• Korean Medical Education Review
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• v.21 no.1
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• pp.51-58
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• 2019

Although 'assessment for learning' rather than 'assessment of learning' has been emphasized recently, student learning before examinations is still unclear. The purpose of this study was to investigate pre-assessment learning activities (PALA) and to find mechanism factors (MF) that influence those activities. Moreover, we compared the PALA and MF of written exams with those of the clinical performance examination/objective structured clinical examination (CPX/OSCE) in third-year (N=121) and fourth-year (N=108) medical students. Through literature review and discussion, questionnaires with a 5-point Likert scale were developed to measure PALA and MF. PALA had the constructs of cognitive and meta-cognitive activities, and MF had sub-components of personal, interpersonal, and environmental factors. Cronbach's ${\alpha}$ coefficient was used to calculate survey reliability, while the Pearson correlation coefficient and multiple regression analysis were used to investigate the influence of MF on PALA. A paired t-test was applied to compare the PALA and MF of written exams with those of CPX/OSCE in third and fourth year students. The Pearson correlation coefficients between PALA and MF were 0.479 for written exams and 0.508 for CPX/OSCE. MF explained 24.1% of the PALA in written exams and 25.9% of PALA in CPX/OSCE. Both PALA and MF showed significant differences between written exams and CPX/OSCE in third-year students, whereas those in fourth-year students showed no differences. Educators need to consider MFs that influence the PALA to encourage 'assessment for learning'.

• Korean Medical Education Review
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• v.21 no.1
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• pp.41-50
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• 2019

The aim of this study is to analyze the current status and performance evaluation systems of faculty in Korean medical colleges and professional graduate medical schools (called medical schools). We developed a research tool based on previous studies and distributed it to 40 medical schools from July to October 2017. The response rate was 100%. We calculated the number of faculty members and analyzed the faculty evaluation systems and awareness according to national and private medical schools. As of 2017, the number of medical faculty in Korea was 11,111 (4,973 faculty were employed by their alma mater, which is 44.76% of the total), with non-medical doctor faculty accounting for 754 of the total. The medical schools reflect research achievements as most important for re-appointment and screening to promote faculty, and the area of education is secondary excepting clinical faculty of private medical schools. However, important issues in the faculty evaluation deal with the relevance of research achievement and the need for qualitative assessment. Some medical schools revised or have been revising the faculty evaluation system in areas such as minimum standards of education for promotion and separation of promotion and tenure review. Opening non-tenure track lines for faculty show positive effects such as increasing the number of positions for hire and easing the financial burdens of medical schools. Downfalls include inconsistencies between the responsibilities and actual practices of tenure not being available and the instability of faculty's status. In conclusion, medical schools need to prepare a faculty evaluation system that fits the position of faculty members and attempt to establish a reasonable compensation system.

• Korean Medical Education Review
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• v.21 no.1
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• pp.1-12
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• 2019

This study is a narrative review introducing global trends in patient safety education within medical schools and exploring the status of Korean education. Core competences for patient safety include patient centeredness, teamwork, evidence- and information-based practice, quality improvement, addressing medical errors, managing human factors and system complexity, and patient safety knowledge and responsibility. According to a Korean report addressing the role of doctors, patient safety was described as a subcategory of clinical care. Doctors' roles in patient safety included taking precautions, educating patients about the side effects of drugs, and implementing rapid treatment and appropriate follow-up when patient safety is compromised. The Korean Association of Medical Colleges suggested patient safety competence as one of eight essential human and society-centered learning outcomes. They included appropriate attitude and knowledge, human factors, a systematic approach, teamwork skills, engaging with patients and carers, and dealing with common errors. Four Korean medical schools reported integration of a patient safety course in their preclinical curriculum. Studies have shown that students experience difficulty in reporting medical errors because of hierarchical culture. It seems that patient safety is considered in a narrow sense and its education is limited in Korea. Patient safety is not a topic for dealing with only adverse events, but a science to prevent and detect early system failure. Patient safety emphasizes patient perspectives, so it has a different paradigm of medical ethics and professionalism, which have doctor-centered perspectives. Medical educators in Korea should understand patient safety concepts to implement patient safety curriculum. Further research should be done on communication in hierarchical culture and patient safety education during clerkship.

• Korean Medical Education Review
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• v.21 no.3
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• pp.143-149
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• 2019

In 2018, The Ministry of Health and Welfare announced its first comprehensive plan for patient safety, which included the imperative to develop a patient safety curriculum for students studying to become health professionals. The aim of this study is to assess current patient safety education and points of consideration for introducing new curriculum. An online survey was used to understand the status of patient safety education in medical schools, and key informant interviews and focus group interviews were used to collect qualitative data on the experience of patient safety education. The results of the online survey from 16 out of 40 medical schools (40% response rate) and the qualitative data analysis were integrated and analyzed. Twelve schools (75%) had established courses related to patient safety. The qualitative responses suggest that patient safety education is appropriate both before and after clinical training through a variety of educational methods, and that the topics should be linked with clinical training. The challenge of securing lecture time to address patient safety was mentioned as a realistic obstacle. When patient safety education is integrated in future curriculum, it is necessary to consider it as a priority. Moreover, in the early stages of introducing patient safety education, a step-by-step, policy-based approach is required for seamless adoption and settlement.

• Korean Medical Education Review
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• v.21 no.3
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• pp.150-154
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• 2019

When standardized patients (SPs) are used for educational purposes, the authenticity of role play and the quality of feedback are essential requirements of SPs. This study was conducted to investigate medical students' assessment of SPs and to identify the components of SPs' performance that were most strongly correlated with patient-physician interaction score. One hundred and forty-two fourth-year medical students were asked to complete the Maastricht Assessment of Simulated Patients (MaSP) at the end of a clinical performance examination. SPs evaluated the patient-physician interactions using a 4-point Likert scale (1=poor to 4=excellent). Medical students' assessment of SPs using the MaSP was positively correlated with patient-physician interactions (r=0.325, p<0.01). Items addressing the authenticity of role play (e.g., "SPs appear authentic," "SPs might be real patients," and "SPs answer questions in a natural manner") were closely correlated with patient-physician interactions (p<0.001, p=0.027, and p=0.017, respectively). These results showed that the MaSP appears to be a useful instrument for evaluating SPs' performance and that the authenticity of SPs' performance was positively correlated with medical students' interactions. In order to improve patient-physician interactions, medical students should be given opportunities to practice their skills with SPs who have been trained to portray patients with a specific condition in a realistic way.

• Korean Medical Education Review
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• v.21 no.2
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• pp.100-111
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• 2019

There are several dimensions of academic burnout experienced by medical and health science college students. The purpose of this study was to examine the effects of academic relationships on academic burnout. Data was collected from 476 Eulji University students using an online survey over 4 days in April of 2018. Of the 264 respondents, 111 studied medicine (42.0%), 105 studied nursing (39.8%), and 48 studied clinical pathology (18.1%). The questionnaire was composed of the following sections: demographics (four questions), general life characteristics (seven questions), academic enthusiasm (eight questions), academic relationships (15 questions), and academic burnout sub-dimensions (partially revised Maslach Burnout Inventory-Student Survey Scale) (11 questions). T-tests and one-way analysis of variance were performed to illustrate the differences among the three departments. The effects of academic relationships and academic enthusiasm on academic burnout were analyzed using linear regression. Comparing the three departments, academic burnout was not found to be statistically significant (p=0.296). However, medical students' academic enthusiasm was significantly lower (p<0.001) and academic relationships were significantly higher (p<0.001) than nursing and clinical pathology students. The difference in academic burnout among the three departments was not significant. However, medical students have stronger academic relationships, while nursing and clinical pathology students were more focused on academics. Relationships and academic enthusiasm contribute to reducing academic burnout. Therefore, strategies need to be developed to deal with academic burnout considering relationship factors.

• Korean Medical Education Review
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• v.21 no.2
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• pp.112-122
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• 2019

The purpose of this study was to identify the current status of the new graduate nurses' education system, to establish guidelines for the education of new graduate nurses, and to provide dates for the improvement of the education system. Eighty-nine hospitals participated in the survey from July to August 2018. The questionnaires consisted of 24 items including general characteristics, new graduate nurses' education system, operation of nursing education teams, and preceptorship programs. The average duration of education/training for new graduate nurses was 57.3 days, and 26.6%-58.5% of general hospitals, hospitals, and long-term care hospitals had less than 30 days of new graduate nurses education/training, which is shorter than the education/training period of tertiary hospitals. There were new nursing education guidelines in 88.8% of all medical institutions and 58.6% of them had nursing education teams. Most of the personnel in charge of nursing education were not dedicated to education. A total of 87.6% of the all participating medical institutions had preceptorship programs, while 23.1%-33.3% of hospitals and long-term care hospitals did not. The breakdown of preceptorship programs showed 68.4% as "preceptor and preceptee are in charge of one team, and preceptor is teaching preceptee," and 19.7% were "preceptor and preceptee are in charge of each team, and preceptor is teaching preceptee at the same time." These results show that standardization and management of new graduate nurses' education programs is necessary. For the standardization and management of new graduate nurses' education programs, joint efforts of nurses' associations and support from the government should be encouraged.

• Korean Medical Education Review
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• v.21 no.2
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• pp.92-99
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• 2019

The aim of this study was to use narrative inquiry to explore the experiences of medical students who faced expulsion, military service, and readmission, and their journeys of identity formation. Three medical students were recruited via snowball sampling, and each participant was interviewed twice. According to the sequence of experiences, their stories were summarized as follows: the process of being expelled, the military service experience and readmission process, and the present. Before all three students were expelled, they lived dissolute lives free of concern from the entrance examination and failed to cope well with dropping out. They felt that military experience had helped them develop interpersonal skills in the clinical setting and the strength to withstand a difficult crisis. Two students were motivated to become doctors after military service, but the other was not. They had reflected deeply over their unique experiences. The scars imprinted from their experiences became a means of stimulation, and they ultimately acquired the resilience and ability to accommodate for and counteract their weaknesses. This appears to have been an important influence on their identity formation. The narrations of their rare experiences can help medical educators more fully understand and support medical students through difficulties, specifically with regard to academic failure or expulsion. These findings may prompt medical professors to think about the kind of guidance or motivation that could help students before expulsion, rather than assuming that they are simply lacking academic ability.

• Korean Medical Education Review
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• v.23 no.2
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• pp.118-127
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• 2021

Due to the coronavirus disease 2019 pandemic, the new norm of online learning has been recognized as core to medical institutions for academic continuity, and students are expected to be motivated and engaged in learning while maintaining distance from other peers and educators. To facilitate students' and educators' newly defined roles in online medical education settings, it is crucial to understand how students are actively motivated and engaged in learning. Hence, this study explored medical students' motivational regulation profiles and examined the effects of motivational regulation strategies (MRS) on cognitive learning and learning engagement for online learning. Data were collected after the end of the first semester in 2020 from a sample of 334 medical students enrolled at a public university school of medicine. Latent profile analysis indicated three subgroups with different motivational regulation profiles: the low-profile, medium-profile, and high-profile groups. Regarding different MRS patterns in the high-profile group, mastery self-talk, performance approach self-talk, and the self-consequating strategy appeared to be most applicable for regulating learners' motivation. Analysis of variance showed that the profile groups with higher levels of MRS use were connected to a higher willingness to use cognitive learning strategies and a higher degree of engagement in online learning. The findings of this study emphasize the use of specific sets of MRS to support learning motivation and the need to design effective self-regulated learning environments in online medical education settings.

• Korean Medical Education Review
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• v.23 no.2
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• pp.80-89
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• 2021

Professional identity formation (PIF) is an essential concept in professional education. Many scholars have explored conceptual frameworks of PIF and conducted empirical studies to advance an understanding of the construct in medical education. Despite its importance, it is unclear what educational approaches and assessment practices are actually implemented in medical education settings. Therefore, we conducted a literature review of empirical studies reporting educational practices for medical learners' PIF. We searched the Web of Science database using keywords and chose 37 papers for analysis based on inclusion and exclusion criteria. Thematic analysis was conducted. Most empirical papers (92%) were from North America and Western Europe and used qualitative research methods, including mixed methods (99%). The papers reported the use of reflection activities and elective courses for specific purposes, such as art as an educational activity. Patient and healthcare experiences were also found to be a central theme in medical learners' PIF. Through an iterative analysis of the key themes that emerged from the PIF studies, we derived the following key concepts and implications: (1) the importance of creating informal and incidental learning environments, (2) ordinary yet authentic patient experiences, (3) a climate of psychosocial safety in a learning environment embracing individual learners' background and emotional development, and (4) the reconceptualization of PIF education and assessment. In conclusion, research on PIF should be diversified to include various cultural and social contexts. Theoretical frameworks should also be diversified and developed beyond Kegan's developmental framework to accommodate the nonlinear and dynamic nature of PIF.