• 제목/요약/키워드: Clinical practice performance

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마황의 안전성에 대한 논란과 비만 치료에 있어서 마황 사용 지침의 필요성 (The Need for Clinical Practice Guidelines in Usage of Mahuang in Weight Loss)

  • 장인수;양창섭;황의형
    • 한방비만학회지
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    • 제7권1호
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    • pp.23-29
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    • 2007
  • Background : Mahuang (Ephedra sinica) has been used widely to treat respiratory disease in traditional medicine for over thousands years. Mahuang preparations contain approximately $0.75{\sim}1%$ ephedrine alkaloids. Recently in North America, the Eephedra alkaloids has aroused a controversy due to its adverse effects in those using whole extracts as "dietary supplements" for weight loss or athletic performance enhancement. Objective : To discuss the need for clinical practice guidelines on the use of Mahuang. Results and Conclusion : It is widely assumed that Mahuang is one of the useful medicines and is safe for human body. Most of scientific literatures support that the safety of Mahuang prescription in common dosage. However, it has been claimed that there were some warnings and apprehensions about the harmfulness of Mahuang as dietary supplements. This article does not negate the fact that it is necessary to pay more attention for use of Mahuang in clinical situations. We assert that the establishment of clinical practice guideline on the use of Mahuang, which is based on scientific materials and consensus, is required in traditional medicine.

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As how artificial intelligence is revolutionizing endoscopy

  • Jean-Francois Rey
    • Clinical Endoscopy
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    • 제57권3호
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    • pp.302-308
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    • 2024
  • With incessant advances in information technology and its implications in all domains of our lives, artificial intelligence (AI) has emerged as a requirement for improved machine performance. This brings forth the query of how this can benefit endoscopists and improve both diagnostic and therapeutic endoscopy in each part of the gastrointestinal tract. Additionally, it also raises the question of the recent benefits and clinical usefulness of this new technology in daily endoscopic practice. There are two main categories of AI systems: computer-assisted detection (CADe) for lesion detection and computer-assisted diagnosis (CADx) for optical biopsy and lesion characterization. Quality assurance is the next step in the complete monitoring of high-quality colonoscopies. In all cases, computer-aided endoscopy is used, as the overall results rely on the physician. Video capsule endoscopy is a unique example in which a computer operates a device, stores multiple images, and performs an accurate diagnosis. While there are many expectations, we need to standardize and assess various software packages. It is important for healthcare providers to support this new development and make its use an obligation in daily clinical practice. In summary, AI represents a breakthrough in digestive endoscopy. Screening for gastric and colonic cancer detection should be improved, particularly outside expert centers. Prospective and multicenter trials are mandatory before introducing new software into clinical practice.

임상간호사의 학습민첩성, 그릿, 긍정심리자본이 간호업무성과에 미치는 영향 (The Influence of Learning Agility, Grit, and Positive Psychological Capital on the Performance of Clinical Nurses)

  • 박창승;이인숙
    • 근관절건강학회지
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    • 제31권2호
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    • pp.75-85
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    • 2024
  • Purpose: The goals of this study were to identify the relationships among learning agility, grit, positive psychological capital, and nursing performance and to determine the impact of these factors on clinical nursing performance. Methods: Between November and December 2021, a descriptive survey design was conducted with a convenience sample of 260 clinical nurse participants from two regional hospitals. Data were collected using the Learning Agility Scale, Grit Scale, Psychological Capital Questionnaire, and the Nursing Performance Scale. Data from 248 nurses were analyzed using descriptive statistics, independent t-test, one-way analysis of variance, Pearson's correlation, and multiple linear regression analysis using SPSS 27.0. Results: Results revealed significant positive correlations between nursing performance and learning agility, grit, and positive psychological capital. Stepwise multiple regression analysis identified positive psychological capital as the strongest predictor of nursing performance, followed by work experience, learning agility, grit, and educational level. These variables accounted for 51% of the variance in nursing performance. Conclusion: This study underscored the importance of positive psychological capital, learning agility, and grit in improving nursing performance. Healthcare organizations should prioritize the development of these attributes among nurses. Implementing strategies to enhance these factors in nursing practice and education could improve nursing performance, potentially resulting in better patient outcomes and increased job satisfaction. Future research should explore specific interventions to cultivate these qualities and assess their long-term impact on nursing practice.

심근 관류 SOECT의 새로운 방법 (New Imaging Techniques in Myocardial Perfusion SPECT)

  • 이동수
    • 대한핵의학회지
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    • 제32권1호
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    • pp.1-9
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    • 1998
  • Gated myocardial SPECT and attenuation correction gave birth to new insights into the pathophysiology of ischemic myocardial perfusion and function in clinical routine practice. Gated myocardial Tc-99m-compound SPECT improved diagnostic accuracy of coronary artery disease and enabled us to observe motion and thickening of myocardial walls as well as myocardial perfusion at the same time. Quantitative and qualitative assessment of myocardial performance and perfusion let us to understand the myocardial physiology in ischemia and infarction. In every patient who underwent gated perfusion SPECT, we will find ejection fraction, left ventricular volumes and regional wall motion. There are hopes to use gated TI-201 SPECT for the same purpose and to use gated SPECT for evaluation of wall motion and thickening at stress or immediate post-stress. Attenuation correction could improve diagnostic accuracy mainly by increasing normalcy ratio or performance of non-expert physicians. Both gated methods and attenuation correction improved specificity of non-expert physicians in diagnosing patients with moderate pretest likelihood. New imaging techniques will fill the desire of cardiologists to examine function and perfusion, and possibly metabolism in their clinical routine practice.

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Treatment Strategies of Improving Quality of Care in Patients With Heart Failure

  • Se-Eun Kim;Byung-Su Yoo
    • Korean Circulation Journal
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    • 제53권5호
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    • pp.294-312
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    • 2023
  • Heart failure (HF) is a global health problem closely related to morbidity and mortality. As the burden of HF increases, it is necessary to manage and treat this condition well. However, there are differences between real-world practice and guidelines for the optimal treatment for HF. Patient-related, healthcare provider-related, and health system-related factors contribute to poor adherence to optimal care. This review article aims to examine HF treatment patterns and treatment adherence in real-world practice, identify clinical gaps to suggest ways to improve the quality of care for HF and clinical outcomes for patients with HF. Although it is important to optimize treatment based on evidence-based guidelines to the greatest extent, it is known that there is still poor treatment adherence, and many patients do not receive guideline-directed medical therapy, especially at the early stages. To improve medication adherence, qualitative evaluation through performance measurement, as well as education of patients, caregivers and medical staff through a multidisciplinary approach are important.

간호대학생의 임상적 추론 역량에 미치는 융합적 영향요인 (Convergence Factors Influencing Clinical Reasoning Competency of Nursing Students)

  • 한숙원;전열어
    • 한국융합학회논문지
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    • 제11권10호
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    • pp.181-186
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    • 2020
  • 본 연구에서는 간호대학생을 대상으로 임상적 추론 역량에 대하여 조사하고 이에 영향을 미치는 요인을 파악하고자 시도되었다. 본 연구는 GPower 3.1.9.4를 이용하여 간호대학생 3, 4학년 297명을 대상으로 간호핵심역량과 관련된 학습능력을 파악하고자 임상적 추론, 문제해결능력, 비판적 사고성향, 임상적 의사결정, 자기주도학습, 임상수행능력을 측정하고 임상적 추론 역량에 영향을 미치는 변수를 검정하는 서술연구이다. 연구결과를 살펴보면, 학년별로 임상적 추론역량을 비교한 결과 유의한 차이를 보였으며(p=0.001), 또한 임상적 추론역량에 대한 영향변수를 확인한 결과 문제해결능력, 임상적 의사결정 능력, 임상수행능력, 임상실습경험(학년)이 유의한 변수로 나타났다.(p,.001). 본 연구결과는 간호대학생의 임상적 추론 역량을 높이기 위한 다양한 교육과정개발의 근거로 활용될 수 있을 것으로 보이며, 향후 임상적 추론 역량을 높일 수 있는 교육 개발을 위한 연구가 필요할 것으로 사료된다.

간호대학생의 시뮬레이션실습 기반 임상판단력과 흡인간호수행능력 (Simulation-based Clinical Judgment and Performance Ability for Tracheal Suction in Nursing Students)

  • 임경춘
    • 한국간호교육학회지
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    • 제23권3호
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    • pp.330-340
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    • 2017
  • Purpose: This study was conducted to explore the relationship between simulation-based clinical judgment and performance ability for tracheal suction in nursing students. Methods: With a convenience sampling, 207 nursing students participated in this descriptive study. Lasater clinical judgment rubric was used for self-reported clinical judgment in addition to observe the skill of tracheal suction using a checklist. Data were analyzed by descriptive statistics, t-test and Pearson's correlation coefficients using the SPSS/WIN 22. Results: A scenario with pneumonia patient was developed to observe the skill of tracheal suction during simulation-based practices. Then self-reported clinical judgment was scored. The mean score of total sum of clinical judgment, total mean of clinical judgment, and performance skill were $36.44{\pm}4.82$, $13.44{\pm}1.71$, and $42.32{\pm}5.05$, respectively. Statistically, students having good skills in suction showed significant differences in clinical judgment of interpreting (p=.031) compared to students having fair skills. Conclusion: The results of this study show that a structured debriefing method utilizing Lasater clinical judgment rubric is helpful. Also, simulation-based practice related to adult nursing in the respiratory system was useful for increasing the core basic skills among nursing students.

약학 실무실습교육에서의 효과적인 피드백 (Providing Effective Feedback within Pharmacy Practice Education)

  • 윤정현
    • 한국임상약학회지
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    • 제27권2호
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    • pp.55-62
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    • 2017
  • Experiential education is a core curriculum of pharmacy education. In experiential education, formative feedback is an integral component of learning and teaching process. Feedback is defined as information provided by a preceptor regarding student's performance based on direct observation. With effective feedback, students can have opportunities to reinforce or correct behaviors and to acquire knowledge or skills. Students highly value and appreciate feedback. They rank provision of effective feedback as one of the most important qualities of preceptors. Preceptors, however, lack an understanding of feedback or practical skills necessary for providing effective feedback. As a result in reality, the feedback provided to students can be differentially effective in improving students' learning. This article describes a theoretical understanding of feedback including definition and value, as well as types of feedback. In addition, practical aspects in providing feedback, such as contents, timing, techniques, and models, are addressed. By understanding the value of feedback and mastering various feedback skills, preceptors will promote students' learning and enhance educational outcomes of experiential education.

Assessment of Acupuncture and Moxibustion Medicine Clinical Practice Using the Objective Structured Clinical Examination

  • Cho, Eunbyul;Lee, Ju-Hyun;Kwon, O Sang;Hong, Jiseong;Cho, Nam Geun
    • Journal of Acupuncture Research
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    • 제38권3호
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    • pp.219-226
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    • 2021
  • Background: The objective structured clinical examination (OSCE) is a widely used method to assess the clinical performance of students in clinical practice. Although OSCE has been used for undergraduate students of Korean medicine, this has not been widely reported. Methods: In 2020, the practical course for acupuncture and moxibustion medicine (acupuncture, electroacupuncture, pharmacopuncture, auricular acupuncture, and burning acupuncture) was taught using flipped learning, according to clinical practice guidelines, and assessed by the OSCE. The appropriateness of this model of education and its evaluation using OSCE were evaluated using a 5-point Likert scale, and the results were analyzed. Results: Of the respondents, 67% reported that the OSCE accurately reflected their competency, and 82% reported that online video lectures helped them to improve their clinical skills. The average adequacy score of the model was > 3.7/5, and the average adequacy score of the checklist used in the OSCE was > 4.1/5 for all 5 clinical application skills. The difference in the mean self-efficacy score between students who had taken the OSCE and those students who had not taken the OSCE, was highest in the burning acupuncture group (0.923). Conclusion: This study showed that students' satisfaction with the OSCE was high and flipped learning was an effective education model. In the future, models representing the human body or simulated patients should be used to evaluate students' skills and attitude.

Effect of a Web-enhanced Clinical Practicum on Learning Outcome of Adult Nursing Practicum in Nursing Students

  • Hwang, Seon-Young;Kang, Hee-Young;Choi, Ja-Yun;So, Hyang-Sook
    • International Journal of Contents
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    • 제8권2호
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    • pp.36-42
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    • 2012
  • This study was conducted to develop Web-based multimedia content that assists undergraduate students in a clinical practicum on adult nursing. The study examined whether students in the intervention group could obtain clinical knowledge and perform more effectively when encouraged to learn Web content as compared with students in the conventional group. Web-based multimedia content consisting of 13 learning modules was developed based on real patients' scenarios through collaboration among college professors. A total of 120 nursing students (74 for the intervention and 46 for the conventional groups) from two universities in G-city, who engaged in a 3-week long clinical practicum in the digestive and respiratory units of a university hospital, participated in the study. Students' knowledge, self-directed learning, and clinical performance ability were measured using self-administered questionnaires. Data for pre- and posttests were collected over a 2-month period, between May and June of 2009. Clinical knowledge and self-reported clinical performance scores were significantly higher in students using the Web-enhanced clinical practicum than in those in the conventional group. However, there was no significant difference in self-directed learning ability between the 2 groups. These results demonstrate that Web-based multimedia content can be an effective educational tool for enhancing students' clinical knowledge and performance.