• Annals of Clinical Neurophysiology
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• v.13 no.1
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• pp.1-12
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• 2011

Transcranial magnetic stimulation (TMS) is a non-invasive tool used to study aspects of human brain physiology, including motor function and the pathophysiology of various brain disorders. A brief electric current passed through a magnetic coil produces a high-intensity magnetic field, which can excite or inhibit the cerebral cortex. Although various brain regions can be evaluated by TMS, most studies have focused on the motor cortex where motor evoked potentials (MEPs) are produced. Single-pulse and paired-pulse TMS can be used to measure the excitability of the motor cortex via various parameters, while repetitive TMS induces cortical plasticity via long-term potentiation or long-term depression-like mechanisms. Therefore, TMS is useful in the evaluation of physiological mechanisms of various neurological diseases, including movement disorders and epilepsy. In addition, it has diagnostic utility in spinal cord diseases, amyotrophic lateral sclerosis and demyelinating diseases. The therapeutic effects of repetitive TMS on stroke, Parkinson disease and focal hand dystonia are limited since the duration and clinical benefits seem to be temporary. New TMS techniques, which may improve clinical utility, are being developed to enhance clinical utilities in various neurological diseases.

• Child Health Nursing Research
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• v.8 no.3
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• pp.344-356
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• 2002

This study was conducted to analyse the current clinical education of pediatric nursing in baccalaurate nursing program, then to give basic data for enhancing the quality of future clinical education of pediatric nursing. Data were collected through self-reported questionnaire by mail from December 2001 to February 2002. The subjects were 29 schools of 50 baccalaurate nursing education programs. The data were analysed by double raters, researcher and assistant researcher. The results were summarized as follows: 1. Twenty-eight schools had the objectives of the clinical education of pediatric nursing, and 28 schools in pediatric ward, 23 schools in nursery, 22 schools in neonatal intensive care unit(NICU), 15 schools in objectives related to profession by clinical site. 2. Credits on clinical education of pediatric nursing were most 15 schools of 3 credits. 3. The clinical sites were mainly the hospital that sick children were admitted in. 4. The clinical teacher were 9 types including pediatric professor and field nurse. 5. On teacher's role, the professor instructed the case study and conference, and field nurse instructed the patient assignment and nursing procedures. 6. All of schools used explanation and conference as a method of clinical education, 1 or 2 schools used PBL or role play or field study. 7. On clinical education content, most of school included Apgar scoring system, physical examination in newborn assessment, respira- tion maintenance, temperature maintenance, infection prevention, nutrition, and bath in newborn care. 8. On clinical education content, most of school included care of incubator, phototheraty, infusion, gavage feeding and how to use the instruments in NICU. Eighteen schools included attachment promotion, and 20 schools case study. 9. On clinical education content, most of school included a checklist of nursing procedures, case study, assessment of growth and development in pediatric ward and other sites. 10.There were various evaluation types in scores, measuring items. In conclusion, the results of this study revealed that there were some discrepancy in the objectives and contents, clinical sites on hospital focused, teacher's role, and diversity of measurement items and ratings in clinical education of pediatric nursing. There is a need for a standardization of content, clinical site, and evaluation tool to improve a quality of clinical education of pediatric nursing based on this study.

• Journal of The Korean Society of Integrative Medicine
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• v.10 no.4
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• pp.71-81
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• 2022

Purpose : This study aimed to present evidence by analyzing the characteristics and effectiveness of group art therapy interventions through an examination of domestic studies on group art therapy for older people with dementia. Methods : The database used DBpia, Riss, and Google Scholar, and the research period was from 2016 to November 2021. For the selected studies, the level of evidence was analyzed, bias evaluation was performed, and patient, intervention, comparison, and outcome were analyzed. For the evaluation of bias, the risk of bias assessment tool for non-randomized study (RoBANS) and Cochrane's risk of bias (RoB) were used. Results : As for the level of evidence of the included studies, level I consisted of five studies, and levels II and III each had one article. As a result of the bias evaluation of five studies through RoB, a "low risk of bias" was found for incomplete result data, selective result reporting, and others, except for four unclear evaluation areas. The "low risk of bias" ratio was 0~25 % in the evaluation of bias in two studies through RoBANS. For the evaluation tool, cognitive evaluation tool was used the most while mini-mental state examination-Korea was used the most frequently. For the intervention method, the most frequently used was group art therapy that employed recall in three studies, while collage, Korean painting, use of paper media, and procedural memory were used in each of the other studies. Each intervention was found to be significantly effective overall. Conclusion : This study provided clinical evidence by systematically reporting research on group art therapy for older people with dementia. In the future, it is necessary to check the effect of group art therapy on various areas other than cognition for older people with dementia. Moreover, the study should be conducted with the risk of bias sufficiently taken into consideration.

• Korean Medical Education Review
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• v.20 no.3
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• pp.135-140
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• 2018

In clinical clerkships, residents function as trainees, workers, and teachers for other medical students. Although residents care for patients in harsh environments and encounter precarious patient-safety situations, they are working towards becoming competent specialists. Residency education programs are very important in cultivating specialists able to adapt to the rapidly-changing medical environment, and are also necessary to improve the quality of specialist training. Competent specialists not only need clinical competency, but also a wide range of abilities including professionalism, leadership, effective communication, cooperation, and attention to continuous professional development/continuing medical education activities. Each Korean association of specialties has its own educational goals and standardized education programs to help residents learn specific techniques and competencies related to medical care for patients, though the training environment of each residency is different within each trainee hospital. Although it is also important to evaluate residency education programs, currently there is only an examination of knowledge and assessment of skills based on mini-clinical evaluation exercises or direct observation of procedural skills. In order to develop an objective and estimable evaluation tool that can assess the overall achievement level within each training course, it is necessary to evaluate the knowledge, skills, and attitudes of residents. Residency education programs need further attention and reform.

• Archives of Plastic Surgery
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• v.33 no.2
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• pp.225-232
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• 2006

The aim of this study is to evaluate the clinical competence of medical student using short case test items. Development of short case test items with definition of an assessment of subject, choice of clinical stations sampling, identification of components of clinical competence to be evaluated, and assessment of practicability and results exploitation. For the last three years 28, 48 and 30 topics were developed annually. Among them 20, 23 and 23 topics were selected. About 50 students were examined annually. The mean score was 72.7, 57.1, 64.3 respectively. The mean preparation time of the students for the examination was 9.8 hours. About 60% of the students prepared the test in small group activity. Our experience suggests that short case test items be feasible for evaluation of student learning in Plastic Surgery. This method should be considered as a useful tool to assess medical student's competence or even an examination for board certification.

• Journal of the Korean Society of Physical Medicine
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• v.19 no.1
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• pp.95-105
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• 2024

PURPOSE: This study aimed to utilize the International Classification of Functioning, Disability, and Health (ICF) tool to identify a problem list and explore intervention effects using proprioceptive neuromuscular facilitation (PNF) for improving the crosswalk performance of patients who have undergone a bilateral hip arthroplasty. METHODS: The subject of this study was a 43-year-old male who had undergone a bilateral hip arthroplasty. To address the subject's functional status, a clinical decision-making process was carried out in the order of examination, evaluation, diagnosis, prognosis, intervention, and outcome. Patient information during the examination was collected using the ICF core set. The evaluation involved listing the items of each problem using the ICF assessment sheet and identifying the interaction between activity limitations and the impairment level. The diagnosis explicitly described the causal relationships derived from the evaluation using ICF terminology. The prognosis presented activity goals, body function, and structured goals in terms of the activity and participation levels that needed to be achieved for an individual's functional status. The intervention approached problems through the four components of the PNF philosophy, namely basic principles and procedures, techniques, and patterns, in an indirect-direct-task sequence. Results were compared before and after the intervention using the ICF evaluation display. RESULTS: The results of the study showed that the primary activity limitation, which was the walking time across the crosswalk, showed improvement, and the trunk's counter rotation and the weight-bearing capacity of both the lower limbs, which were impairment level indicators, were enhanced. CONCLUSION: This study suggests that PNF intervention strategies will serve as a positive approach for improving crosswalk walking in patients with bilateral hip arthroplasty.

• The Journal of Korean Academic Society of Nursing Education
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• v.14 no.2
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• pp.232-243
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• 2008

Purpose: The study was aimed to suggest a model re-entry program into the job market for inactive registered nurses, based on the development and management of a program and the evaluation of its efficiency. Method: The participants in the program were 82 inactive nurses and the development and evaluation of the program followed ADDIE. To develop the program, general characteristics and demand on re-entry into the job market were investigated. Satisfaction level of the program and confidence in nursing practice were measured to evaluate it. Result: Participants were 45 years old, had 6 years' clinical experience, and had 14 inactive career years on average. The program included basic and core education courses, and a clinical course. The participants were satisfied with its management, and 80.3 percent of them agreed with the need for the program. Also, clinical sites and instructors in the clinical course were satisfactory. Participants gained high confidence in nursing practice skills. Conclusion: The study showed the goal of the program was accomplished by motivating inactive nurses for re-entry to the work force and enhancing capability in duty. The program needs standardizing, and field adaptability should be strengthened through clinical practice. An evaluation tool for the program has to be developed.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.7
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• pp.3213-3218
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• 2012

When patients with advanced breast cancer (ABC) are treated with neoadjuvant chemotherapy (NACT), efficacy is monitored by the extent of tumor shrinkage. Since their publication in 1981, World Health Organization (WHO) guidelines have been widely practiced in clinical trials and oncologic practice, for standardized tumor response evaluation. With advances in cancer treatment and tumor imaging, a simpler criterion based on one-dimensional rather than bi-dimensional (WHO) tumor measurement, named Response Evaluation Criteria in Solid Tumors (RECIST) was introduced in 2000. Both approaches have four response categories: complete response, partial response, stable disease and progressive disease (PD). Bi-dimensional measurement data of 151 patients with ABC were analysed with WHO and RECIST criteria to compare their response categories and inter criteria reproducibility by Kappa statistics. There was 94% concordance and 9/151 patients were recategorized with RECIST including 6/12 PD cases. RECIST therefore under-estimates and delays diagnosis of PD. This is undesirable because it may delay or negate switch over to alternate therapy. Analysis was repeated with a new criteria named RECIST-Breast (RECIST-B), with a lower threshold for PD (${\geq}10%$ rather than ${\geq}20%$ increase of RECIST). This showed higher concordance of 97% with WHO criteria and re-categorization of only 4/151 patients (1/12 PD cases). RECIST-B criteria therefore have advantages of both ease of measurement and calculations combined with excellent concordance with WHO criteria, providing a practical clinical tool for response evaluation and offering good comparison with past and current clinical trials of NACT using WHO guidelines.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.29 no.1
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• pp.145-156
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• 2016

Objective : We performed a literature review for developing the clinical phenotype evaluation system of atopic dermatitis.Methods : We searched the papers that describe symptoms for atopic dermatitis through Oriental Medicine Advanced Searching Integrated System(OASIS) and Korean Studies Incategoryation Service System(KISS). We looked through all the papers and finally chose 47 papers that are suitable for inclusion. Then, we extracted symptoms from these papers and arranged them in order of frequency and validity through experts' conference.Results : We found 360 papers and chose 47 papers. We decided to include general information of patients, systemic and dermatologic symptoms in evaluation category of atopic dermatitis. Through experts' conference, it was decided that general information has age, sex and body type; Systemic symptoms have 9 items; Dermatologic symptoms have 15 items.Conclusion : To evaluate atopic dermatitis objectively, the standardization of diagnostic tool is needed. Therefore we developed a clinical phenotype evaluation system of atopic dermatitis.

• Korean Medical Education Review
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• v.23 no.1
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• pp.37-45
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• 2021

In light of the need for a tool to evaluate the clinical practice education environment as perceived by medical and nursing students, this study is was conducted to develop and validate the Korean version of the Undergraduate Clinical Education Environment Measure (K-UCEEM) as a measurement tool for managing the clinical practice education climate and quality of education. For validation, the UCEEM consisting of 25 items developed by Pia Strand in 2013 was adapted according to standard translation procedures. The K-UCEEM questionnaire was administered to 73 medical students and 135 nursing students who participated in clinical practice at one medical institution. Exploratory factor analysis and confirmatory factor analysis were conducted to confirm the validity of the instrument's structure. In order to determine referential validity, the relationships among stresses in clinical practice were examined, and differences in factor scores were compared by gender and college. It was confirmed that the scale of 24 items and five factors showed a moderate model fitness index. The reliability of the factors ranged from 0.786 to 0.867. In addition, all five factors were found to have negative correlations with the clinical practice stress sub-factor, and there were statistically significant differences by gender and college. Through this study, the validity and reliability of the K-UCEEM were verified. In the future, it is expected that further verification of the scale, as well as evaluation and improvement of the clinical practice education environment based on this scale, will occur.