• 의학교육논단
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• 제20권3호
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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.

• 의학교육논단
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• 제20권3호
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• pp.123-127
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• 2018

Graduate medical education is the most important phase among the three stages of medical education. It links basic medical education and continuing professional development. It is also a critical period in acquiring meaningful knowledge, skills and professionalism. The residents should be able to develop the core common competencies on top of their specialozeds field's expertise, in order to function as independent and qualified physicians. Despite the obvious importance of graduate medical education, the system in Korea has been designed and executed to meet the needs of the hospitals in the perspective of manpower management, rather than to educate and empower the residents. As a result, graduate medical education in Korea lacks clear educational objectives and systemic, resident-centered curriculums. Yet, we have no accreditation body to evaluate graduate medical education programs. In order to normalize graduate medical education, an integrated and unified institution that manages the whole process of the graduate medical education is desperately needed. Special attention should be given to the role of medical schools in educating the core common competencies. The Korean Association of Medical Colleges, the Korean Institute for Medical Education and Evaluation, and the Korean Academy of Medical Sciences should cooperate intimately to establish a new organization for the systemic management and development of graduate medical education.

• Advances in Traditional Medicine
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• 제1권1호
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• pp.1-7
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• 2000

Although Oriental medicines have long been used effectively in treating many diseases throughout the world, the pharmacological mechanisms of most Oriental medicines used have not been defined. As part of our continuing search for biologically active antiallergic drugs from natural sources, Oriental medicines were analyzed. Some Oriental medicines have been used against various allergic diseases for generations, and still occupies an important place in traditional medicine in Korea. It is also still unclear how Oriental medicine prevents allergic disease in experimental animal models. Some Korean folk medicines inhibited the mast cell-mediated allergic reaction. This review summarizes the effective folk medicine in experimental effect of allergic reaction. Potential antiallergic folk medicines include: Poncirus trifoliata; Siegesbeckia glabrescence; Solanum lyratum; Aquilaria agallocha; Ulmi radicis; Polygonum tinctorium; Hwanglyun-Haedok-Tang; Rehmannia glutinosa; Kum- Hwag-San; Syzygium aromaticm; Spirulina platensis; Sosiho-Tang; Sinomenium acutum; Schizonepta tenuifolia; Shini-San; Magnoliae flos; Sochungryoung-Tang; Oryza sativa; Cryptotympana atrata; Salviae radix; Rosa davurica; Asiasari radix; Chung-Dae-San; and Cichorium intybus. Understanding the mechanisms of action for these Oriental medicines can permit drug development and laying of the ground-work for evaluating potential synergistic effects by addition and subtraction of prescriptions.

• 한국철도학회:학술대회논문집
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• 한국철도학회 2007년도 춘계학술대회 논문집
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• pp.1121-1128
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• 2007

Subway routes $1{\sim}4$ were constructed in gravel roadbed track structure in consideration of the technological capabilities, construction cost and duration at the time of the initial construction. As such, 224.8km, approximately 81.2% of entire length, of total length of railway track at 276.9km was constructed on gravel roadbed. However, improvement of gravel roadbed to concreted roadbed began in 1998 due to problems including frequent repair works and limited time application for such works caused by occurrence of tract distortion during operation as well as lowering of roadbed functions and generation of dust caused by frictional power, impact absorption capabilities, abrasion and crushing of gravel on roadbed. Currently, this improvement is continuing with target of converting entire route into concreted roadbed structure. Therefore, this Study modifies formula for setting cant, analyze the correlation between wearing of rail side of the curvature and cant insufficiency following increasing of the running speed of the train, and to present the directions for fundamental review for adjustment of cant insufficiencies at the time of improvement of gravel roadbed to concreted roadbed that is being implemented on the operational tracks of the railway trains.

• Asian Pacific Journal of Cancer Prevention
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• 제16권3호
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• pp.853-857
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• 2015

Background: Gastric cancer is the most common cancer in the Iranian population. The aim of this study was to determine the effect of clinicopathological factors on prognosis by meta-analysis. Materials and Methods: A literature search was conducted using MEDLINE, EMBASE and Cochrane library and extensive literature search using the Persian databases until February 2011. Prospective follow up studies with multivariate analysis of overall survival of the patients with gastric cancer were included in this review. The data were analyzed by CMA.2. Publication bias are checked by funnel plot and data are shown as Forest plots. Results: From a total of 63 articles, 14 retrospective studies which examined 5 prognostic factors and involving 10,500 patients were included. Tumor size (>35mm) was the main significant factor predicting an unfavorable prognosis for the patients with gastric cancer (RR=1.829, p<0.001) followed by presence of distant metastases (RR=1.607, p<0.001), poor differentiation (RR=1.408, p<0.001) and male sex (RR=1.194, p<0.001). Lymph node metastases (RR=1.058, p=0.698) and moderate differentiation (RR=0.836, p=0.043) were not statistically significant as prognostic factors. Conclusions: This meta-analysis suggests that tumor size>35mm, poor differentiation, presence of distant metastasis and male gender are strongly associated with a poor prognosis in Iranian patients with gastric cancer.

• 대한간호학회지
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• 제29권3호
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• pp.551-562
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• 1999

The purse of this study is to identify whether ethical values of Korean nurses are deontological or utilitarian. Nurse's ethical value questionnaire was developed from review of the literature and interview of nurses in the clinical settings. Ethical problem are categorized into four areas 1) human life 2) nurse-patient relationship 3) nurse-nursing task relationship 4) nurse-collegue relationship The data were obtained from 250 nurses in the clinical settings from Jun. to July in 1998 using the ethical value questionnaire developed by Lee (1990). The analysis of data was done by Pearson's correlation coefficient, t-test and anova. The results of this study were as follows : 1. The ethical values of human life slightly took up the position of utilitarian. 2. The ethical value of nurse-patient relationship slightly took up the deontological position. 3. The ethical value of nurse-nursing task relationship slightly took up the deontological position. 4. The ethical value of nurse-collegue relationship greatly took up the deontological position. 5. The ethical values of nurses related to demographic characteristics of age, marital status, position. Therefore it is suggested that new strategies and continuing education programs be established to help clinical nurses formlulate higher ethical values.

• Journal of Trauma and Injury
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• 제25권4호
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• pp.283-286
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• 2012

A trauma surgeon is always concerned about child abuse when he or she meets injured children. Abused children will be neglected if trauma surgeons only concentrate on the injured site or physical dynamics. Lately, violence on children has increased in Korea. Therefore, in this study, we considered child abuse through a review of the literatures. An eleven-year-old boy visited the emergency room vomiting with abdominal distension. He had been kicked in the abdomen by his step-mother 10 days earlier. The computed tomography revealed a transected pancreas tail and neck with a large pesudocyst (Fig. 1) and laboratory findings showed an elevated amylase level of more than 6,500 IU/L. Because he complained of severe pain with rebound tenderness on the whole abdomen, he underwent an emergent laparotomy, a distal pancreatectomy of the tail portion with an anti-leakage procedure on the cut surface of the pancreas. However, he underwent a distal pancreatectomy again on the neck portion of the pancreas because of a continuing pseudocyst with severe pain that could not be controlled with conservative managements. After that, his symptoms were improved and he returned to his daily life.

• 의학교육논단
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• 제15권3호
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• pp.144-150
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• 2013

Before Outcome-based curriculum reform, medical graduate school and medical schools of korea need to understand limit or threshold of outcome-based education's point of view. This article examines the multi-dimensional concept of competence suggested by Stoof and colleagues and discusses about implication for outcomebased education in medical education of Korea. Because Stoof and colleagues's five dimensions of competence reveal various concepts and educational methods of competence. Therefore, It is possible to use to identify the strengths and weaknesses of outcome-based education of Korea as a reference standard. Five dimensions of competence suggested by Stoof and colleagues is consist of 'personal vs. task characteristics,' 'individual vs. distributed competence,' 'specific vs. general competence,' 'levels of competence vs. competence as a level,' and 'teachable vs. non-teachable.' Implication for outcome-based education in medical education of Korea is, first, that It should recognize to outcome-based education as a one of educational models approaching to competence. Second, discussion about competence should be expanded from pre-medical education to graduated medical education and continuing medical education.

• 의학교육논단
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• 제15권3호
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• pp.125-135
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• 2013

Since the establishment of the national medical licensing examination board in 1992, the medical licensing examination system has changed enormously and this has had a number of impacts on examination services. All those reforms were aimed at improving the relevance and reliability of the test. Several attempts of the testing system have appeared in the new examination service, and which have also brought about the changes in the medical school curriculum such as introducing integrated courses instead of traditional subjects, using test scores as a reference to the post-graduation selection test. Some examples of changes in the examination system are as follows: 1) choosing three integrated test subjects and outlines of their reference content instead of 15 academic subjects, 2) adjusting the ratio of multiple choice question items to focus more on the problem solving level, 3) introduction of 'one-best answer' single set and 'extended matching type items, 4) item construction based on real clinical cases and real clinical materials. Recently, a clinical skill test system has been introduced to measure examinees' basic clinical skills competencies. Despite continuing efforts, the examination system still has many issues remaining to be solved. These problems include the differential weighting of test items, appropriate threshold for passing, and practicality of pre-testing to stabilize the passing rate and avoid the hazards of newness and undesirably difficult test items.

• 의학교육논단
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• 제22권1호
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• pp.16-27
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• 2020

The accreditation process (AccP) is both an opportunity and a burden for medical schools-which one it becomes depends on how medical schools recognize and utilize the AccP. In other words, if a medical school recognizes the AccP only as a formal procedure or as a means for continuing medical education, it will be a burden for the medical school. However, if a medical school recognizes the real and positive value of the AccP, it can be both an opportunity and a tool for developing medical education. The educational value of the AccP is to improve the quality, equity, and efficiency of medical education, along with increasing the options of choice. In order for the AccP to contribute to the development of medical education, accrediting agencies and medical schools must first be recognized as part of an "educational alliance" working together towards common goals. Secondly, clear guidelines on the accreditation standards should be periodically reviewed and shared. Finally, a formative evaluation using self-evaluation as a system that can utilize the AccP as an opportunity to develop medical education must be introduced. This type of evaluation system could be developed through collaboration among medical schools, academic societies for medical education, and the accrediting authority.