• Journal of Korean Dental Science
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• 제3권2호
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• pp.34-39
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• 2010

In our daily practice, we think about the diagnosis of our patient and get into a situation wherein we have to make a clinical decision. Diagnosis and treatment come from the knowledge and experiences that each dentist should have, but sometimes, we can have doubts on our decisions. "On what evidence did I make such decision? Was that really right?" Drawing our attention these days as a possible answer to this question, evidence-based dentistry seeks to apply the best available evidence gained from the scientific method to medical decision making. To make a good decision, the strength of evidence is assessed. Specifically, randomized controlled trial, systematic review, and meta-analysis are considered the highest level of evidence; cohort study, case control study, case series, animal study, bench test, and biological plausibility follow. With the approach of evidence-based dentistry, we can make objective, scientifically sound clinical decisions. It is also patient-oriented, incorporating clinical experiences and stressing good judgments; thorough and comprehensive, it uses transparent methodology. That is the reason evidence-based dentistry can be better than other assessment methods when we make a clinical decision in modern dentistry.

• 한국콘텐츠학회논문지
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• 제13권2호
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• pp.322-330
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• 2013

본 연구는 치과위생사의 비판적 사고성향, 직무만족도, 임상적 의사결정능력을 알아보고, 변인간의 관계를 규명하여 치과위생사 교육 전략 수립의 기초 자료를 제공하고자 한다. 대상자의 대부분은 평균연령 30.6세, 여성, 전문대학졸업, 7년 이상 경력, 치과의원에 근무하는 것으로 나타났다. 비판적 사고성향에서 진실추구 3.36점, 성숙 3.00점으로 나타났다. 임상적 의사결정능력에서는 가치와 목표에 대한 검토가 3.39점, 대안과 선택에 대한 조사가 3.10점으로 나타났다. 직무만족에서 전문적 위치 3.20점, 보수 및 승지에서 2.84점으로 나타났다. 비판적 성향에서는 종교, 학력, 총 근무경력, 근무현장에서 통계학적으로 유의한 차이가 있었으며, 임상적 의사결정능력에서는 종교와 학력에서 유의한 차이가 있었고, 직무만족에서는 종교, 학력, 총 근무경력, 근무현장에서 그룹간의 유의한 차이가 있었다. 비판적 사고성향은 임상적 의사결정능력 및 직무만족도에서 정적인 상관관계를 나타났다. 임상적 의사결정능력은 직무만족도에서 정적인 상관관계를 나타냈다. 본 연구결과를 통해 비판적 사고성향과 임상적 의사결정능력과 직무만족도간에 유의한 상관관계를 보여주므로, 학부 교육 과정에서부터 비판적 사고성향과 임상적 의사결정 능력과 직무만족을 향상시킬 수 있는 내용을 포함시키고, 임상현장에 있는 치과위생사를 위한 지속적인 추가 실무교육을 실시해야 한다.

• 한국치위생학회지
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• 제20권3호
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• pp.369-378
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• 2020

Objectives: The purpose of this study is to examine the correlation between the critical thinking disposition of dental hygienists and the variables associated with clinical decision making and job performance to analyze factors affecting job performance. Methods: A questionnaire survey was administered to 166 dental hygienists from June 24 to August 8, 2019. We analyzed results with t-test, Mann-Whitney U test, ANOVA, Pearson's correlation analysis and a multiple regression analysis using the SPSS Windows version 23.0(SPSS Inc. IL, USA). Results: Critical thinking disposition was the highest for open-mindedness and clinical decision making ranked highest for canvassing of objectives and values. Job performance ranked highest in terms of assist with dental treatment. Factors affecting dental hygienists' job performance were clinical decision making and critical thinking disposition(p<0.001, adj. R² =31.4). Conclusions: It is expected that this study will provide basic data for the development of programs to enhance the job performance of dental hygienists. Furthermore, it is necessary to actively support plans such as conducting seminars at dental institutions and providing educational participation opportunities.

• 가정간호학회지
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• 제30권2호
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• pp.163-173
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• 2023

Purpose: The aim of this descriptive research study was to identify the factors affecting the ethical decision-making of nursing students. Methods: A convenience sample of 193 nursing students from three nursing colleges in D city who were engaged in clinical practice completed an online Google Forms questionnaire from September 9 to September 20, 2021. Using SPSS 23.0, data were analyzed with descriptive statistics, an independent t-test, a one-way ANOVA, Scheffé's test, Pearson's correlation coefficient, and a multiple regression analysis. Results: The influencing factors of ideal ethical decision-making were guilt (β=.38, p<.001), awareness of the nurses' Code of Ethics (β=.18, p=.023) and motivation for entering school, among general characteristics (β=-.18, p=.033). The explanatory power of the model was 22.2%. Further, the influencing factors of realistic ethical decision-making were ideal ethical decision-making (β=.26, p=.001) and grade (among general characteristics) (β=.15, p=.029); the explanatory power of the model was 17.9%. Conclusion: Various educational tools and programs pertaining to making ideal and ethical decisions must be enhanced to promote ethical choices in clinical areas and realistic ethical decision-making ability to actually make such choices. This focus may enable nurses to improve their nursing professionalism in the future.

• 성인간호학회지
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• 제26권4호
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• pp.403-412
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• 2014

Purpose: The purpose of this study was to validate the Korean version of shortened Nursing Decision-Making Instrument developed by Lauri & $Salanter{\ddot{a}}$(2002). Methods: The subjects were 247 nurses working in eight hospitals of Korea. Data were collected by questionnaires from June to July, 2012 and were analyzed by Principal Component Analysis for construct validity and Cronbach's ${\alpha}$ coefficient for reliability. Results: Factor loadings of the four subscales ranged from .32 to .73. The explained variance from the four factors was 48.54% of the total variance. The factors were named 'implementation of plan, monitoring and evaluation', 'plans of action', 'data collection', and 'data processing and identification'. The first factor consisted of 6 items which explained 13.21% of the total variance and the second factor contained 8 items. The Cronbach's ${\alpha}$ coefficients of the four subscales were from .64 to .81. Conclusion: The Korean version of the shortened Nursing Decision-Making Instrument has satisfactory construct validity and reliability. However, that the scores of the analytic items weren't reversed unlike the analysis method of the original tools is the biggest limitation of this study. In addition, based on the fact that there were several discrepancies for item interpretation of Korean comparing to the findings of the instrument development study, repetitive researches would be suggested.

• 간호행정학회지
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• 제9권3호
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• pp.459-480
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• 2003

Purpose: This study was done to analyze the contents of nurses' ethical decision-making in four of hypothetical dilemma cases using the Cameron's Ethical Decision-Making Model of 'Value, Be, Do'. Method: Sixteen nurses who work at ICU at present or worked before, participated from April 10 to May 10 in 2002. The participants were interviewed three times each and for 40 minutes at once, with a structured questionnaire at their working places and locker rooms. The data was analyzed by a procedure of qualitative content analysis into three categories; what should I value, who should I be, what should I do. Result: 1) In consistency, most of subjects showed a unified voice in 'Value, Be, Do'. Exceptionally 8 subjects showed inconsistency such as 3 in active treatment to the incurable patients(case 1), 1 in treatment truth-telling to the terminally ill patients(case 2), 3 in conflict with uncooperative doctors(case 3), 3 in dying patients and euthanasia(case 4). Only one subject showed inconsistency in 3 dilemma cases. 2) Closing the interview procedure, the subjects evaluated Cameron's Model as it would help them build consistent value, carry right action, and cope to conflicts. Conclusion: On the basis of the results, it is recommended that nursing ethics should adopt the ethical decision-making model, and be applied to the curriculum of nursing colleges and continuing education program for clinical nurses.

• 보건의료산업학회지
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• 제9권1호
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• pp.67-79
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• 2015

The aim of this descriptive cross-sectional study was determine the effect of critical thinking and clinical decision-making on ethical dilemmas. A survey of dental hygienists residing in Busan and South Gyeongsang, Korea was conducted using convenience sampling between September and December, 2013. A total of 153 responses were used in the final analysis. Data analysis and structural equation modeling were performed with IBM SPSS Statistics(version 21.0) and AMOS(version 18.0) programs. A negative(-) correlation coefficient(-0.37) was observed between critical thinking and ethical dilemmas on statistical analysis, i.e., higher critical thinking led to less ethical dilemmas(p=0.024, CR=-2.264). The values from the structural equation model were ${\chi}^2=98.124$ df=66, GFI=0.919, AGFI=0.871, and RMSEA=0.057. This study proposed a theoretical model in which critical thinking, ethical values, and decision-making skills should be firmly established to effectively respond to specific situations, such as ethical dilemmas, and that greater tendencies for critical thinking led to less ethical dilemmas, thereby demonstrating a negative(-) correlation between the two parameters.

• 대한간호학회지
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• 제49권4호
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• pp.411-422
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• 2019

Purpose: The purpose of this study was to adapt, modify, and validate the Nursing Anxiety and Self-Confidence with Clinical Decision-Making Scale ($NASC-CDM^{(c)}$) for Korean nursing students. Methods: Participants were 183 nursing students with clinical practice experience in two nursing colleges. The construct validity and reliability of the final Korean version of the $NASC-CDM^{(c)}$ were examined using exploratory and confirmatory factor analyses and testing of internal consistency reliability. For adaptation and modification, the instrument was translated from English to Korean. Expert review and a cross-sectional survey were used to test the instrument's validity. Results: The Korean version of the $NASC-CDM^{(c)}$ (KNASC-CDM) was composed of 23 items divided into four dimensions: (i) Listening fully and using resources to gather information; (ii) Using information to see the big picture; (iii) Knowing and acting; and (iv) Seeking information from clinical instructors. The instrument explained 60.1% of the total variance for self-confidence and 63.1% of the variance for anxiety; Cronbach's ${\alpha}$ was .93 for self-confidence and .95 for anxiety. Conclusion: The KNASC-CDM can be used to identify anxiety and self-confidence in nursing students' clinical decision-making in Korea. However, further research should be done to test this instrument, as it is classified differently from the original $NASC-CDM^{(c)}$ version.

• 한국임상수의학회지
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• 제25권3호
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• pp.146-151
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• 2008

During the clinical decision making practitioners are often faced with performing diagnostic tests to solve the presenting problems seen in the patients. The diagnostic utility of a test has traditionally been described by technical terms such as sensitivity, specificity, and positive (PPV) and negative predictive value (NPV). Although well known, clinicians are frequently unclear about the concept and application of these terms in everyday evidence-based clinical decision making. Sensitivity and specificity, which are intrinsic properties of diagnostic tests, summarizes the characteristics of the test over a population. The PPV and NPV are greatly dependent on the population prevalence of disease, and thus they do not transferable to different patients or clinical settings. Besides, considering the fact that clinicians more often interested in knowing the extent to which a test result could confirm or exclude of a condition under consideration (posttest probability), these measures do not provide answers on this question. The likelihood ratios (LR) using the information contained in sensitivity and specificity are becoming increasingly popular for reporting the usefulness of diagnostic tests because this term provide an indication of posttest probability as a function of the pretest probability. In this article, clinical applications of LR are illustrated with some practical examples. Discussion is also included of the inherent limitations regarding diagnostic test characteristics.

• 한국산업융합학회 논문집
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• 제25권6_2호
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• pp.1083-1090
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• 2022

Since renal cell carcinoma(RCC) has various examination and treatment methods according to clinical stage and histopathological characteristics, it is required to determine accurate and efficient treatment methods in the clinical field. However, the process of collecting and processing RCC medical data is difficult and complex, so there is currently no AI-based clinical decision support system for RCC treatments worldwide. In this study, we propose a clinical decision support system that helps clinicians decide on a precision treatment to each patient. RCC standard big database is built by collecting structured and unstructured data from the standard common data model and electronic medical information system. Based on this, various machine learning classification algorithms are applied to support a better clinical decision making.