• Title/Summary/Keyword: 임상 추론

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Influence of Self-reflection and Insight, and Academic Self-efficacy on Clinical Reasoning Competence among Nursing Students (간호대학생의 자기성찰 및 통찰력, 학업적 자기효능감이 임상추론역량에 미치는 영향)

  • Ahn, Ju Hyun;Kim, Myoungsuk
    • Journal of East-West Nursing Research
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    • v.26 no.2
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    • pp.176-184
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    • 2020
  • Purpose: The purpose of this study was to investigate the influence of nursing students' self-reflection and insight, and academic selfefficacy on their clinical reasoning competence. Methods: Data were collected from 147 third- and fourth-year nursing students who had more than 6 months of clinical training experience. Clinical reasoning competence, self-reflection and insight, and academic self-efficacy were measured using self-reported questionnaires. Data analysis was conducted with IBM SPSS 25.0 using one-way ANOVA, independent t-test, Pearson correlation coefficient, and multiple regression analysis. Results: Clinical reasoning competence was positively correlated with self-reflection and insight (r=.24, p=.003) and academic self-efficacy (r=.30, p<.001). Academic self-efficacy (β=.23, p=.011), dissatisfaction with major (β=-.17, p=.034), and 5~8 case studies (β=-.39, p=.027) were identified as factors influencing clinical reasoning competence (adjusted R2=.15). Conclusion: To improve the clinical reasoning competence of nursing students, it is necessary to develop the academic self-efficacy of complex cases and provide critical inquiries, debriefing tailored to clinical reasoning, and sufficient reflection during clinical and simulation practice.

A Pilot Study on Cognitive Styles in Clinical Reasoning Based on Clinical Specialty and Experience by Korean Physical Therapists (임상분야와 임상경력에 따른 임상추론의 인지적 방식에 관한 선행 연구)

  • Ryu, Young Uk
    • The Journal of Korean Physical Therapy
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    • v.24 no.5
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    • pp.370-376
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    • 2012
  • Purpose: This study examined whether there are differences in cognitive styles between orthopedic and neurological physical therapists, and whether these differences change with clinical experience in clinical reasoning. Methods: A survey study was conducted on 88 orthopedic and neurologic physical therapists working in South Korea. The survey items used by May and Dennis (1991) were translated, and only those items related to data-gathering and information-processing were used. Results: The cognitive style was similar in the orthopedic and neurologic physical therapists, but the clinical experience affected the cognitive styles of clinical reasoning. Physical therapists with more than 60 months clinical experience responded most positively to the preceptive and systematic styles in clinical reasoning. Conclusion: These results suggest that physical therapy education should provide physical therapy students with a clinical reasoning process related specifically to a particular clinical field.

Neuropsychological Tests in Consultation Neurology (자문 시 유용한 신경인지검사)

  • Oh, Jee-Young
    • Korean Journal of Psychosomatic Medicine
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    • v.18 no.1
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    • pp.11-18
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    • 2010
  • The clinical assessment of a patient with a cerebral lesion is not easy to physicians. Extensive neuropsycho-logical tests often need both skilled experience and some special tools. Some bedside tests equally provide valuable clues to localize cerebral lesion, when a clinician knows functional anatomy of cerebral hemisphere. In this article, several techniques used to evaluate cerebral cortical function will be introduced.

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Effects of a Nursing Simulation Learning Module on Clinical Reasoning Competence, Clinical Competence, Performance Confidence, and Anxiety in COVID-19 Patient-Care for Nursing Students (코로나19 간호시뮬레이션 학습모듈이 간호대학생의 임상추론역량, 임상수행능력, 간호수행자신감 및 불안에 미치는 효과)

  • Kim, Ye-Eun;Kang, Hee-Young
    • Journal of Korean Academy of Nursing
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    • v.53 no.1
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    • pp.87-100
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    • 2023
  • Purpose: This study aimed to develop a nursing simulation learning module for coronavirus disease 2019 (COVID-19) patient-care and examine its effects on clinical reasoning competence, clinical competence, performance confidence, and anxiety in COVID-19 patient care for nursing students. Methods: A non-equivalent control group pre- and post-test design was employed. The study participants included 47 nursing students (23 in the experimental group and 24 in the control group) from G City. A simulation learning module for COVID-19 patient-care was developed based on the Jeffries simulation model. The module consisted of a briefing, simulation practice, and debriefing. The effects of the simulation module were measured using clinical reasoning competence, clinical competence, performance confidence, and anxiety in COVID-19 patient-care. Data were analyzed using χ2-test, Fisher's exact test, t-test, Wilcoxon signed-rank test, and Mann-Whitney U test. Results: The levels of clinical reasoning competence, clinical competence, and performance confidence of the experimental group were significantly higher than that of the control group, and the level of anxiety was significantly low after simulation learning. Conclusion: The nursing simulation learning module for COVID-19 patient-care is more effective than the traditional method in terms of improving students' clinical reasoning competence, clinical competence, and performance confidence, and reducing their anxiety. The module is expected to be useful for educational and clinical environments as an effective teaching and learning strategy to empower nursing competency and contribute to nursing education and clinical changes.

Causal inference from nonrandomized data: key concepts and recent trends (비실험 자료로부터의 인과 추론: 핵심 개념과 최근 동향)

  • Choi, Young-Geun;Yu, Donghyeon
    • The Korean Journal of Applied Statistics
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    • v.32 no.2
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    • pp.173-185
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    • 2019
  • Causal questions are prevalent in scientific research, for example, how effective a treatment was for preventing an infectious disease, how much a policy increased utility, or which advertisement would give the highest click rate for a given customer. Causal inference theory in statistics interprets those questions as inferring the effect of a given intervention (treatment or policy) in the data generating process. Causal inference has been used in medicine, public health, and economics; in addition, it has received recent attention as a tool for data-driven decision making processes. Many recent datasets are observational, rather than experimental, which makes the causal inference theory more complex. This review introduces key concepts and recent trends of statistical causal inference in observational studies. We first introduce the Neyman-Rubin's potential outcome framework to formularize from causal questions to average treatment effects as well as discuss popular methods to estimate treatment effects such as propensity score approaches and regression approaches. For recent trends, we briefly discuss (1) conditional (heterogeneous) treatment effects and machine learning-based approaches, (2) curse of dimensionality on the estimation of treatment effect and its remedies, and (3) Pearl's structural causal model to deal with more complex causal relationships and its connection to the Neyman-Rubin's potential outcome model.

The Effect of Active Learning on Critical Thinking Disposition, Problem Solving Ability, and Self-leadership of Nursing Students in Online Nursing Health Assessment Practice Class (온라인 건강사정실습 수업에서 능동학습이 간호대학생의 비판적사고성향, 문제해결능력, 셀프리더십에 미치는 효과)

  • Ma, Hyunhee
    • The Journal of the Convergence on Culture Technology
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    • v.8 no.5
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    • pp.39-50
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    • 2022
  • The Purpose of this study was to confirm the effects of Active learning application on thecritical thinking disposition, problem-solving ability, and self-leadership of nursing students in the online health assessment practice course in the COVID-19 pandemic situation. Data collection was conducted from September 1st to December 17th, 2021 for 78 nursing students in the Department of Nursing at University D, and the collected data was analyzed using the SPSS/WIN 20 program. As a result of this study, the critical thinking disposition (t=-2.11 p=.038) and self-leadership (t=-2.07 p=.042) were statistically significantly increased after active learning was applied to the online nursing health assessment practice class. SOAP, Outcome-Present-Test(OPT) worksheet, clinical reasoning webs, mind map writing are confirm to improve critical thinking disposition, problem solving ability, self-leadership of nursing student, so research to confirm the effect in face to face classed should be conducted.

A Clinical Nomogram Construction Method Using Genetic Algorithm and Naive Bayesian Technique (유전자 알고리즘과 나이브 베이지언 기법을 이용한 의료 노모그램 생성 방법)

  • Lee, Keon-Myung;Kim, Won-Jae;Yun, Seok-Jung
    • Journal of the Korean Institute of Intelligent Systems
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    • v.19 no.6
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    • pp.796-801
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    • 2009
  • In medical practice, the diagnosis or prediction models requiring complicated computations are not widely recognized due to difficulty in interpreting the course of reasoning and the complexity of computations. Medical personnel have used the nomograms which are a graphical representation for numerical relationships that enables to easily compute a complicated function without help of computation machines. It has been widely paid attention in diagnosing diseases or predicting the progress of diseases. A nomogram is constructed from a set of clinical data which contain various attributes such as symptoms, lab experiment results, therapy history, progress of diseases or identification of diseases. It is of importance to select effective ones from available attributes, sometimes along with parameters accompanying the attributes. This paper introduces a nomogram construction method that uses a naive Bayesian technique to construct a nomogram as well as a genetic algorithm to select effective attributes and parameters. The proposed method has been applied to the construction of a nomogram for a real clinical data set.

Analysis and Application of Nursing Management Practicum Case Simulation for Developing Performance-Centered Education (성과중심 교육과정 개발을 위한 간호관리실습 사례시뮬레이션 적용 및 내용 분석)

  • Lim, Ji Young;Ko, Gug Jin
    • The Journal of the Korea Contents Association
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    • v.17 no.9
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    • pp.235-254
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    • 2017
  • The purpose of this study was to develop a nursing management case simulation (NMCS) framework based on the five components of nursing management process and to apply it to clinical nursing practice of nursing college students. The subjects of this study were NMCS reports submitted by the 4th grade 105 nursing students of an university. The research tool is a simulation framework for nursing management practice. It reflects the brainstorming and debriefing process used in the previous simulation exercise based on the five elements of planning, organization, human resource management, directing and control of the nursing management process respectively. As a result of the study, 32 nursing management cases were found to have 79.6% correct rate, 11.6% concept error rate, and 5.6% classification error rate in the first brainstorming and debriefing process for the five components of nursing management process. On the other hand, in the second brainstorming and debriefing process, 94.6% correct rate, 0.0% concept error rate, and 4.4% classification error rate. Based on these results, the NMCS framework developed in this study can be applied to the nursing management theory and practice course of nursing college students as well as simulation based job training and maintenance educations for clinical nurses. Therefore, we propose follow-up studies in various clinical nursing settings and a longitudinal cohort study to investigate the effect of nursing management job skills of nursing college students after graduation.

Confidence Bounds following Adaptive Group Sequential Tests with Repeated Measures in Clinical Trials (반복측정자료를 가지는 적응적 집단축차검정에서의 신뢰구간 추정)

  • Joa, Sook Jung;Lee, Jae Won
    • The Korean Journal of Applied Statistics
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    • v.26 no.4
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    • pp.581-594
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    • 2013
  • A group sequential design can end a clinical trial early if a confirmed efficacy or a futility of study medication is found during clinical trials. Adaptation can adjust the design of clinical trials based on accumulated data. The key to this methodology is considered to control the overall type 1 error rate while maintaining the integrity of clinical trials. The estimation would be more complex and the sample size calculation will be more difficult if the clinical trials have repeated measurement data. Lee et al. (2002) suggested a repeated observation case by using the independent increments properties of the interim test statistics and investigated the properties of the proposed confidence interval based on the stage-wise ordering. This study extend Lee et al. (2002) to adaptive group sequential design. We suggest test statistics for the adaptation as redesigning the second stage of clinical trials and induce the stage-wise confidence interval of parameter of interests. The simulation will help to confirm the suggested method.

Evaluating Course of Pediatric Dentistry on Correlation Analysis between Dental Students' Achievements of Subjects and OSCE (임상술기능력평가와 교과목간의 학업성취도 분석을 통한 소아치과학의 교육과정 평가)

  • Bang, Jaebeum;Rim, Jaeyoung;Park, Jaehong
    • Journal of the korean academy of Pediatric Dentistry
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    • v.40 no.4
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    • pp.253-259
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    • 2013
  • This study aimed to evaluate the courses of pediatric dentistry based on correlation analysis between scores of objective structured clinical examination (OSCE) and related subjects for 79 fourth-year students. The score of theory were related to preclinical (r = 0.449, p = 0.000) and clerkship (r = 0.437, p = 0.000) each, but the scores of clerkship were not related to OSCE. To make the students skillful for clerkship, more professor's firsthand teaching on treating patients and adequate numbers of clinical professors are required. Patients who come to the university dental hospital prefer to be treated by professors rather than students. In these circumstances, educational conditions should be arranged by ensuring the number of professors for teaching students to improve their clinical competence through direct instruction and feedback to students. In addition, pragmatic improvement plans, which allow continuous education and evaluation about basic techniques to be examined in the clinical practice course, should be compromised with the more concrete evaluation of the curriculum in order to evaluate theoretical knowledge and technical trainings to be well exercised and deepened in the practical clinical field.