• Journal of Preventive Medicine and Public Health
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• 제27권4호
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• pp.793-805
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• 1994

Investigating the existence of volume-outcome relationships for specific disease groups relates directly to the policy issue of whether, and how, specific inpatient services should be regionalized. This study examined whether medical costs and lengths of stay as outcomes were affected by changes in volume within hospitals. Based on the claims data obtained from National Federation of Medical Associations, each six disease categories from medical and surgical conditions were selected and 29,720 cases from 1,266 hospitals were analyzed. Main findings of the research can be summarized as follows: 1. Analyzing volume and cost per case relationship, tonsillectomy class 1, hernia procedure class 0, appendectomy and cesarean section class 0,1 in surgical conditions showed negative relationship significantly. In cases of medical conditions, costs per case in respiratory neoplasm class 2, COPD class 1, 2, digestive malignancy were also related to volume negtively. 2. Comparing volume with length of stay per case, lens procedure class 0, hernia procedure class 0, appendectomy class 0,1, cesarean section class 1 in surgical conditions showed negative relationships significantly. In medical conditions, volume of respiratory neoplasm class 2, COPD class 1,2, digestive malignancy class 0 were associated with negatively. 3. Within same disease categories, changes in cost and length of stay per case to volume were more remarkable in severe cases. These results suggested a significant inverse relationship between disease cases and cost, length of stay per case as outcome variables.

• 대한예방한의학회지
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• 제25권2호
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• pp.13-31
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• 2021

Objectives : The objectives of this study are to provide the education of communication skills in the class of theories of Korean medical famous physicians and to survey students' perception of the effect. Methods : The class of theories of Korean medical famous physicians was newly designed and was given to students. The results from the questionnaire survey with second year students at department of Korean medicine were applied to the evaluation of study issues. The scale used for this study was the modified version of 'Beyer-Fetzer's Essential Elements of Communication Skills Assessment Sheet', which was developed by researchers in line with the education of Korean medicine. Results : In six (except for 'opening a conversation') out of seven categories, post-test results were more improved than pretest results. In the category of communication skills (a total of 25 questions), post-test results were higher than pretest results in all items. Among them, 13 items were statistically significant. With regard to the question as to how important the class of communication skills is to raise their professionalism as Korean medicine doctor, post-test result was higher than pretest result. Regarding an appropriate education point of time, there were various points in the entire period of curriculum. The appropriateness of teaching-learning method was positively evaluated. In terms of the content helpful for learning, learner-oriented activities was preferred over teacher-oriented lecturing. Conclusions : The communication skills learned in the class of theories of Korean medical famous physicians were effective. Communications skills should be taught constantly in the entire curriculum in order to raise students' professionalism as Korean medicine doctor. In terms of education method, it is desirable to design a class based on students' various activities, rather than lecturing.

• 대한예방한의학회지
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• 제17권1호
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• pp.163-179
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• 2013

Objectives : After analyzing the proficiency of medical communication of the students in College of Korean Traditional Medicine using standardized patients, we suggests ways to improve clinical practice in the future class and medical communication curriculum development. Methods : 20 students before clinical practice class (3rd grade) and 20 students after 1 year clinical practice class (4th grade) participated and did their medical interview on Standardized patient. They were evaluated on patient-physician communication skills by standardized patients and professor evaluator. In addition to be evaluated on patient-physician relationship, medical interview skills by professor evaluator. Results : As follows in the evaluation of clinical practice with standardized patients 1. More than half of the participated students regardless of their grade received poor score in their medical communication evaluated by SP(Standardized patient) and PE(Professor evaluator). 2. Greeting, History taking parts were higher in the 4th students who received 1 year clinical practice class, but verbal-nonverbal response, voice tone parts were higher in the 3rd students who do not received clinical practice lesson. 3. Pronunciation&Voice tone parts were higher in the male students but, gathering information part was higher in the female students. Conclusions : We think that the current clinical practice lessons are insufficient as a way to learn and improve medical knowledge and medical communication skills, and it is necessary a new form of clinical practice class. Participatory lesson using standardized patient could be a good alternative of that in the future class.

• 대한예방한의학회지
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• 제22권2호
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• pp.1-12
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• 2018

Objectives : Recently, the interest on medical education in flipped learning has been growing. Competency-based curriculum is also required through changes in teaching methods within the Korean medicine education. In this study, flipped learning method was applied to 'medical ethics' class to examine the perception and experience of flipped learning from the Korean medical student's perspectives. Methods : The study was conducted on 15 preparatory course freshmen students who took the 'medical ethics' course, in the second semester of the year 2017 at 'A' University. The study was proceded in two steps; 1) fill-in the questionnaire twice (before and after the class), and 2) in-depth interview with semi-structured questionnaire. The $1^{st}$ questionnaire in the first step was consisted of 'Experience on flipped learning before the class', 'Which section of the flipped learning class do participants have expectation', 'Interest and expectation on flipped learning'. In the $2^{nd}$ questionnare, the participants were asked 'Which section of the flipped learning section that the learning effect was maximized', 'Association between 'flipped learning' method and 'Medical ethics' course' with 5-point Likert scale and frequency. Results : The results showed that flipped learning method works very effectively in the 'medical ethics' course (63.6%). After the flipped learning class, the participants showed positive change in a attitude of the class (72.7%). However, this teaching method might be inappropriate for participants who had difficulties in pre-learning or a passive attitude and lecture-centered instruction (LCI) classes. Conclusions : Though applying flipped learning method to the 'Medical Ethics' was effective, to make pre-learning better, the instructors should prepare countermeasures for passive participants, help interact well among the participants, and plan a lesson thoroughly for changing LCI classes to student-centerd instruction(SCI).

• 대한한방소아과학회지
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• 제29권4호
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• pp.23-28
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• 2015

Objectives The purpose of this study is to examine the development of PBL Module and the possibility of the evaluation on the Korean medical Pediatrics class. Methods In this study, we examined the 32 case reports (four teams for three years) which were made by the Korean medicine school $4^{th}$ year students, who attended the discussion class. The student read the given materials and identified the purpose of the subjects and selected the learning issues, investigated them. After then they discussed the subjects and made the reports. Results The learning issues by students were similar, the students worked to study them with research papers, books, internet materials and personal subjects. After class, the students showed the change of their thoughts and they could accept the other one. Conclusions This study suggests it is possible that the development of PBL Module and the evaluation on the Korean medical Pediatrics Class.

• 대한치과교정학회지
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• 제47권5호
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• pp.277-288
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• 2017

Objective: Treating Class II subdivision malocclusion with asymmetry has been a challenge for orthodontists because of the complicated characteristics of asymmetry. This study aimed to explore the characteristics of dental and skeletal asymmetry in Class II subdivision malocclusion, and to assess the relationship between the condyle-glenoid fossa and first molar. Methods: Cone-beam computed tomographic images of 32 patients with Class II subdivision malocclusion were three-dimensionally reconstructed using the Mimics software. Forty-five anatomic landmarks on the reconstructed structures were selected and 27 linear and angular measurements were performed. Paired-samples t-tests were used to compare the average differences between the Class I and Class II sides; Pearson correlation coefficient (r) was used for analyzing the linear association. Results: The faciolingual crown angulation of the mandibular first molar (p < 0.05), sagittal position of the maxillary and mandibular first molars (p < 0.01), condylar head height (p < 0.01), condylar process height (p < 0.05), and angle of the posterior wall of the articular tubercle and coronal position of the glenoid fossa (p < 0.01) were significantly different between the two sides. The morphology and position of the condyle-glenoid fossa significantly correlated with the three-dimensional changes in the first molar. Conclusions: Asymmetry in the sagittal position of the maxillary and mandibular first molars between the two sides and significant lingual inclination of the mandibular first molar on the Class II side were the dental characteristics of Class II subdivision malocclusion. Condylar morphology and glenoid fossa position asymmetries were the major components of skeletal asymmetry and were well correlated with the three-dimensional position of the first molar.

• 한국간호교육학회지
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• 제2권
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• pp.32-55
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• 1996

It was enacted 'Emergency Medical Act' in January, 1994 beginning the emergency medical service system from 1982, and while it was established the emergency medical department in junior college providing the detailed agenda about emergency medical technician and the regulation relative to the application of a law on the emergency medical act in 1995, the fire school and the National Medical Center are enforced the curriculum. It is very important subject faced for the construction of emergency medical system to produce a number of emergency medical technicians to be sufficient to the role of emergency aid. In this study it is analysed the training curriculum for the emergency medical technician and presented the improvement plans. 1. Though it needs the qualification level of first and second class in the selection process, the more important thing needs the detailed qualification level by term of one's service and the skills of business accomplishment. 2. In the examination management, (1) written examination is composed of the questions to understand how much faithfully they carry out the practical business as the emergency medical technicians, (2) it is added practical examination as the item to appraise the situation disposal ability. 3. It is necessary to prescribe the activity in the medical institution and ambulance arrangement through the development of 'Business Treatment Guide'. 4. For the regional balanced disposition of emergency medical personnel it is selected balanceably the educational institution by eight medical service areas, and considering the characteristics of region it is necessary to manage, in the practical business training course, another special course such as the mountains medical aid and sea medical aid. 5. In the period of education the first class needs the practical business training period of a certain period after passing examination, and the second class needs the extension of the period. 6. As the problems to improve in the curriculum [1] in the first class course (1) intensification of practical educaiton (2) reinforcement of curriculum (3) the development of standardized curriculum etc., [2] in the second class course (1) varieties of curriculum (2) intensification of basic first aid treatment education.

• 대한치과교정학회지
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• 제42권4호
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• pp.190-200
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• 2012

Objective: The displacement of the hyoid bone (HB) is a critical biomechanical component of the swallowing function. The aim of this study was to evaluate the swallowing-induced vertical and horizontal displacements of the HB in subjects with 2 different magnitudes of skeletal Class III malocclusion, by means of real-time, balanced turbo-field-echo (B-TFE) cine-magnetic resonance imaging. Methods: The study population comprised 19 patients with mild skeletal Class III malocclusion, 16 with severe skeletal Class III malocclusion, and 20 with a skeletal Class I relationship. Before the commencement of the study, all subjects underwent cephalometric analysis to identify the nature of skeletal malformations. B-TFE images were obtained for the 4 consecutive stages of deglutition as each patient swallowed 10 mL of water, and the vertical and horizontal displacements of the HB were measured at each stage. Results: At all stages of swallowing, the vertical position of the HB in the severe Class III malocclusion group was significantly lower than those in the mild Class III and Class I malocclusion groups. Similarly, the horizontal displacement of the HB was found to be significantly associated with the severity of malocclusion, i.e., the degree of Class III malocclusion, while the amount of anterior displacement of the HB decreased with an increase in the severity of the Class III deformity. Conclusions: Our findings indicate the existence of a relationship between the magnitude of Class III malocclusion and HB displacement during swallowing.

• 한국통신학회논문지
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• 제34권8C호
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• pp.772-781
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• 2009

This paper proposes a novel algorithm for the efficient classification and retrieval of medical images. After color and edge features are extracted from medical images, these two feature vectors are then applied to a multi-class Support Vector Machine, to give membership vectors. Thereafter, the two membership vectors are combined into an ensemble feature vector. Also, to reduce the search time, Correlated Categories Vector is proposed for similarity matching. The experimental results show that the proposed system improves the retrieval performance when compared to other methods.

• 대한치과교정학회지
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• 제53권2호
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• pp.67-76
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• 2023

Objective: Morphometric and morphological evaluation of the mandibular condyle in adults and to identify its correlation with skeletal malocclusion patterns. Methods: Cone-beam computed tomography scans of 135 adult patients were used in this study and classified into groups according to four criteria: (1) sex (male and female); (2) sagittal skeletal discrepancy (Class I, Class II, and Class III); (3) vertical skeletal discrepancy (hyperdivergent, normodivergent, and hypodivergent); and age (group 1 ≤ 20 years, 21 ≤ group 2 < 30, and group 3 ≥ 30 years). The morphometrical variables were mandibular condyle height and width, and the morphological variable was the mandibular condyle shape in coronal and sagittal sections. Three-dimensional standard tessellation language files were created using itk-snap (open-source software), and measurements were performed using Meshmixer (open-source software). Results: The mandibular condyle height was significantly greater (p < 0.05) in patients with class III malocclusion than in those with class I or II malocclusion; the mandibular condyle width was not significantly different among different sexes, age groups, and sagittal and vertical malocclusions. There were no statistical associations between various mandibular condyle shapes and the sexes, age groups, and skeletal malocclusions. Conclusions: The condylar height was greatest in patients with class III malocclusion. The condylar height and width were greater among males than in females. The mandibular condyle shapes observed in sagittal and coronal sections did not affect the skeletal malocclusion patterns.