• Title/Summary/Keyword: 진료수행평가

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Difference in Results according to Scorer and Test Date in Clinical Practice Test (진료수행 시험에서 채점자 및 시험 일자에 따른 결과 차이)

  • Kwon, So-Hee;Kim, Young-Jon
    • The Journal of the Korea Contents Association
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    • v.18 no.8
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    • pp.345-352
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    • 2018
  • The purpose of this study is to clarify the difference between the scoring results by scorer(doctors and standardization patients) and examination dates. A total of 101 students in the fourth grade of medical school participated in four clinical practice test. Students were randomly assigned to either day-1 or day-2, which was consisted of a standardized patient scoring set or a physician scoring set. Station checklists consisted of history taking, physical examination, patient education, physician-patient relationship and clinical courtesy. The achievement scores of each case and each domain were converted to the standard score, and the differences between groups were compared. Female students' achievement scores were significantly higher than male students' achievement scores in all domains. There was no significant difference between means by the standardized patients' group and doctors group. Day-2 group was significantly higher than day-1 group in both of history taking and physical examination domains. If the principles of checklist are clearly defined, the scorer status (either physician or standardized patients) does not determine the difference of students' practice test scores.

An Study on Decision Tree Analysis with Imbalanced Data Set : A Case of Health Insurance Bill Audit in General Hospital (의사결정나무 분석에서 불균형 자료의 분석 연구 : 종합병원의 건강보험료 청구 심사 사례)

  • Heo Jun;Kim Jong-U
    • Proceedings of the Korean Operations and Management Science Society Conference
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    • 2006.05a
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    • pp.1667-1676
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    • 2006
  • 다른 산업과 달리 병원/의료 산업에서는 건강 보험료 심사 평가라는 독특한 검증 과정이 필수적으로 있게 된다. 건강 보험료 심사 평가는 병원의 수익 문제 뿐 아니라 적정한 진료행위를 하는 병원이라는 이미지와도 맞물려 매우 중요한 분야이며, 특히 대형 종합병원일수록 이 부분에 많은 심사관련 인력들을 투입하여, 병원의 수익과 명예를 위해서 업무를 수행하고 있다. 본 논문은 이러한 건강보험료 청구 심사 과정에서, 사전에 수많은 진료 청구 건 중 심사 평가에서 삭감이 될 수 있는 진료 청구 건을 데이터 마이닝을 통해서 발견하여, 사전의 대비를 철저히 하고자 하는 한 국내의 대형 종합병원의 사례를 소개하고자 한다. 데이터 마이닝을 적용함에 있어, 주요한 문제점 중의 하나는 바로 지도학습 기법을 적용하기에 곤란한 데이터 불균형 문제가 발생하는 것이다. 이런 불균형 문제를 해소하고, 비교 조건 중에 가장 효율적인 삭감 예상 진료 건 탐지 모형을 만들어 내기 위하여 데이터 불균형 문제의 기본 해법인 과, Sampling 오분류 비용의 다양하고 혼합적인 적용을 통하여, 적합한 조건을 가지는 의사결정 나무 모형을 도출하였다.

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Associations of Communication Skills, Self-Efficacy on Clinical Performance and Empathy in Trainee Doctors (전공의 의료커뮤니케이션 능력과 진료수행 자기효능감, 공감능력과의 상관관계)

  • Kim, Doehyung;Kim, Min-Jeong;Lee, Haeyoung;Kim, Hyunseuk;Kim, Youngmi;Lee, Sang-Shin
    • Korean Journal of Psychosomatic Medicine
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    • v.29 no.1
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    • pp.49-57
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    • 2021
  • Objectives : This study evaluated the medical communication skills of trainee doctors and analyzed the relationship between medical communication skills, self-efficacy on clinical performance (SECP) and empathy. Methods : A total of 106 trainee doctors from a university hospital participated. The questionnaire comprised self-evaluated medical communication skills, modified SECP and the Korean version of the Jefferson Scale of Empathy-Health Professionals version. The mean difference in medical communication skills scores according to gender, age, division (intern, internal medicine group or surgery group) and position (intern, first-/second- and third-/fourth-year residents) were analyzed. Pearson correlation coefficients were determined between medical communication skills, modified SECP and empathy. The effects of each variable on medical communication skills were verified using the structural equation model. Results : There were no statistically significant mean differences in self-evaluated medical communication skills according to gender, age, division or position. Medical communication skills had a significant positive correlation with modified SECP (r=0.782, p<0.001) and empathy (r=0.210, p=0.038). Empathy had a direct effect on modified SECP (β=0.30, p<0.01) and modified SECP had a direct effect on medical communication skills (β=0.80, p<0.001). Empathy indirectly influenced medical communication skills, mediating modified SECP (β=0.26, p<0.05). Conclusions : Medical communication skills are an important core curriculum of residency programs, as they have a direct correlation with SECP, which is needed for successful treatment. Moreover, the medical communication needs a new understanding that is out of empathy.

Evaluation of Hypertension Prevention and Management Programs Conducted by Community Health Nurse Practitioners in Rural Areas of Korea (농촌지역 보건진료소의 고혈압 예방 및 관리사업 평가)

  • Kwon, Myung-Soon;Cho, Won-Jung;Kim, Mi-Ja;Lee, Hyeon-Kyeong
    • Korean Journal of Health Education and Promotion
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    • v.27 no.5
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    • pp.41-50
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    • 2010
  • Objectives: This study aims to evaluate effectiveness of hypertension prevention and management programs (HPMPs) in rural Korea. Methods: A questionnaire survey was conducted with 700 community health practitioners working at primary health care posts (PHCPs). The questionnaire had four domains, which were hypertension management, hypertension prevention, the PHCP environment, and evaluation system, each with different maximum weighted values (WVs). Weighted values of 100 indicate the best effectiveness for the HPMP in all four domains. Results: The average WVs and percent effectiveness of all four domains combined was 61.65 (62%); the hypertension management domain was 28.81 (72%); the hypertension prevention domain was 23.44 (67%); the PHCP environment was4.29(43%); and the evaluation system was5.10(34%). Conclusion: The HPMPs were generally effective, and hypertension management was the most effective. The environment of PHCPs and the evaluation system of HPMPs should be improved to increase the effectiveness of the HPMPs.

Effect of Gap between Expected Job and Performed Job on Turnover Intention and Job Satisfaction in Clinical Dental Hygienists (치과위생사의 기대업무와 수행업무 격차가 이직의도와 직무만족도에 미치는 영향)

  • Choi, Ha-Na;Bae, Hyun-Sook;Cho, Young-Sik
    • Journal of dental hygiene science
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    • v.11 no.5
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    • pp.463-469
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    • 2011
  • The purpose of this study was to investigate effect of gap between expected job and performed job on job satisfaction and turnover intention in clinical dental hygienists. A total 292 hygienist in dental hospitals and dental offices in nationwide completed a questionnaire on their daily routine job and job which they expected and measured gap between expected job and performed job, such as chairside assisting, preventive care, consultation, reception. The study showed the gap on chairside assisting job among age, career and showed the gap on consultation among age, education, career and showed the gap on reception among age, career. gap on chairside assisting, salary satisfaction, personal day affected job satisfaction and gap on chairside assisting, children, salary satisfaction affected turnover intention. The study showed that salary satisfaction and gap on chairside assisting associated with turnover intention and job satisfaction. Personal day affected job satisfaction but did not affect turnover intention.

치과에서의 의료사고와 의료분쟁의 이해

  • Hwang, Chung-Ju
    • The Journal of the Korean dental association
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    • v.36 no.7 s.350
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    • pp.503-512
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    • 1998
  • 건강과 의료에 관심이 높아지면서 의료수요는 날로 증가하게 되었고 이에 따르는 의료분쟁 또한 증가하는 추세이다. 본의 아니게 발생한 의료사고는 의료분쟁으로 발전하게 되는데 과실과 악결과 그리고 이에 따르는 인과관계와 책임여부를 따지게 된다. 이를 규명하기 위해서는 의료인은 주의의무와 설명의무를 잘 수행했는지와 환자 또한 의무를 잘 수행했는지를 평가하게 된다. 일단 의료분쟁이 생기지 않도록 최선의 진료와 환자와의 대화가 요구되며 분쟁시 화해, 조정, 소송 등으로 해결하며 이 과정 각각에서의 준비와 대책을 세워야 할 것이다. 현재의 상황에서 언제 어디서 일어날지 모르는 의료분쟁을 방지하려면 진료기술의 숙련도를 높이고 발전하는 새로운 의학 정보를 얻는데 게으르지 말아야하며 특히 환자를 대하는데 진단, 치료과정, 치료의 후유증, 위험성에 관한 자세한 설명을 통하여 환자 스스로 결정할 수 있는 의료환경이 요구되며 가장 기본적인 의료기록부 작성에 관심을 가져야 할것이다.

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Reliability of Standardized Patients as Raters in Objective Structured Clinical Examination (객관 구조화 절차 기술 평가에서 채점자로서의 표준화환자의 신뢰도)

  • Son, Hee-Jeong;Moon, Joong-Bum;Lee, Hyang-Ah;Roh, Hye-Rin
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.1
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    • pp.318-326
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    • 2011
  • The purpose of this study is to investigate whether standardized patient(SP) can be used as a reliable examiner in Objective Structured Clinical Examination(OSCE). 4 SPs and 4 faculties who have more than 2 years experience of OSCE scoring were selected. For 1 assignment 2 members of faculty and 2 SPs were designated as raters. SPs were educated for assessing 2 technical skills, male Foley catheter insertion and wound dressing, for 8 hours (4 hours / day, each topic). The definition, method, cautions and complications for each of procedural skills were covered in the education. Theoretical lectures, video learning, faculty demonstration and practical training on mannequins were employed. The 8 raters were standardized for an hour with simulated OSCE scoring using previous videos on the day before the OSCE. Each assessment was composed of 14 checklists and 1 global rate. The allotted time for each assignment was 5minutes and for evaluation time 2 minutes per student. The evaluation from the faculty and SPs were compared and analyzed with the GENOVA program. The overall generalizability coefficient (G coefficient) was 0.839 from two cases of OASTS. The reliability of the raters was high, 0.946. The inter-rater agreement between faculty group and SP group was 0.949 for checklist and 0.908 for global rating. Therefore SPs can play a role of raters in OSCE for procedural skills, if they are given the appropriate training.

Shape Comparison for Human Organ Models Using Multi-resolution Silhouette Images (다해상도 실루엣 영상을 이용한 인체 장기 모델에 대한 형상 비교)

  • 김정식;최수미
    • Proceedings of the Korean Information Science Society Conference
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    • 2003.10b
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    • pp.688-690
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    • 2003
  • 본 논문에서는 다해상도 2차원 실루엣 영상들을 이용하여 3차원 모델간의 형상 유사성을 비교하기 위한 방법을 제안한다. 제안 시스템은 포즈 정규화 모듈, 유사성 계산 모듈, 3차원 시각화 모듈로 구성된다. 형상 비교를 위해서 먼저, 3차원 인체 장기 모델을 입력으로 받아서 정규화를 수행하고, 다해상도 깊이맵을 획득한다. 이어서 유사성 비교를 위해 실루엣 영상을 추출한 후, 유사도 측정을 위해 시그니쳐를 측도로 사용한다. 최종적으로 계산된 결과들은 3차원 글리프 및 컬러 코딩을 이용하여 시각화된다. 본 논문에서 제시한 3차원 형상 비교 시스템은 전처리 단계에서의 정규화 수행을 통하여 스케일 및 회전 변환에 불변하는 특성을 보인다. 그리고 다양한 레벨의 깊이맵을 형상 비교에 사용하여 다해상도 기반의 유사성 평가를 지원하며, 평가 계산 속도와 정확성간의 유연성을 제공한다. 또한 3차원 히스토그램. 3차윈 글리프. 컬러 코딩 시각화 기법들과 2차원 실루엣 피킹 인터페이스를 통하여 인체 장기 모델간의 정량적 형상 차이를 사용자가 직관적으로 평가할 수 있도록 한다. 본 시스템은 차후 데이터베이스를 이용한 원격 진료 시스템에서의 질병 진단, 추적 관찰. 치료계획 등에 활용될 수 있을 것이다.

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The Effect of Re-building of Public Health Facilities on the Hypertension Control in the Rural Area (농촌 보건기관의 신축이 고혈압 환자 혈압 조절에 미치는 영향)

  • Chun, Sung-A;Na, Baeg-Ju;Kim, Chul-Woung;Lee, Moo-Sik
    • Journal of agricultural medicine and community health
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    • v.33 no.1
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    • pp.37-45
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    • 2008
  • Objectivesthe hypertension control in the rural area.Method: 6 health centers and 59 health subcenters in some Chung-chung province was surveyed. And 29,503 patients were finally selected who had records of prescription about hypertension at list once in those medical doctor was a medical specialist or not, and whether the facilities were recently rebuilded or not was measured.Results: The Overall control rate was 53.9%. Women had higher hypertension control rate than men. And 60s and 70s years old are had higher hypertension control rate than 40s and 80s years old. Patients who patient who treated in rebuilded public health facilities had higher hypertension control rate.Conclusions: Rebuilding of public health facilities were related to increasing control rate of hypertensive patients.

The Change of perception according to the fidelity of simulation in Objective Structured Clinical Examination for Procedural Skill of 4th Medical Students (의전원 4학년 학생의 과정기술 객관구조화진료시험에 도입된 시뮬레이션의 충실도에 따른 인식 변화)

  • Son, Hee-Jeong;Kim, Jin-Uk;Yi, Yu-Ri;Hwang, Byeong-Moon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.3
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    • pp.1178-1185
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    • 2012
  • The 4th year medical students were randomly divided and designated as group HF and LF, representing high and low fidelity simulations respectfully. Both groups performed OSCE on 2 topics(adult intubation and IV cannulation) with each composed of the same scenario. Each scenario was developed by a faculty in charge of clinical skill education with supervision from 2 other faculty members. High fidelity simulations were designed as in-situ simulations in real OR. Low fidelity simulations had the same scenarios but the environment was simulated only with a simple task trainer in the classroom. All students participated in series of survey using a Likert scale before and after the simulations. The provided data was anlayzed with paired T-test and Mann-Whiteney test(p<0.05). The post simulations self evaluation score for group HF was lower than pre-simulation self confidence score for both topics of adult intubation and IV cannulation where as for group LF, it was lower only for adult intubation(p<0.05). In group HF, the needs for clinical training on both topics increased after the simulation. In group LF, there was no significant change of needs for clinical training between pre and post simulation survey. This suggest that fidelity may be a helpful factor to improve the motivation of the students and further study on economical aspect should be addressed.