OSCE scores (R=0.371, p<0.01). The written examination was highly correlated with GPA through the second year, which mainly evaluated medical knowledge (R=0.771, p<0.01). A relatively high correlation was observed between CPX/OSCE scores and GPA in the clerkship (R=0.641, p<0.01). The summative CPX/ OSCE scores showed a moderate correlation with formative CPX/OSCE scores in the second year (R=0.464, p< 0.01). The third-year students' score was quite low on the written examination and slightly low on the CPX/OSCE compared to that of the fourth-year students. The written examination and CPX/OSCE cannot replace each other and should be combined with other methods of evaluation to measure competency. Early OSCE and workplacebased assessment should be useful in the early assessment of clinical skills competency.

• 의학교육논단
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• 제10권2호
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• pp.25-44
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• 2008

Objectives: Through using of the strong research method like a Randomized Controlled Trial: RCT, we have to heighten quality of Medical Education study. I'd like to introduce "CONSORT", which stands for Consolidated Standards of Reporting Trials. Contents: Preventive Service Task Force(200l) in USA proposed Levels of evidence for enlarging evidence-based Practice: EBP. And the CONSORT was introduced, which encompasses various initiatives developed by the CONSORT Group to alleviate the problems arising from inadequate reporting of randomized controlled trials (RCTs). the CONSORT has 13 guides like these: 1. How participants were allocated to interventions 2. Scientific background and explanation of rationale 3. Eligibility criteria for participants. The settings and locations where the data were collected. 4. Precise details of the interventions intended for each group and how and when they were actually administered 5. Specific objectives and hypotheses 6. Clearly defined primary and secondary outcome measures, When applicable. any methods to enhance the quality of measurements (e.g., multiple observations, training of assessors) 7. How sample size was determined. When applicable, explanation of any interim analyses and stopping rules 8. Method used to generate the random allocation sequence, Details of any restriction [of randomization] 9. Method used to implement the random allocation sequence 10. Who generated the allocation sequence, who enrolled participants. and who assigned participants to their groups 11. Whether or not participants, those administering the interventions, and those assessing the outcomes were blinded to group assignment. If done, how the success of blinding was evaluated 12. Statistical methods used to compare groups for primary outcome(s), Methods for additional analyses, such as subgroup analyses and adjusted analyses 13. Flow of participants through each stage (a diagram is strongly recommended) Specifically, for each group report the numbers of participants randomly assigned. receiving intended treatment, completing the study protocol. and analyzed for the primary outcome. Results and Conclusion: Randomized Controlled Trial: RCT guided of CONSORT will contribute to do stronger evidence-based medical studies.