• Title/Summary/Keyword: Hospital Clinical Training

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Noncontrast Computed Tomography-Based Radiomics Analysis in Discriminating Early Hematoma Expansion after Spontaneous Intracerebral Hemorrhage

  • Zuhua Song;Dajing Guo;Zhuoyue Tang;Huan Liu;Xin Li;Sha Luo;Xueying Yao;Wenlong Song;Junjie Song;Zhiming Zhou
    • Korean Journal of Radiology
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    • v.22 no.3
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    • pp.415-424
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    • 2021
  • Objective: To determine whether noncontrast computed tomography (NCCT) models based on multivariable, radiomics features, and machine learning (ML) algorithms could further improve the discrimination of early hematoma expansion (HE) in patients with spontaneous intracerebral hemorrhage (sICH). Materials and Methods: We retrospectively reviewed 261 patients with sICH who underwent initial NCCT within 6 hours of ictus and follow-up CT within 24 hours after initial NCCT, between April 2011 and March 2019. The clinical characteristics, imaging signs and radiomics features extracted from the initial NCCT images were used to construct models to discriminate early HE. A clinical-radiologic model was constructed using a multivariate logistic regression (LR) analysis. Radiomics models, a radiomics-radiologic model, and a combined model were constructed in the training cohort (n = 182) and independently verified in the validation cohort (n = 79). Receiver operating characteristic analysis and the area under the curve (AUC) were used to evaluate the discriminative power. Results: The AUC of the clinical-radiologic model for discriminating early HE was 0.766. The AUCs of the radiomics model for discriminating early HE built using the LR algorithm in the training and validation cohorts were 0.926 and 0.850, respectively. The AUCs of the radiomics-radiologic model in the training and validation cohorts were 0.946 and 0.867, respectively. The AUCs of the combined model in the training and validation cohorts were 0.960 and 0.867, respectively. Conclusion: NCCT models based on multivariable, radiomics features and ML algorithm could improve the discrimination of early HE. The combined model was the best recommended model to identify sICH patients at risk of early HE.

The study of stress, satisfaction and the frequency of performing of Dental hygiene students to clinical training (일부 지역 치위생과 학생의 임상실습에 대한 수행빈도, 만족도 및 스트레스에 관한 연구)

  • Park, Young-Nam;Yoon, Sung-Uk;Lee, Kyeong-hee
    • Journal of Digital Convergence
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    • v.14 no.9
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    • pp.359-367
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    • 2016
  • This study will be used as basic data to hold clinical training effective by researching and analyzing frequency, satisfaction and stress for the clinical practice of dental hygiene course students. The survey was undergone from Feb. 1, 2014 to Mar. 31 for 219 dental hygiene course juniors who had experienced clinical training in 3 year colleges located in Daejeon and Chungcheong Province. From the study, general and university hospital holds the highest satisfaction in clinical practice and dental offices in acquiring skills. Also, a significant difference is shown between the frequency and satisfaction according to clinical training sheets. The highest degree of stress is shown in dental offices for 'toothbrushing training and dental health education' and in general and university hospital for 'patient counselling'. Therefore, consideration should be made to establish the direction of education, standard criteria and evaluation method for student clinical training to raise its effectiveness.

Analysis of procedural performance after a pilot course on endovascular training for resuscitative endovascular balloon occlusion of the aorta

  • Sung Wook Chang;Dong Hun Kim;Dae Sung Ma;Ye Rim Chang
    • Journal of Trauma and Injury
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    • v.36 no.1
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    • pp.3-7
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    • 2023
  • Purpose: As resuscitative endovascular balloon occlusion of the aorta (REBOA) is performed in an extremely emergent situation, achieving competent clinical practice is mandatory. Although there are several educational courses that teach the REBOA procedure, there have been no reports evaluating the impact of training on clinical practice. Therefore, this study is aimed to evaluate the effects of the course on procedural performance during resuscitation and on clinical outcomes. Methods: Patients who were managed at a regional trauma center in Dankook University Hospital from August 2016 to February 2018 were included and were grouped as precourse (August 2016-August 2017, n=9) and postcourse (September 2017- February 2018, n=9). Variables regarding injury, parameters regarding REBOA procedure, morbidity, and mortality were prospectively collected and reviewed for comparison between the groups. Results: Demographics and REBOA variables did not differ between groups. The time required from arterial puncture to balloon inflation was significantly shortened from 9.0 to 5.0 minutes (P=0.003). There were no complications associated with REBOA after the course. Mortality did not show any statistical difference before and after the course. Conclusions: The endovascular training for REBOA pilot course, which uses a modified form of flipped learning, realistic simulation of ultrasound-guided catheter insertion and balloon manipulation, and competence assessment, significantly improved procedural performance during resuscitation of trauma patients.

Survey on the undergraduate curriculum in clinical pharmacology and interns' prescribing ability in South Korea

  • Gu, Namyi;Kim, Kyong-Jee;Lim, Chi-Yeon;Lee, Jun Kyu;Rhee, Moo-Yong;Shin, Kwang-Hee;Lee, Seung-Hwan;Ahn, Sangzin
    • Translational and Clinical Pharmacology
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    • v.26 no.3
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    • pp.128-133
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    • 2018
  • Appropriate prescription writing is one of the critical medical processes affecting the quality of public health care. However, this is a complex task for newly qualified intern doctors because of its complex characteristics requiring sufficient knowledge of medications and principles of clinical pharmacology, skills of diagnosis and communication, and critical judgment. This study aims to gather data on the current status of undergraduate prescribing education in South Korea. Two surveys were administered in this study: survey A to 26 medical schools in South Korea to gather information on the status of undergraduate education in clinical pharmacology; and survey B to 244 intern doctors in large hospitals to gather their opinions regarding prescribing education and ability. In survey A, half of the responding institutions provided prescribing education via various formats of classes over two curriculums including lecture, applied practice, group discussions, computer-utilized training, and workshops. In survey B, we found that intern doctors have the least confidence when prescribing drugs for special patient populations, especially pregnant women. These intern doctors believed that a case-based practical training or group discussion class would be an effective approach to supplement their prescribing education concurrently or after the clerkship in medical schools or right before starting intern training with a core drug list. The results of the present study may help instructors in charge of prescribing education when communicating and cooperating with each other to improve undergraduate prescribing education and the quality of national medical care.

NHS Hospital Pharmacist Training Programme in UK (영국의 NHS 병원약사 수련 현황)

  • Kim, Yun Jung
    • Korean Journal of Clinical Pharmacy
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    • v.25 no.4
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    • pp.209-215
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    • 2015
  • The aim of the research was to explore post-registration training opportunities for NHS hospital pharmacists which contributes to promote structural reform of the professional development and lifelong learning for Korean hospital pharmacists. In UK, all pharmacists are required to complete at least 9 Continuing Professional Development (CPD) entries per each year to maintain their professional registration. Types of accredited postgraduate qualification (part-time) in Pharmacy Practice available for hospital pharmacists are Postgraduate Certificate (PgCert, year 1), Postgraduate Diploma (PgDip, year 2), Master of Science (MSc year 3), and Professional Doctorate in Pharmacy programme (DPharm, 4-5 years or more). Clinical pharmacy diploma is more likely to become a minimum qualification in order to progress whilst working for the NHS. Pharmacy independent prescribers are allowed to prescribe all medications except cocaine, dipipanone, and diamorphine for the purpose of treating addiction within their competencies. NHS pharmacists are also classified by band point system depending on their practical/clinical knowledge and skills which starting from band 5 (Pre-registration pharmacist) up to band 9. Various learning and development options are also offered including teaching sessions, conferences and local forums.

Review the Governance of Graduate Medical Education (대학(대학원) 졸업 후 의사 수련교육 거버넌스 고찰)

  • Park, Hye-Kyung;Park, Yoon-Hyung
    • Health Policy and Management
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    • v.29 no.4
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    • pp.394-398
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    • 2019
  • Education on the physician continues with undergraduate medical education, graduate medical education, and continuous medical education. The countries such as the United States, Japan, the United Kingdom, German, and others are required to undergo training in the clinical field for 2 years after completing the national medical examination, and to become doctors after passing the clinical practice license test. Korea can obtain a medical license and become a clinical doctor at the same time if it passes written and practical tests after completing 6 years of undergraduate medical education or 4 years of graduate school. About 90% of medical school graduates replace clinical practice with 4-5 years of training to acquire professional qualifications, but this is an option for individual doctors rather than an extension of the licensing system under law. The medical professional qualification system is implemented by the Ministry of Health and Welfare on the regulation. In fact, under the supervision of the government, the Korean Hospital Association, the Korean Medical Association, and the Korean Academy of Medical Sciences progress most procedures. After training and becoming a specialist, the only thing that is given to a specialist is the right to mark him or her as a specialist in marking a medical institution and advertising. The government's guidelines for professional training are too restrictive, such as the recruitment method of residents, annual training courses of residents, dispatch rule of the residents, and the quota of residents of training hospitals. Although professional training systems are operated in the United States, the United Kingdom, France, and Germany, most of them are organized and operated by public professional organizations and widely recognize the autonomy of academic institutions and hospitals. Korea should also introduce a compulsory education system after graduating from medical education and organize and initiate by autonomic public professional organization that meets global standards.

The Effectiveness of School Based Short-Term Social Skills Training in Children with Attention-Deficit/Hyperactivity Disorder(ADHD) (ADHD 초등학생을 위한 학교 중심 사회성기술 훈련 프로그램의 효과에 대한 연구)

  • Paek, Myung-Jae;Ahn, Jung-Kwang;Lim, So-Yun;Kim, Yang-Ryul;Park, Min-Hyeon;Kim, Boong-Nyun;Cho, Soo-Churl;Shin, Min-Sup;Kim, Jae-Won;Kim, Hyo-Won
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.20 no.2
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    • pp.82-89
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    • 2009
  • Objectives: Children with attention-deficit hyperactivity disorder(ADHD) often have difficulties in social behavior. The aim of this study was to evaluate the effectiveness of a short-term training program for improving social skills, self-perception and attention deficits. Methods: The subjects were nine children diagnosed with ADHD with(or without) other mental disorders using the Diagnostic Interview Schedule for Children(DISC-ADHD) module. Children were given eight sessions of a social skills training program. Parents of children simultaneously participated in their own training which was designed to support their children's generalization of skills. Assessments included child, parent and teacher ratings of social skills, self-perception and attention deficit at baseline and post-treatment. Results: Social skills training led to significant improvements in child-reported measures of self-esteem, in teacher reported measures of social skills, and in parent-reported measures of attention deficit. Conclusion: This study suggests that short-term social skills training programs for children with ADHD may improve their social skills, self-perception and attention deficits.

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Autoimmunity and intestinal colonization by Candida albicans in patients with type 1 diabetes at the time of the diagnosis

  • Gursoy, Semra;Kockar, Tuba;Atik, Sezen Ugan;Onal, Zerrin;Onal, Hasan;Adal, Erdal
    • Clinical and Experimental Pediatrics
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    • v.61 no.7
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    • pp.217-220
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    • 2018
  • Purpose: Type 1 diabetes mellitus (T1DM) is a chronic and immune-mediated disease, which is characterized by the progressive destruction of pancreatic beta cells. T1DM precipitates in genetically susceptible individuals through environmental factors. In this study, we aimed to evaluate the impact of autoimmunity and intestinal colonization of Candida albicans on the development of T1DM. Methods: Forty-two patients newly diagnosed with T1DM and 42 healthy subjects were included in this monocentric study. The basic and clinical characteristics of the patients were recorded. T1DM-, thyroid-, and celiac-associated antibodies were evaluated. Stool cultures for C. albicans were performed to assess whether or not gut integrity was impaired in patients with T1DM. Results: The evaluation of T1DM- and thyroid-associated antibodies showed that the prevalences of islet cell antibodies and antithyroperoxidase positivity were higher in the study patients than in the patients in the control group. Furthermore, the direct examination and culture of fresh stool samples revealed that 50% of the patients with T1DM and 23.8% of the control subjects had fungi (C. albicans). Conclusion: Through this study, we suggest that the presence of intestinal C. albicans colonization at the time of the diagnosis of T1DM may indicate impairment of normal intestinal microbiota. We also suggest that there may be a tendency of T1DM in patients with a high prevalence of intestinal C. albicans.