• The Journal of the Korea Contents Association
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• v.13 no.3
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• pp.287-298
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• 2013

To develop a technique classifying patients based on computerized clinical data followed by validity verification by comparing with nurse's examination. Class scores were determined by nurses for a day on 348 resident patients in 7 wards of a general hospital according to KPCS-1. The class scores were simultaneously evaluated by reviewing the computerized clinical data acquired from the hospital management information system. These two class scores were both significantly different among different departments as well as disease patterns. Intraclass correlation analysis resulted a very high correlation coefficient of 0.96(p<0.01) between the two scoring methods, but the clinical data scores were somewhat higher. An automated patient classification system seemed possible to be developed in future with further enhancement of the present results based on computerized clinical data without manual scoring, which can be applied for performance evaluation as well as workforce planning.

• Journal of Korean Neurosurgical Society
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• v.66 no.4
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• pp.382-392
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• 2023

Objective : The use of indocyanine green videoangiography (ICG-VA) to assess blood flow in the brain during cerebrovascular surgery has been increasing. Clinical studies on ICG-VA have predominantly focused on qualitative analysis. However, quantitative analysis numerical modelling for time profiling enables a more accurate evaluation of blood flow kinetics. In this study, we established a multiple exponential modified Gaussian (multi-EMG) model for quantitative ICG-VA to understand accurately the status of cerebral hemodynamics. Methods : We obtained clinical data of cerebral blood flow acquired the quantitative analysis ICG-VA during cerebrovascular surgery. Varied asymmetric peak functions were compared to find the most matching function form with clinical data by using a nonlinear regression algorithm. To verify the result of the nonlinear regression, the mode function was applied to various types of data. Results : The proposed multi-EMG model is well fitted to the clinical data. Because the primary parameters-growth and decay rates, and peak center and heights-of the model are characteristics of model function, they provide accurate reference values for assessing cerebral hemodynamics in various conditions. In addition, the primary parameters can be estimated on the curves with partially missed data. The accuracy of the model estimation was verified by a repeated curve fitting method using manipulation of missing data. Conclusion : The multi-EMG model can possibly serve as a universal model for cerebral hemodynamics in a comparison with other asymmetric peak functions. According to the results, the model can be helpful for clinical research assessment of cerebrovascular hemodynamics in a clinical setting.

• Journal of Biomedical Engineering Research
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• v.32 no.2
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• pp.134-143
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• 2011

The selection of meaningful clinical tests and its reference values from a high-dimensional clinical data with imbalanced class distribution, one class is represented by a large number of examples while the other is represented by only a few, is an important issue for differential diagnosis between similar diseases, but difficult. For this purpose, this study introduces methods based on the concepts of both discernibility matrix and function in rough set theory (RST) with two discretization approaches, equal width and frequency discretization. Here these discretization approaches are used to define the reference values for clinical tests, and the discernibility matrix and function are used to extract a subset of significant clinical tests from the translated nominal attribute values. To show its applicability in the differential diagnosis problem, we have applied it to extract the significant clinical tests and its reference values between normal (N = 351) and abnormal group (N = 101) with either cholecystitis or cholelithiasis disease. In addition, we investigated not only the selected significant clinical tests and the variations of its reference values, but also the average predictive accuracies on four evaluation criteria, i.e., accuracy, sensitivity, specificity, and geometric mean, during l0-fold cross validation. From the experimental results, we confirmed that two discretization approaches based rough set approximation methods with relative frequency give better results than those with absolute frequency, in the evaluation criteria (i.e., average geometric mean). Thus it shows that the prediction model using relative frequency can be used effectively in classification and prediction problems of the clinical data with imbalanced class distribution.

• 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.

• Korean Journal of Adult Nursing
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• v.23 no.1
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• pp.1-9
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• 2011

Purpose: To evaluate undergraduate nursing students' ability in clinical competence, critical thinking, and problem solving following enrollment in a clinical reasoning course. Methods: A clinical reasoning course utilizing a human patient simulator and scenarios was offered to 22 senior students at a College of Nursing in Seoul. Students' clinical competence was measured with a checklist of 15 items by analyzing students' performance recorded on video tapes for eight scenarios. Critical thinking disposition and problem solving were measured by a self-administered questionnaire before and after the course. Data were analyzed using descriptive statistics and Wilcoxon signed-rank test. Results: The high scored items of clinical competence were: 'obtain relevant subjective/objective data', 'interpret vital signs', 'communicate with healthcare providers', and 'utilize standard precautions including handwashing.' Students' critical thinking and problem solving scores following the course were increased with statistical significance. Conclusion: A clinical reasoning course utilizing a human patient simulator creates a realistic clinical environment for nursing students and provides the opportunity to obtain clinical competence, critical thinking, and problem solving skills.

• Journal of Korean Academy of Nursing
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• v.37 no.6
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• pp.863-871
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• 2007

Purpose: The purpose of this study was to investigate the factors influencing nurses' clinical decision making focusing on critical thinking disposition. Methods: The subjects of this study consisted of 505 nurses working at one of the general hospitals located in Seoul. Data was collected by a self-administered questionnaire between December 2006 and January 2007. Data was analyzed by one way ANOVA, Pearson correlation coefficients, and stepwise multiple regression using SPSS Win 14.0. Results: The mean scores of critical thinking disposition and clinical decision making were 99.10 and 134.32 respectively. Clinical decision making scores were significantly higher in groups under continuing education, with a master or higher degree, with clinical experience more than 5 years, or with experts. Critical thinking disposition and its subscales have a significant correlation with clinical decision making. Intellectual eagerness/curiosity, prudence, clinical experience, intellectual honesty, self-confidence, and healthy skepticism were important factors influencing clinical decision making(adjusted $R^2=33%$). Conclusion: Results of this study suggest that various strategies such as retaining experienced nurses, encouraging them to continue with education and enhancing critical thinking disposition are warranted for development of clinical decision making.

• Korean Journal of Adult Nursing
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• v.15 no.3
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• pp.373-382
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• 2003

Purpose: The purpose of this study is to investigate the perception of nursing students' on-site clinical experience at intensive care unit(ICU), which will help on developing fundamental tool to enhance the effect of their clinical practice. Method: Van Manens hermeneutic-phenomenological method has been used to analyze the data. Participants consisted of 74 third-year nursing students who performed the clinical practice at an ICU in C university hospital. The students got the group interviews and kept the clinical diaries. Data was collected from series of group interviews and contents of the students clinical diaries. Result: Major concerns related to students clinical practice were found as follows : "being nervous about unfamiliar machines and situations", "being frustrated about the patients", "feeling of helplessness", "being stupefied from witnessing a death", "realizing the importance of health", "realizing individual patient's precious value through family's love", "realizing the importance of treating a patient as humanbein g", "realizing the differences between theory and practice", "modelizing two aspects of nursing: professional and personal", "readiness to become a capable nurse". Conclusion: We are able to obtain in-depth understandings about the nursing students lived experience of clinical practice at the ICU. Based upon this, there is a need to develop a better nursing intervention enhance the effectiveness of the nursing students clinical practice.

• Child Health Nursing Research
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• v.12 no.1
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• pp.5-14
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• 2006

Purpose: The purpose of study was to describe and evaluate the educational status regarding clinical practicum for child health nursing to facilitate student's clinical compliance for the bachelor's degree in Korea. Methods: The study was a descriptive study and included data from 40 institutions among the 53 university nursing programs in Korea(75.5% response rate). Data were collected using mailed semi structured questionnaires and content analysis was done. Results: Findings show that most institutions have common learning objectives for the clinical practicum; neonatal care, high risk infant care, hospitalized child care, and advanced nursing practice. The mode for theoretical credits in child health nursing was 5 to 6 and 3 to 4 credits for clinical practice. The practice settings were prepared to provide diverse experiences, including childcare centers, and community centers with various learning activities. Evaluation for learning outcomes included faculty and instructors. It was pointed out that updating evaluation based on student and faculty feedback is important for a comprehensive practicum evaluation. Conclusions: Findings suggest that there is a -need for a generalized curriculum for clinical practicum and for the expanding role of advanced nursing practice-, a need for diverse clinical settings for practice, and effective guidance and learning activities. It is significantly noted that the attitude and teaching methodologies of clinical instructor's are highly important to effective clinical learning outcomes.

• Women's Health Nursing
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• v.18 no.4
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• pp.312-320
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• 2012

Purpose: This study was conducted to examine the effects of simulation-based education on communication skill and clinical competence in maternity nursing practicum. Methods: This study used a non-equivalent control pretest-posttest design. The simulation-based education in maternity nursing practicum consisted of two clinical situation scenarios pertaining to patients with normal and high-risk deliveries. The control group consisted of 35 students in 2010 and the experimental group consisted of 35 students in 2009. The experimental group was given the simulation-based education using a high-fidelity patient simulator over 3 sessions, whereas the control group was given a conventional pre-clinical practice orientation before maternity nursing clinical practicum. Data were collected using a questionnaire, which included questions to assess communication skill and clinical competence. Data were analyzed using SPSS/WIN 18.0. Results: Members of the experimental group, who received the simulation-based education, showed significantly higher communication skill and clinical competence scores than the control group (t=-2.39, p = .020; t=-2.71, p = .009). Conclusion: The simulation-based education in maternity nursing practicum is effective in promoting communication skill and clinical competence. With application of diverse clinical situation scenarios, it is recommended to develop and apply simulation-based education using a high-fidelity simulator in the area of maternity nursing.

• Korean Journal of Clinical Laboratory Science
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• v.44 no.4
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• pp.239-244
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• 2012

This study aims to analysis the curriculum problems and its improvements and to investigate curricula satisfaction among the students majoring in Clinical Pathology. A college used as a population, and 80 effective survey data were collected by sampling the graduates who carried out the clinical field training in third grade year. For statistical analysis of the collected data, the Stata(version 12.0) statistical package was used for frequency analysis, pearson correlations test and multiple regression analysis. The results of the analysis were as follows; First, the result showed that the synthetical theory curriculum has an positive effect on curricula satisfaction. Second, it was found that extension of both the clinical field training and laboratory and practice education have an significant influence direction of positiveness on curricula satisfaction. Third, as the problems of curriculum, the students selected shortage of english subjects connected with the job. We must intensify additional subjects (english ability) for job as the improvement of curriculum. Accordingly, academic, industrial circles and students are supposed to jointly seek for the plan for the enhancement of clinical field training satisfaction.