• 제목/요약/키워드: 논단

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개발도상국 의사들의 역량강화를 위한 임상연수 프로그램의 효과 (The Effect of a Clinical Training Program for Capacity Building of Medical Doctors in a Developing Country)

  • 윤현배;신좌섭;이승희;김도환;김은정;조계현;황진영
    • 의학교육논단
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    • 제17권2호
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    • pp.78-87
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    • 2015
  • Mongolia is suffering from the inadequate capacity of medical doctors due to a poor education and training system. The purpose of this article is to evaluate the effect of a clinical training program for capacity building of medical doctors in Mongolia, and to suggest an effective model for continuing professional development in developing countries. Based on the results of a needs assessment, Korean and Mongolian medical experts developed a clinical training program and trained the trainers on 32 topics regarding major clinical problems in 6 specialties, including cardiology, endocrinology, pediatrics, obstetrics and gynecology, neurology, and emergency medicine. Surveillance survey and pre/post-test were used on every topic to evaluate the satisfaction and achievement, respectively, of the trainees. Six months after the clinical training program, we interviewed a sample of medical professionals to evaluate the change and impact. A total of 612 (person-year) medical doctors participated in the training, and the average score for satisfaction was 7.69 out of 8. The average score of the pre-test was 46.9 out of 100, while the post-test was 82.4. After the training, the medical doctors were applying their new knowledge and skills to their practice, and using the materials as guidelines, which improved their practice and increased patient satisfaction. They also started their own training program and adopted new equipment at their hospitals. The satisfaction and achievement of the trainees were very high, and there was significant change in the medical practice, education system, and infrastructure after the training program. This training program can be an effective model for capacity building of medical doctors in developing countries.

의과대학 교수들의 탈진: 부산·경남지역 3개 의과대학 교수 탈진 빈도와 양상 (Burnout among Medical School Faculty Members: Incidence and Demographic Characteristics at Three Medical Schools in the Busan and Gyeongnam Area of Korea)

  • 서지현;김부경;배화옥;임선주;김경한
    • 의학교육논단
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    • 제16권2호
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    • pp.67-76
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    • 2014
  • Few studies have examined burnout among the faculty of medical schools in the Republic of Korea. The aim of this study was to determine the level of burnout and its associated factors among the faculty members of three medical schools in the Busan-Gyeongnam area, and to summarise the available literature on burnout. We conducted the survey using a validated questionnaire that incorporated the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) as well as questions about demographic characteristics, working experience, health, lifestyle, most time spent and most difficult work, and suicidal ideation and job quitting ideation of the survey participants. MBI-HSS scores were analysed in the three dimensions of emotional exhaustion (EE), depersonalization (De), and personal accomplishment (PA). Through the survey, the 186 professors, 49% among the total, provided data which were included in the present analysis. More than thirty per cent (37.1%) of the professors reported at least 1 symptom of burnout. For burnout dimensions, 11.8% of the respondents scored high for EE burnout, 25.3% for De, and 14.5% for PA, with 1.6% scoring high on all three dimensions of burnout. High burnout was found to be strongly associated with several of the variables under study, especially hours worked per week, self-rated health, career (range, 4 to 9 years), and age (range, 50 to 59 years). The EE score was highest for the professors who chose 'patient care' as the most difficult type of work. This study showed that just over one-third of professors have at least 1 symptom of burnout and working more hours per week, short length of work (years), and especially suicidal ideation seem to be associated with the burnout of medical school faculty members in the Busan-Gyeongnam area. In summary, a greater risk of burnout of physicians (including medical professors) seems to be associated with specialties at the front line of care, working more hours per week, work-life imbalance, low self-efficacy, depression, and conflicts with colleagues and patients.

현대의학과 환상통 - 이응준의 『약혼』을 중심으로 (Modern Medicine and Phantom Pain)

  • 반재유
    • 의학교육논단
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    • 제13권1호
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    • pp.25-34
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    • 2011
  • Modern medicine has early experienced the absence of mimesis and has been trying to replace the absence with objective grounds and experimental data. However, as medicine became science, the crisis of medicine spread more widely. Microscopic powers and violences are invisible, but individuals are powerless and vainly unable to resist. The anguish or introspection about the situation is sometimes described in stories such as An Engagement by Lee Eung Jun. An Engagement is mentioned in this article due to the writer's attitude, which shows his introspection and desire for harmony through the wounds of each trivial character. The writer is unceasingly talking about suffering people in his story and his seriousness enables readers to find his stronger sympathy over life and death than in any other medical stories. In fact, it is impossible for readers to comprehend the confusing propositions which the writer pours out, and even uncomfortable to read the story. Nevertheless, the propositions are always in contact with reality. Perhaps it is not the writer's confusing propositions that make us uncomfortable. It might be ourselves who are always alienated and starved. We can say that the characters' pains and wounds are phantom pains caused by the absence of mimesis. Since there is no affected area, their pains cannot be measured by only scientific medicine. However, the current medical profession regards objective research evidences as absolute truth and allows them to be the sole criterion. Although scientific skills such as DNA analysis and MRI scan can be the substitutes for doctors' judgment, so much of medicine is still interpersonal relationships. An Engagement. As a person promises to marry another, as all beings together in the world promise to subordinate to one another, every subject is consistently a valuable part of each other for the writer's eyes. He is aware that it is originally impossible to get engaged to the world, but he does not give up the possibility of genuine communication. In today's post-modernism society, where a large number of pathological views define the members and the world itself, endless questioning of existence and digging into pathology will be the only way to reduce the gap between individuals and their world. This article does not say that a literary work will lead the change of medical paradigm. It sprang from a desire for medical humanities to gain more interest of the medical field, where the encounter between literature and medicine is still unfamiliar, and to make medical education recognize the importance of humanities. Starting with this work, I believe that the humanities will help us to find the solution to the age of absence of mimesis and to the crisis of medicine.

가정의학 임상실습과정에 대한 구조화된 평가 (Structured Assessment to Evaluate a Family Medicine Clerkship Program)

  • 박은주;이상엽;임선주;윤소정;감비성;백선용;김윤진;우재석;이정규;정동욱;조영혜;이유현;탁영진
    • 의학교육논단
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    • 제19권1호
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    • pp.47-55
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    • 2017
  • This study was conducted to analyze the strengths and weaknesses of a 3-week family medicine clerkship program based on the results of an online survey taken by the students (N=127) and a structured interview with a focus group (n=10), aimed to improve the quality of the clerkship program. The online survey contained questions pertaining to goals, schedule, contents, arrangement, atmosphere, environment, evaluation, and satisfaction regarding the clerkship. The focus group interview addressed the schedule and achievements of the program. Scores were reported on a 5-point Likert scale. Most students were highly satisfied with the overall quality of the clerkship. The structured interview results showed that 97.6% of the clerkship program was executed according to the schedule. The focus group reported a perfect score of 5 points on several measures including: accomplishment of the educational goals of the family medicine clerkship, providing many chances to obtain medical histories and perform physical examinations on real patients, experience with various symptoms and diseases, positive attitudes of faculty members when teaching, notification of the guidelines for evaluation beforehand, well-constructed and effective clerkship schedule, and reflection of student feedback. However, the focus group gave low scores on: support for health accidents of students, access to patient information, enough opportunities to practice clinical skills, appropriate rest facilities for students, and fairness of clerkship evaluation process. In conclusion, the structured evaluation performed after the 3-week clerkship program motivated students and helped them ensure an efficient clerkship. This structured evaluation also suggested basic data to make the professor who is subject of the assessment. This study shows that structured assessment is an effective method which can be used to improve the quality of clerkships.

의대생과 비의대생의 학업 스트레스와 영향요인에 관한 연구 (Academic Stress and Its Influencing Factors among Medical and Non-Medical Students)

  • 성안나;허수연;윤정교;이지연;최민기;전종하;김재훈;박귀화;임정수;고광필;정재훈;최윤형
    • 의학교육논단
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    • 제23권2호
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    • pp.128-138
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    • 2021
  • This study examined the relationships among personality traits, coping efficacy, and academic stress in medical and non-medical students in South Korea, and investigated the mediating effect of coping efficacy in the relationship between personality traits and academic stress. The study group comprised 210 medical students and 175 non-medical students. They were asked to rate their personality traits, coping efficacy, and academic stress. The data were analyzed using IBM SPSS ver. 26.0 (IBM Corp., Armonk, NY, USA) and AMOS ver. 26.0 (IBM Corp.). Medical students scored higher for examination stress and lower for extroversion than non-medical students. In both groups, extroversion and conscientiousness positively affected coping efficacy, while neuroticism influenced it negatively. Neuroticism directly influenced all types of academic stress in both groups, while extroversion and conscientiousness only had direct effects on examination stress among medical students. Coping efficacy mediated the associations between personality traits and academic stress, except for the relationship between neuroticism and grade stress among medical students. The study indicates that coping efficacy had a significant effect on relieving academic stress among students with higher scores for extroversion and conscientiousness. Efforts should be made to decrease neuroticism to lower academic stress, as the relationship between neuroticism and academic stress is not directly influenced by coping efficacy. The implications of these results are discussed regarding a consultation system for students, especially those in medical school.

한국 의과대학·의학전문대학원의 전문직 간 교육 현황과 요구 분석 (The Current Status and Needs Analysis of Interprofessional Education in Korean Medical Colleges)

  • 박귀화;유지혜;윤보영;이동현;이승희;최재정;박경혜
    • 의학교육논단
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    • 제24권2호
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    • pp.141-155
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    • 2022
  • The purpose of this study was to investigate the current status of interprofessional education (IPE) and the efforts required to promote, popularize, and implement it in Korea. The IPE status of 40 medical colleges was investigated using a survey with questions regarding the details of IPE, the future plans and necessary support required, and the reasons for not implementing IPE. Thirty-two medical colleges responded, of which 10 are implementing or have implemented IPE. Most of these colleges started IPE in 2018, and the duration of IPE was less than 9 hours. All medical colleges held classes with nursing students. As for the type of IPE, there were independent courses for IPE, one-time special lectures, or partial sessions in one course. Lectures, discussions and presentations, role playing, and high-fidelity simulations were mainly used as educational methods. The support and interest of the dean was the most important facilitating factor. No medical colleges were currently preparing to implement IPE, four colleges had planned IPE but failed to implement it, and 16 had no plans for IPE at all. All medical colleges cited scheduling or cooperation with other majors as the most significant barrier. All the colleges listed their requirements for educational materials, cases, guidelines, and teaching and learning methods for IPE from external institutions. To activate IPE, it is necessary to create an appropriate atmosphere and conditions for developing IPE competencies and a model suitable for the domestic situation. External medical education support organizations should distribute IPE development guidelines and educational materials, form a network between medical colleges with IPE experience, and make efforts to promote the importance of IPE.

한국의 환자 중심 의사 역량 프레임 타당화를 위한 델파이 연구 (A Delphi Study to Validate the Patient-Centered Doctor's Competency Framework in Korea)

  • 임선주;김영전;김찬웅;이건호;이선우;전우택;정한나;윤소정
    • 의학교육논단
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    • 제25권2호
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    • pp.139-158
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    • 2023
  • Defining a competent doctor is important for educating and training doctors. However, competency frameworks have rarely been validated during the process of their development in Korea. The purpose of this study was to validate the patient-centered doctor's competency framework, which had been developed by our expert working group (EWG). Two rounds of Delphi questionnaire surveys were conducted among a panel of experts on medicine and medical education. The panel members were provided with six core competencies, 17 sub-competencies, and 53 enabling competencies, and were asked to rate the importance of these competencies on a 5-point Likert scale. Between April and July 2021, a total of 28 experts completed both rounds. The data of the Delphi study were analyzed for the mean, standard deviation, median, inter-rater agreement (IRA), and content validity ratio (CVR). A CVR >0.36 and IRA ≥0.75 were deemed to indicate validity and agreement. This study found that five enabling competencies were not valid, and agreement was not reached for three sub-competencies and two enabling competencies. In consideration of CVR and the individual opinions of panel members at each session, the final competencies were extracted through consensus meetings of the EWG. The competencies were modified into six core competencies, 16 sub-competencies, and 47 enabling competencies. This study is meaningful in that it proposes patient-centered doctor's competencies enabling the development of residents' milestone competencies, an assessment system, and educational programs.

학생지원체계 개선을 위한 학생주도 교육평가 사례 (Student Engagement in Student Support System Reform: A Case Study)

  • 장예나;김서윤;강지윤;강동화;권나현;김가연;김나래;김상훈;김성우;김주희;김채연;박신영;박주연;박지수;이건호;임보라;윤보영
    • 의학교육논단
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    • 제25권2호
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    • pp.174-183
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    • 2023
  • Educational evaluation involves data collection and the analysis of various education-related factors to make decisions that improve educational quality. Systematic educational evaluation is essential for enhancing the quality of education. This study reports a case of student-conducted process evaluation of a medical school's student support system and the procedure for devising improvement plans. Sixteen Inje University College of Medicine students participated in the Education Evaluation Committee (IUCM-EEC) to understand the educational improvement process as learners and actively achieve improvement. The Quality Improvement Committee of the Inje University College of Medicine (IUCM-QIC) decided to reform its student support system based on a previous educational evaluation in 2019. The evaluation of the student support system was conducted for 10 months in 2021 by the student subcommittee, under the guidance of the IUCM-EEC. The CIPP (context-input-process-product) evaluation model was used for a systematic evaluation. Accordingly, the subcommittee developed evaluation criteria and indicators, and analyzed relevant data collected from surveys and the previous literature. For further recommendations and revision ideas, the student subcommittee members interviewed faculty members from six other medical schools and also conducted a focus group interview with the dean and vice deans of IUCM. Finally, the student subcommittee submitted a report to the IUCM-QIC. Communication with various stakeholders is essential for a successful evaluation process. In this case, students, as key stakeholders in education, evaluated the student support system. Their active participation helped improve their understanding of the evaluation process.