• 제목/요약/키워드: Clinical reasoning

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ICF Tool을 적용한 뇌졸중 환자의 바닥에 앉고 일어서기에 대한 중재전략의 증례 (A Case Report of Intervention Strategy applied ICF Tool about Floor to Stand and Stand to Floor for Stroke Patient)

  • 윤태원;김태윤
    • 대한물리치료과학회지
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    • 제18권1호
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    • pp.33-49
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    • 2011
  • The process of physical therapy uses a problem-solving approach to enhance a patients's functioning status. The International Classification of Functioning, Disability and Health(ICF) is the common concept for the functioning in the world. Physical therapists require the ability to identify problems, formulate hypothesis, and plan intervention strategies through clinical reasoning. In the clinical process, physical therapists need to use standard and common languages in speech and in documentation. The purpose of this study was to suggest the process of making strategy for efficient intervention, examining and evaluating the functional problem of the person with stroke using ICF tools. For the first step in this process model, therapists could list the information relating to functional problems used by the ICF Core set and then could identify the interaction among the problems using the ICF assessment sheet. For the next step, therapist is needed to make the hypothesis and hypothesis testing, and then set a primary functional goals and therapeutic goals in detail after prioritizing the problems to be managed based on the problem list. Finally, after setting the identified problems as the purpose of intervention through the hypothesis testing, therapist could do some intervention after making a plan to solve these problems, and find out the outcomes using the ICF evaluation display. This report illustrates how to apply the process based on ICF concept into physical therapy practice. Making a decision for the most efficient intervention requires that therapists use the clinical reasoning process based on ICF concept.

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'간호관리 및 윤리' 교과목의 문제중심학습 패키지 개발 및 평가 (Development and Evaluation of a Problem-based Learning in Nursing Management and Ethics)

  • 김인숙;정제인;김은현;이태화
    • 간호행정학회지
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    • 제13권1호
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    • pp.53-64
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    • 2007
  • Purpose: This study was aimed to develop and evaluate of a Problem-based Learning (PBL) in the course of Nursing Management and Ethics. Method: The design of the study was both methodological and one group only pre-post design. The sample included 61 senior students who are currently enrolled in Nursing management and Ethics course in college of nursing. Data regarding PBL evaluation were collected on the critical thinking and clinical reasoning using structured questionnaires during March to June, 2005. Data were analyzed using descriptives and paired t-test. Results: A total of three PBL packages was developed by the two faculty members and two teaching assistants who are majoring in nursing management. PBL packages that had been developed was applied to 61 senior students for three months. Critical thinking and clinical reasoning were measured twice pre and post the application of PBL packages. There were statistically significant differences in the critical thinking and clinical reasoning between the pre and post PBL application. Conclusion: PBL was considered to be effective in understanding the learning concepts in the Nursing Management and Ethics. Further research on the facilitative strategies and development model considering the characteristics of Nursing Management and Ethics course is needed.

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사례기반추론을 이용한 대용량 데이터의 실시간 처리 방법론 : 고혈압 고위험군 관리를 위한 자기학습 시스템 프레임워크 (Data Mining Approach for Real-Time Processing of Large Data Using Case-Based Reasoning : High-Risk Group Detection Data Warehouse for Patients with High Blood Pressure)

  • 박성혁;양근우
    • 한국IT서비스학회지
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    • 제10권1호
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    • pp.135-149
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    • 2011
  • In this paper, we propose the high-risk group detection model for patients with high blood pressure using case-based reasoning. The proposed model can be applied for public health maintenance organizations to effectively manage knowledge related to high blood pressure and efficiently allocate limited health care resources. Especially, the focus is on the development of the model that can handle constraints such as managing large volume of data, enabling the automatic learning to adapt to external environmental changes and operating the system on a real-time basis. Using real data collected from local public health centers, the optimal high-risk group detection model was derived incorporating optimal parameter sets. The results of the performance test for the model using test data show that the prediction accuracy of the proposed model is two times better than the natural risk of high blood pressure.

Data Mining Techniques for Medical Informatics: Application to SNP Analysis

  • 천세학;김진;박윤주;함기백;천세철
    • 한국지능정보시스템학회:학술대회논문집
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    • 한국지능정보시스템학회 2005년도 공동추계학술대회
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    • pp.258-263
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    • 2005
  • Haplotype-based analysis using high-density SNP markers have gained a great attention in evaluating genes in gene analysis and various clinical situations. However, there has been no research on disease diagnostic modeling based on SNPs analysis to our knowledge. The purpose of this study is to explore how knowledge discovery techniques are applied in medical informatics area and proposes a Case Based Reasoning (CBR) technique for diagnosis of gastric caner using Single Nucleotide Polymorphism(SNP).

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의과대학 임상실습에서의 학생평가방법: 과거, 현재 및 제언 (Assessment of Medical Students in Clinical Clerkships)

  • 이상엽;임선주;윤소정;백선용;우재석
    • 의학교육논단
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    • 제15권3호
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    • pp.120-124
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    • 2013
  • The clinical clerkship focuses students on developing their ability to perform comprehensive diagnosis and management of patients with common undifferentiated problems by the integration of knowledge and clinical reasoning. Therefore, the clerkship evaluation system should assess their actual problem solving and professional behavior. However, concern remains that clerkship evaluations are imprecise and highly variable. This review is designed to provide faculty members with concepts, options, and a methodology to actively teach and evaluate the clinical clerkship, as well as offer encouragement and inspiration to medical students. We reviewed past and current clinical clerkship evaluations and discuss several tips to improve clinical excellence such as continuity, transparency of the evaluation process, a faculty development program, practical examination of clinical skills, implementation of a checklist for recording exposure and skills, providing prompt and constructive feedback to students, self-evaluation of professional performance, varying multi-faceted assessment combinations, being outpatient clinic-centered, and having dedicated faculty members who give students one-on-one contact with a preceptor.

동결견 환자의 상지 기능 회복에 대한 ICF Tool을 적용한 중재 전략과 문서 기록-사례연구 (ICF Tool applied Intervention Strategy and Charting on Upper Extremity Functional Recovery of the Frozen Shoulder Patient - Case Study)

  • 공선웅;임현철;정연우
    • 대한정형도수물리치료학회지
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    • 제17권1호
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    • pp.35-44
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    • 2011
  • Background: This study was to suggest the process of making strategy for effective intervention and evaluation on functional problems of the frozen shoulder patient applied International Classification of Functioning Disability and Health (ICF) Tools. Methods: The patient was 48years old woman with right shoulder adhesive capsulitis and calcific tendinitis. In first phase, therapists could list the information relating to functional problems used by the ICF Core set and then could confirm the interaction among the problems using the ICF assessment sheet. In second phase, therapist is needed to make the hypothesis and hypothesis testing and then set a primary functional goals and therapeutic goals in detail after prioritizing the problems to be managed based on the problem list. Lastly, after setting the confirmed problems as the purpose of intervention through the hypothesis testing, therapist could do some intervention after making a plan to solve these problems. Results: This report illustrates how to apply the process based on ICF concept into physical therapy practice. The decided hypothesis and goal that are to solve the problems the client faced were remarkably meaningful. Conclusions: Clinical decision making for the most effective intervention requires that therapists use the clinical reasoning process based on ICF concept.

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악하부종괴에 대한 임상적 연구 (CLINICAL STUDY ON SUBMANDIBULAR MASSES)

  • 장현석;유준영
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제18권4호
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    • pp.701-705
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    • 1996
  • There are many kind of diagnostic entities in submandibular or neck masses, and we can set up treatment plan and estimate treatment result, prognosis by accurate diagnosis. By reasoning medical and dental history, physical examination, anatomical consideration of masses in submandibular or neck area, location of masses, laboratory and radiographic studies, we can formulate a clinical diagnosis or differential diagnosis. Although a clinical diagnosis might suffice in some instances, a definitive(microscopic) diagnosis is frequently required for proper treatment. In order to get some information about making accurate diagnosis and setting up appropriate treatment plan, we did clinical study and histopathologic classification of 82 patients who visited and were operated for submandibular masses at Department of Oral and Maxillofacial Surgery in Seoul National University Hospital from 1988 to 1992. The result were as follows : 1. Submandibular masses occured most frequently in forties and fifties, and there was no sex predilection. 2. Chief complaints were in order of mass, swelling, pain and consistency were soft mass, mobile hard mass, firm mass, diffuse swelling in descending order. 3. Most frequent pathologic finding was lymphadenitis. 4. Site of submandibular masses were submandible, neck, submental, retromandible in descending order, and there was no predilection between left and right side. 5. Accuracy rate between clinical impression and result was 51.2%.

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논증강화교육이 의학과 학생의 문제바탕학습 경험에 미치는 영향 (Effect of Argumentation Instruction on Medical Student Experiences with Problem-Based Learning)

  • 주현정
    • 의학교육논단
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    • 제19권2호
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    • pp.101-108
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    • 2017
  • When participating in problem-based learning (PBL), it is important for medical students to generate claims and provide justifications for their claims in small group discussions. This study aimed to investigate the effect of argumentation instruction on medical student learning experiences with PBL. A total of one hundred first-year preclinical students from Inje University College of Medicine, who had attended argumentation instruction, participated in this study. All of the participants completed a 5-point Likert scale questionnaire regarding their learning experiences with PBL, before and after the argumentation instruction. The questionnaire comprised 22 items with eight subcategories: argumentation activity, reflection, integration of basic and clinical science, identification of lack of knowledge, logical thinking, self-directed study, communication, and attitude toward discussion. The collected data were analyzed through a paired-sample t-test. The results of this study found that the argumentation instruction promoted the preclinical students' experiences with argumentation activities, reflection, an integration of basic and clinical science, the identification of their lack of knowledge, logical thinking, and self-directed study, and it increased positive attitudes toward group discussion. The findings suggest argumentation instruction can enhance medical student group discussions and help students achieve the objectives of PBL, including acquisition of basic and clinical science knowledge and development of clinical reasoning and self-directed learning abilities, which can highlight the meaningful learning experiences students have with PBL.