• Title/Summary/Keyword: 자동진단

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Liver Splitting Using 2 Points for Liver Graft Volumetry (간 이식편의 체적 예측을 위한 2점 이용 간 분리)

  • Seo, Jeong-Joo;Park, Jong-Won
    • The KIPS Transactions:PartB
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    • v.19B no.2
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    • pp.123-126
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    • 2012
  • This paper proposed a method to separate a liver into left and right liver lobes for simple and exact volumetry of the river graft at abdominal MDCT(Multi-Detector Computed Tomography) image before the living donor liver transplantation. A medical team can evaluate an accurate river graft with minimized interaction between the team and a system using this algorithm for ensuring donor's and recipient's safe. On the image of segmented liver, 2 points(PMHV: a point in Middle Hepatic Vein and PPV: a point at the beginning of right branch of Portal Vein) are selected to separate a liver into left and right liver lobes. Middle hepatic vein is automatically segmented using PMHV, and the cutting line is decided on the basis of segmented Middle Hepatic Vein. A liver is separated on connecting the cutting line and PPV. The volume and ratio of the river graft are estimated. The volume estimated using 2 points are compared with a manual volume that diagnostic radiologist processed and estimated and the weight measured during surgery to support proof of exact volume. The mean ${\pm}$ standard deviation of the differences between the actual weights and the estimated volumes was $162.38cm^3{\pm}124.39$ in the case of manual segmentation and $107.69cm^3{\pm}97.24$ in the case of 2 points method. The correlation coefficient between the actual weight and the manually estimated volume is 0.79, and the correlation coefficient between the actual weight and the volume estimated using 2 points is 0.87. After selection the 2 points, the time involved in separation a liver into left and right river lobe and volumetry of them is measured for confirmation that the algorithm can be used on real time during surgery. The mean ${\pm}$ standard deviation of the process time is $57.28sec{\pm}32.81$ per 1 data set ($149.17pages{\pm}55.92$).

The Clinical Usefulness Measurement of the Whole Body Percent Fat Calculated by the Part Bone Mineral Density Measurement (부분골밀도 측정을 통해 산출되는 체지방률의 임상적 유용성에 대한 평가)

  • Kang, Young-Eun;Kim, Eun-Hye;Kim, Ho-Sung;Choi, Jong-Sook;Choi, Woo-Jun
    • The Korean Journal of Nuclear Medicine Technology
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    • v.15 no.1
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    • pp.3-9
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    • 2011
  • Purpose: Generally dual energy X-ray absorptiometry has been used for the purpose of evaluation of osteoporosis and treatment. Recently the interest of obesity came to be high and body percent fat test is increasing. Existing measure of body fat have to scan the whole body can be evaluated, but only lumbar spine and hip measurements was assumed to be whole body fat as well as improving the software. It tries to check whether the part measured value not being whole body measurement has the validity or not compared with the value calculated with the method that it is different, it forgives through a correlation with a (BIA) and (BMI). Materials and Methods: In 2010, the body percent fat was measured among the examinee coming to the Asan Medical Center public health care center from March till August against 90 females more than 40 years old through (DXA) and BIA. BMI utilized the value which wrote an hight and weight measured through the body measuring instrument in the examinee information and is automatically calculated. In addition, it classified as the low weight ($13-18.5kg/m^2$), normal ($18.5-25kg/m^2$), and corpulence ($25-30kg/m^2$) based on BMI and so that it could check whether there was the difference according to the weight or not BMI and BIA and correlation between DXA were analyzed in each group. The statistical program for the analysis used SPSS 12.0. Results: The comparison of DXA at 3 which it divides into the low weight and normal and corpulence groups and BIA did not show the difference noted statistically in all groups and the between group comparison was exposed to do not have a meaning. The body percent fat measured by the correlation analysis result DXA at the state that it doesn't divide into the group showed the high correlation (r=0.908, p0.01) noted statistically compared with BMI and showed the high correlation noted statistically in a comparison with BIA (r=0.927, p0.01). Conclusion: It confirmed that the whole body percent fat presumed from the part bone density measurement showed the excel correlation compared with BIA and BMI and information is high. There is still no clear standard about the presumed whole body percent fat and it is difficult to evaluate the fat evaluation by the bone mineral density measurement. However, it is determined that the information offering which is more objective through the comparative study with the body percent fat which is very efficient and in that it can obtain till the information about a fat as well as diagnosis of the osteoporosis through the bone density checkup is measured by the afterward telegraph bone density checkup and is clinically useful is possible.

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The Differences of Anthropometric and Polysomnographic Characteristics Between the Positional and Non-positional Obstructive Sleep Apnea Syndrome (체위 의존성 및 체위 비의존성 폐쇄성 수면 무호흡증후군의 신체계측인자 및 수면구조의 차이)

  • Park, Hye-Jung;Shin, Kyeong-Cheol;Lee, Choong-Kee;Chung, Jin-Hong;Lee, Kwan-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.6
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    • pp.956-963
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    • 2000
  • Backgrounds : Obstructive sleep apnea syndrome(OSA) can divided into two groups, positional(PP) and non-positional(NPP) obstructive sleep apnea syndrome, according to the body position while sleeping. In this study, we evaluated the differences of anthropometric data and polysomnographic recordings between the two types of sleep apnea syndrome. Materials : Fifty patients with OSA were divided two groups by Cartwright's criteria. The supine respiratory disturbance index (RDI) was at least two times higher than the lateral RDI in the PP group, and the supine RDI was less than twice the lateral RDI in the NPP group. This patients underwent standardized polysomnographic recordings. The anthropometric data and polysomnographic data were analyzed, statistically. Results : Of all 50 patients, 30% were found to be positional OSA. BMI was significantly higher in the PP group(p<0.05). Total sleep time was significantly longer in the PP group (350.6$\pm$28.2min, 333.3$\pm$46.0min, (p<0.05). Sleep efficiency was high in the PP group(89.6$\pm$6.4%, 85.6$\pm$9.9%, p<0.05). Deep sleep was significantly higher and light sleep was lower in the PP group than in the NPP group but no difference was observed in REM sleep between the two groups. Apnea index(AI) and RDI were significantly lower( 17.0$\pm$10.6, 28.5$\pm$13.3, p<0.05) and mean arterial oxygen saturation was higher in the PP group(92.7$\pm$1.8%. p<0.05) than in the NPP group. Conclusion : Body position during sleep has a profound effect on the frequency and severity of breathing abnormalities in OSA patients. A polysomnographic evaluation for suspected OSA patients must include monitoring of the body position. Breathing function in OSA patients can be improved by controlling their obesity and through postural therapy.

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Development of a High Heat Load Test Facility KoHLT-1 for a Testing of Nuclear Fusion Reactor Components (핵융합로부품 시험을 위한 고열부하 시험시설 KoHLT-1 구축)

  • Bae, Young-Dug;Kim, Suk-Kwon;Lee, Dong-Won;Shin, Hee-Yun;Hong, Bong-Guen
    • Journal of the Korean Vacuum Society
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    • v.18 no.4
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    • pp.318-330
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    • 2009
  • A high heat flux test facility using a graphite heating panel was constructed and is presently in operation at Korea Atomic Energy Research Institute, which is called KoHLT-1. Its major purpose is to carry out a thermal cycle test to verify the integrity of a HIP (hot isostatic pressing) bonded Be mockups which were fabricated for developing HIP joining technology to bond different metals, i.e., Be-to-CuCrZr and CuCrZr-to-SS316L, for the ITER (International Thermonuclear Experimental Reactor) first wall. The KoHLT-1 consists of a graphite heating panel, a box-type test chamber with water-cooling jackets, an electrical DC power supply, a water-cooling system, an evacuation system, an He gas system, and some diagnostics, which are equipped in an authorized laboratory with a special ventilation system for the Be treatment. The graphite heater is placed between two mockups, and the gap distance between the heater and the mockup is adjusted to $2{\sim}3\;mm$. We designed and fabricated several graphite heating panels to have various heating areas depending on the tested mockups, and to have the electrical resistances of $0.2{\sim}0.5$ ohms during high temperature operation. The heater is connected to an electrical DC power supply of 100 V/400 A. The heat flux is easily controlled by the pre-programmed control system which consists of a personal computer and a multi function module. The heat fluxes on the two mockups are deduced from the flow rate and the coolant inlet/out temperatures by a calorimetric method. We have carried out the thermal cycle tests of various Be mockups, and the reliability of the KoHLT-1 for long time operation at a high heat flux was verified, and its broad applicability is promising.

Study on the Usefulness of Using Anterior and Posterior Views for Calculation of Total Relative Uptake Ratio in 99mTc-DMSA Renal Scan (99mTc-DMSA 검사에서 상대 신섭취율 산출 시 양면상 촬영의 유용성에 대한 고찰)

  • Kim, Joo-Yeon;Lee, Han-Wool;Kwon, O-Jun;Kim, Jung-Yul;Park, Min-Soo;Cho, Seok-Won;Kang, Chun-Goo;Kim, Jae-Sam
    • The Korean Journal of Nuclear Medicine Technology
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    • v.19 no.1
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    • pp.37-43
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    • 2015
  • Purpose $^{99m}Tc-DMSA$ renal scintigraphy serves as location, size and shape of kidney, so it has been used for diagnosis and passage observation after the operation or treatment. There are 3 methods of calculating the relative renal uptake ratio such as geometric mean of the counts from the anterior and posterior views, arithmetical mean from the only posterior view and posterior view which applied the renal depths. In this study, we seek to correlation between the change of total relative uptake ratio according to different inspection methods of obtaining the renal count rate. Materials and Methods The phantom experiments proceeded 5 times depending on each renal depth with the kidney phantom and tissue equivalent materials. In the clinical research, we investigated 36 adult patients who had visited our hospital from february to october, 2014 and received $^{99m}Tc-DMSA$ renal scan. The equipment was used as a gamma camera named INFINIA (General Electric Healthcare, milwaukee, USA) and we drew the region of interests through semiautomatic method by using Xeleris Ver. 2.1220 of GE. In addition, we obtained the lateral view of kidney to measure the renal depth of each patient. Then the results were compared with 3 methods of calculating relative renal uptake ratio. Results The phantom studies show when the difference between the left ant right kidney depth were less than 1 cm, there were no statistically significant difference among values calculated through anterior and posterior views and only posterior view (P>0.05), while the excess of 1cm, the results showed a statistically significant change in the value (P<0.05). In case of clinical research, the correlation between total relative uptake ratio by obtaining both sides of image and posterior view applied the kidney depth (r=0.999) was higher than by obtaining only posterior view and applying the kidney depth to one side image (r=0.988). Conclusion This study has found that, the difference of calculating total relative uptake ratio compared with obtaining anterior and posterior views and only posterior view. In order to reduce the error, we recommend the method of obtaining anterior and posterior views and is considered to be useful, particularly the patients have similar uptake ratio of left and right kidney and difficulties of measurements of kidney depth.

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Standardization and Management of Interface Terminology regarding Chief Complaints, Diagnoses and Procedures for Electronic Medical Records: Experiences of a Four-hospital Consortium (전자의무기록 표준화 용어 관리 프로세스 정립)

  • Kang, Jae-Eun;Kim, Kidong;Lee, Young-Ae;Yoo, Sooyoung;Lee, Ho Young;Hong, Kyung Lan;Hwang, Woo Yeon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.22 no.3
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    • pp.679-687
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    • 2021
  • The purpose of the present study was to document the standardization and management process of interface terminology regarding the chief complaints, diagnoses, and procedures, including surgery in a four-hospital consortium. The process was proposed, discussed, modified, and finalized in 2016 by the Terminology Standardization Committee (TSC), consisting of personnel from four hospitals. A request regarding interface terminology was classified into one of four categories: 1) registration of a new term, 2) revision, 3) deleting an old term and registering a new term, and 4) deletion. A request was processed in the following order: 1) collecting testimonies from related departments and 2) voting by the TSC. At least five out of the seven possible members of the voting pool need to approve of it. Mapping to the reference terminology was performed by three independent medical information managers. All processes were performed online, and the voting and mapping results were collected automatically. This process made the decision-making process clear and fast. In addition, this made users receptive to the decision of the TSC. In the 16 months after the process was adopted, there were 126 new terms registered, 131 revisions, 40 deletions of an old term and the registration of a new term, and 1235 deletions.

Topic Modeling Insomnia Social Media Corpus using BERTopic and Building Automatic Deep Learning Classification Model (BERTopic을 활용한 불면증 소셜 데이터 토픽 모델링 및 불면증 경향 문헌 딥러닝 자동분류 모델 구축)

  • Ko, Young Soo;Lee, Soobin;Cha, Minjung;Kim, Seongdeok;Lee, Juhee;Han, Ji Yeong;Song, Min
    • Journal of the Korean Society for information Management
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    • v.39 no.2
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    • pp.111-129
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    • 2022
  • Insomnia is a chronic disease in modern society, with the number of new patients increasing by more than 20% in the last 5 years. Insomnia is a serious disease that requires diagnosis and treatment because the individual and social problems that occur when there is a lack of sleep are serious and the triggers of insomnia are complex. This study collected 5,699 data from 'insomnia', a community on 'Reddit', a social media that freely expresses opinions. Based on the International Classification of Sleep Disorders ICSD-3 standard and the guidelines with the help of experts, the insomnia corpus was constructed by tagging them as insomnia tendency documents and non-insomnia tendency documents. Five deep learning language models (BERT, RoBERTa, ALBERT, ELECTRA, XLNet) were trained using the constructed insomnia corpus as training data. As a result of performance evaluation, RoBERTa showed the highest performance with an accuracy of 81.33%. In order to in-depth analysis of insomnia social data, topic modeling was performed using the newly emerged BERTopic method by supplementing the weaknesses of LDA, which is widely used in the past. As a result of the analysis, 8 subject groups ('Negative emotions', 'Advice and help and gratitude', 'Insomnia-related diseases', 'Sleeping pills', 'Exercise and eating habits', 'Physical characteristics', 'Activity characteristics', 'Environmental characteristics') could be confirmed. Users expressed negative emotions and sought help and advice from the Reddit insomnia community. In addition, they mentioned diseases related to insomnia, shared discourse on the use of sleeping pills, and expressed interest in exercise and eating habits. As insomnia-related characteristics, we found physical characteristics such as breathing, pregnancy, and heart, active characteristics such as zombies, hypnic jerk, and groggy, and environmental characteristics such as sunlight, blankets, temperature, and naps.

The Clinical Significance of ${\gamma}{\delta}$ T lymphocytes in patients with pleural tuberculosis (결핵환자에서 말초혈액과 흉막액내 ${\gamma}{\delta}$ T 림프구의 의의)

  • Song, Kwang Seon;Shin, Kye Chul;Kim, Do Hun;Hong, Ae Ra;Kim, Hee Seon;Yong, Suk Joong
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.1
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    • pp.44-51
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    • 1997
  • Background : The changes of the composition in the T-lymphocyte are important as an immunological abnormality in the pathogenesis of tuberculosis. Previously, the second type of TCR dimer(${\gamma}{\delta}$ T lymphocyte) that did not express CD4 or CD8 molecules was found. In other reports the presence of this type of lymphocytes was increased in the initial stage of tuberculous infections. Method : To determine whether there are some differences in the T-lymphocyte subsets in the peripheral blood or pleural effusion between pleural tuberculosis and other pleurisy. Thirty patients with pleural effusion among the forty-nine patients were examined T-lymphocyte subset analysis(CD4+T-cell,CD8+ T-cell,${\gamma}{\delta}$ T-lymphocytes) with anti- Leu4, anti-Leu3a, anti-Lea2a, anti HLA-DR and anti-TCR-${\gamma}{\delta}$-1(Becton & Dickinson Co.). Results : The average age of the patients was 50 years old(17-81year). There were 33 males and 16 female patients. Patiensts with tuberculosis are 30cases(tuberculous pleurisy 15), lung cancer 12cases(malignant effusion 9) and pneumonia 7cases(parapneumonic effusion 6cases) In T lymphocyte subsets of pleural effusion, helper T lymphocyte(54.6 + 13.8 %) of tuberculous pleurisy was higher than that(36.2 + 25.3 %) of non-tuberculous pleurisy(p=0.04). The peripheral blood ${\gamma}{\delta}$ T-lymphocytes in tuberculousis was insignificantly higher than non-tuberculous patients(p= 0.24). The peripheral blood ${\gamma}{\delta}$ T-lymphocytes and pleural ${\gamma}{\delta}$ T-Iymphocytes in tuberculous pleurisy was insignificantly higher than in non-tuberculous pleurisy(p= 0.16, p= 0.12). Conclusion : The percentage of -${\gamma}{\delta}$ T lymphocytes among the total T-lymphocytes is not significantly increased in the peripheral blood or pleural effusion of the pleural tuberculosis. ${\gamma}{\delta}$ T lymphocytes is less useful as a diagnostic method of pleural tuberculosis.

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Roles and Preparation for the Future Nurse-Educators (미래 간호교육자의 역할과 이를 위한 준비)

  • Kim Susie
    • The Korean Nurse
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    • v.20 no.4 s.112
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    • pp.39-49
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    • 1981
  • 기존 간호 영역 내 간호는 질적으로, 양적으로 급격히 팽창 확대되어 가고 있다. 많은 나라에서 건강관리체계가 부적절하게 분배되어 있으며 따라서 많은 사람들이 적절한 건강관리를 제공받지 못하고 있어 수준 높은 양질의 건강관리를 전체적으로 확대시키는 것이 시급하다. 혹 건강관리의 혜택을 받는다고 해도 이들 역시 보다 더 양질의 인간적인 간호를 요하고 있는 실정이다. 간호는 또한 간호영역 자체 내에서도 급격히 확대되어가고 있다. 예를들면, 미국같은 선진국가의 건강간호사(Nurse practitioner)는 간호전문직의 새로운 직종으로 건강관리체계에서 독자적인 실무자로 그 두각을 나타내고 있다. 의사의 심한 부족난으로 고심하는 발전도상에 있는 나라들에서는 간호원들에게 전통적인 간호기능 뿐 아니라 건강관리체계에서 보다 많은 역할을 수행하도록 기대하며 일선지방의 건강센터(Health center) 직종에 많은 간호원을 투입하고 있다. 가령 우리 한국정부에서 최근에 시도한 무의촌지역에서 졸업간호원들이 건강관리를 제공할 수 있도록 한 법적 조치는 이러한 구체적인 예라고 할 수 있다. 기존 간호영역내외의 이런 급격한 변화는 Melvin Toffler가 말한 대로 ''미래의 충격''을 초래하게 되었다. 따라서 이러한 역동적인 변화는 간호전문직에 대하여 몇가지 질문을 던져준다. 첫째, 미래사회에서 간호영역의 특성은 무엇인가? 둘째, 이러한 새로운 영역에서 요구되는 간호원을 길러내기 위해 간호교육자는 어떤 역할을 수행해야 하는가? 셋째 내일의 간호원을 양성하는 간호교육자를 준비시키기 위한 실질적이면서도 현실적인 전략은 무엇인가 등이다. 1. 미래사회에서 간호영역의 특성은 무엇인가? 미래의 간호원은 다음에 열거하는 여러가지 요인으로 인하여 지금까지의 것과는 판이한 환경에서 일하게 될 것이다. 1) 건강관리를 제공하는 과정에서 컴퓨터화되고 자동화된 기계 및 기구 등 새로운 기술을 많이 사용할 것이다. 2) 1차건강관리가 대부분 간호원에 의해 제공될 것이다. 3) 내일의 건강관리는 소비자 주축의 것이 될 것이다. 4) 간호영역내에 많은 새로운 전문분야들이 생길 것이다. 5) 미래의 건강관리체계는 사회적인 변화와 이의 요구에 더 민감한 반응을 하게 될 것이다. 6) 건강관리체계의 강조점이 의료진료에서 건강관리로 바뀔 것이다. 7) 건강관리체계에서의 간호원의 역할은 의료적인 진단과 치료계획의 기능에서 크게 탈피하여 병원내외에서 보다 더 독특한 실무형태로 발전될 것이다. 이러한 변화와 더불어 미래 간호영역에서 보다 효과적인 간호를 수행하기 위해 미래 간호원들은 지금까지의 간호원보다 더 광범위하고 깊은 교육과 훈련을 받아야 한다. 보다 발전된 기술환경에서 전인적인 접근을 하기위해 신체과학이나 의학뿐 아니라 행동과학 $\cdot$ 경영과학 등에 이르기까지 다양한 훈련을 받아야 할 필요가 있다. 또한 행동양상면에서 전문직인 답게 보다 진취적이고 표현적이며 자동적이고 응용과학적인 역할을 수행하도록 훈련을 받아야 한다. 그리하여 간호원은 효과적인 의사결정자$\cdot$문제해결자$\cdot$능숙한 실무자일 뿐 아니라 소비자의 건강요구를 예리하게 관찰하고 이 요구에 효과적인 존재를 발전시켜 나가는 연구자가 되어야 한다. 2. 미래의 간호교육자는 어떤 역할을 수행해야 하는가? 간호교육은 전문직으로서의 실무를 제공하기 위한 기초석이다. 이는 간호교육자야말로 미래사회에서 국민의 건강요구를 충족시키기는 능력있는 간호원을 공급하는 일에 전무해야 함을 시사해준다. 그러면 이러한 일을 달성하기 위해 간호교육자는 무엇을 해야 하는가? 우선 간호교육자는 두가지 측면에서 이 일을 수정해야 된다고 본다. 그 하나는 간호교육기관에서의 측면이고 다른 하나는 간호교육자 개인적인 측면엣서이다. 우선 간호교육기관에서 간호교육자는 1) 미래사회에서 요구되는 간호원을 교육시키기 위한 프로그램을 제공해야 한다. 2) 효과적인 교과과정의 발전과 수정보완을 계속적으로 진행시켜야 한다. 3) 잘된 교과과정에 따라 적절한 훈련을 철저히 시켜야 한다. 4) 간호교육자 자신이 미래의 예측된 현상을 오늘의 교육과정에 포함시킬 수 있는 자신감과 창의력을 가지고 모델이 되어야 한다. 5) 연구 및 학생들의 학습에 영향을 미치는 중요한 의사결정에 학생들을 참여시키도록 해야한다. 간호교육자 개인적인 측면에서는 교육자 자신들이 능력있고 신빙성있으며 간호의 이론$\cdot$실무$\cdot$연구면에 걸친 권위와 자동성$\cdot$독창성, 그리고 인간을 진정으로 이해하려는 자질을 갖추도록 계속 노력해야 한다. 3. 미래의 간호원을 양성하는 능력있는 간호교육자를 준비시키기 위한 실질적이면서도 현실적인 전략은 무엇인가? 내일의 도전을 충족시킬 수 있는 능력있는 간호교육자를 준비시키기 위한 실질적이고 현실적인 전략을 논함에 있어 우리나라의 실정을 참조하겠다. 전문직 간호교육자를 준비하는데 세가지 방법을 통해 할 수 있다고 생각한다. 첫째는 간호원 훈련수준을 전문직 실무를 수행할 수 있는 단계로 면허를 높이는 것이고, 둘째는 훈련수준을 더 향상시키기 위하여 학사 및 석사간호교육과정을 발전시키고 확대하는 것이며, 셋째는 현존하는 간호교육 프로그램의 질을 높이는 것이다. 첫째와 둘째방법은 정부의 관할이 직접 개입되는 방법이기 때문에 여기서는 생략하고 현존하는 교과과정을 발전시키고 그 질을 향상시키는 것에 대해서만 언급하고자 한다. 미래의 여러가지 도전에 부응할 수 있는 교육자를 준비시키는 교육과정의 발전을 두가지 면에서 추진시킬 수 있다고 본다. 첫째는 국제간의 교류를 통하여 idea 및 경험을 나눔으로서 교육과정의 질을 높일 수 있다. 서로 다른 나라의 간호교육자들이 정기적으로 모여 생각과 경험을 교환하고 연구하므로서 보다 체계적이고 효과적인 발전체인(chain)이 형성되는 것이다. ICN같은 국제적인 조직에 의해 이러한 모임을 시도하는 것인 가치있는 기회라고 생각한다. 국가간 또는 국제적인 간호교육자 훈련을 위한 교육과정의 교환은 한 나라안에서 그 idea를 확산시키는데 효과적인 영향을 미칠 수 있다. 충분한 간호교육전문가를 갖춘 간호교육기관이 새로운 교육과정을 개발하여 그렇지 못한 기관과의 연차적인 conference를 가지므로 확산시킬 수도 있으며 이런 방법은 경제적인 면에서도 효과적일 뿐만 아니라 그 나라 그 문화상황에 적합한 교과과정 개발에도 효과적일 수 있다. 간호교육자를 준비시키는 둘째전략은 현존간호교육자들이 간호이론과 실무$\cdot$연구를 통합하고 발전시키는데 있어서 당면하는 여러가지 요인-전인적인 간호에 적절한 과목을 이수하지 못하고 임상실무경험의 부족등-을 보충하는 방법이다. 이런 실제적인 문제를 잠정적으로 해결하기 위하여 1) 몇몇 대학에서 방학중에 계속교육 프로그램을 개발하여 현직 간호교육자들에게 필요하고 적절한 과목을 이수하도록 한다. 따라서 임상실무교육도 이때 실시할 수 있다. 2) 대학원과정 간호교육프로그램의 입학자의 자격에 2$\~$3년의 실무경험을 포함시키도록 한다. 결론적으로 교수와 학생간의 진정한 동반자관계는 자격을 구비한 능력있는 교수의 실천적인 모델을 통하여서 가능하게 이루어 질수 있다고 믿는 바이다.

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