• The Journal of Korean Medicine
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• 제44권4호
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• pp.59-71
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• 2023

Objectives: The new educational system emphasizes acquisition of clinical competency by the time of graduation from Korean medicine colleges that allow Korean medicine doctors to immediately perform clinical tasks. This study investigated awareness of competency-based education in Korean medicine hospital residents who must simultaneously undergo training and assist medical students in clinical practice. Methods: This was a qualitative research that was conducted using focus group interviews (FGIs) to investigate the awareness of demands for improvement in competency-based Korean medicine education in Korean medicine hospital. To apply the principles and procedures of FGIs, a semi-structured questionnaire was developed. Data analysis was conducted using the five steps of framework analysis. Results: According to contents analysis, first competency-based education that reflects actual clinical practice tasks is needed. Second, sufficient basic skill mastery education must be reinforced. Third, an intermediate curriculum that mediates clinical practice and basic education is needed. Fourth, the Objective Structured Clinical Examination and Clinical Performance Examination must be expanded to prepare for the Korean medicine doctor practical test. Conclusions: Korean medicine residents reported the gap between clinical practice and use of knowledge and skills acquired in the curriculum while acting as direct observers and educations of clinical clerkship in hospitals. Based on this exploratory study it is necessary to conduct research on the educational competency of Korean medicine residents who play an important role as educational leaders in Korean medicine clinical practice training.

• Korean Medical Education Review
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• 제20권2호
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• pp.65-71
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• 2018

Western medicine was first introduced to Korea by Christian missionaries and then by the Japanese in the late 19th century without its historical, philosophical, cultural, social, political, and economic values being communicated. Specifically, during the Japanese colonial era, only ideologically 'degenerated' medicine was taught to Koreans and the main orthodox stream of medicine was inaccessible. Hence, Korean medical education not only focuses on basic and clinical medicine, but also inherited hierarchical discrimination and structural violence. After Korea's liberation from Japan and the Korean war, the Korean medical education system was predominantly influenced by Americans and the Western medical education system was adopted by Korea beginning in the 1980s. During this time, ethical problems arose in Korean medical society and highlighted a need for medical humanities education to address them. For Korean medical students who are notably lacking humanistic and social culture, medical humanities education should be emphasized in the curriculum. In the Fourth Industrial Revolution, human physicians may only be distinguishable from robot physicians by ethical consciousness; consequentially, the Korean government should invest more of its public funds to develop and establish a medical humanities program in medical colleges. Such an improved medical education system in Korea is expected to foster talented physicians who are also respectable people.

• The Journal of Korean Medicine
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• 제45권1호
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• pp.1-16
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• 2024

Introduction: The importance of clinical skills training in traditional Korean medicine education is increasingly emphasized. Since the clinical skills tests are high-stakes tests that determine success in national licensing exams, it is essential to develop reliable multifaceted analysis methods for clinical skills tests in actual education settings. In this study, we applied the multifaceted validity evaluation methods to the evaluation results of the cardiopulmonary resuscitation module to confirm the applicability and effectiveness of the methods. Methods: In this study, we used internal consistency, factor analysis, generalizability theory G-study and D-study, ANOVA, Kendall's tau, descriptive statistics, and other statistical methods to analyze the multidimensional validity of a cardiopulmonary resuscitation test in clinical education settings over the past three years. Results: The factor analysis and internal consistency analysis showed that the evaluation rubric had an unstable structure and low concordance. The G-study showed that the error of the clinical skills assessment was large due to the evaluator and unexpected errors. The D-study showed that the variance error of the evaluator should be significantly reduced to validate the evaluation. The ANOVA and Kendall's tau confirmed that evaluator heterogeneity was a problem. Discussion and Conclusion: Clinical skills tests should be continuously evaluated and managed for validity in two steps of pre-production and actual implementation. This study has presented specific methods for analyzing the validity of clinical skills training and testing in actual education settings. This study would contribute to the foundation for competency-based evidence-based education in practical clinical training.

• Korean Medical Education Review
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• 제20권1호
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• pp.20-31
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• 2018

Good assessment is crucial for feedback on curriculum and to motivate students to learn. This study was conducted to perform item analysis on the Medical Education Assessment Consortium clinical knowledge mock examination (MEAC CKME) (2011-2016) and to evaluate several effects to improve item quality using both classical test theory and item response theory. The estimated difficulty index (P) and discrimination index (D) were calculated according to each course, item type, A (single best answer)/R (extended matching) type, and grading of item quality. The cut-off values used to evaluate P were: >0.8 (easy); 0.6-0.8 (moderate); and <0.6 (difficult). The cut-off value for D was 0.3. The proportion of appropriate items was defined as those with P between 0.25-0.75 and D ${\geq}0.25$. Cronbach ${\alpha}$ was used to assess the reliability and was compared with those of the Korean Medical Licensing Examination (KMLE). The results showed the recent mean difficulty and decimation index was 0.62 and 0.20 for the first MEAC CKME and 0.71 and 0.19 for the second MEAC CKME, respectively. Higher grade items evaluated by a self-checklist system had better D values than lower grade items and higher grade items gradually increased. The preview and editing process by experts revealed maintained P, decreased recall items, increased appropriate items with better D values, and higher reliability. In conclusion, the MEAC CKME (2011-2016) is deemed appropriate as an assessment to evaluate students' competence and prepare year four medical students for the KMLE. In addition, the self-checklist system for writing good items was useful in improving item quality.

• Korean Medical Education Review
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• 제18권2호
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• pp.58-64
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• 2016

The birth of the scientific revolution, brought forth by Vesalius and Copernicus in 1543, marked the beginning of a new age. However, the changes such as treatment effectiveness, survival rate, prevalence of specific diseases, etc. had not yet become clear during the 16th century. In the early 17th century, Boerhaave emphasized bedside teaching and practice. His attitude influenced numerous students and educators, so many medical students visited hospital wards where he worked. From the late 18th to 19th centuries, Jenner's smallpox vaccination, Pasteur's anthrax and rabies vaccinations, and Koch's four postulates used to detect pathogens were developed using the scientific research method, which initiated big changes for medicine. Flexner, credited for reporting the new medical education system, adopted scientific medicine. He believed medical students must study basic medical science since it could be the foundation of clinical medicine and lead to a revolution in the field. He proposed a new medical curriculum composed of two-years of basic medicine and two-years of clinical medicine, which has been used more than 100 years. During the late 20th century, bedside teaching rounds decreased gradually as scientific medicine has become popular. Many medical educators in many articles have proposed bedside education as an effective method for medical learning. Despite the advent of the age of artificial intelligence and the changing of medical environments in the near future, bedside education will be more useful and important for medical students, educators, and patients as it is a traditional method and essential for patients who desire a more personal approach.

• Korean Medical Education Review
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• 제26권1호
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• pp.41-47
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• 2024

The ultimate goal of career guidance is to help medical students develop a career plan that matches their personal characteristics, allows them to train in their desired subspecialty, and helps them to adapt well to medical practice after graduation. Gachon Medical School has designed a longitudinal career guidance program called GLORI (Gachon Longitudinal Orientation and Career Development), which is based on the outcome of each phase. The program consists of regular courses and portfolio-based career guidance from a mentor professor. In phase 2 (basic medical science), the "Career Seminar" course was developed. This course focuses on self-understanding through a psychological inventory, exploration of postgraduate career paths, and interviews with professors in specialties of interest. In phase 3 (the integration of basic and clinical science), the "Exploring Nonclinical Career Options" course was introduced. This course presents perspectives from doctors who have followed various pioneering career trajectories, including biomedical engineering, medical journalism, writing, public health, health care administration, the pharmaceutical and medical device industries, and other areas. All teaching methods were designed to encourage student participation. The assessment methods are assignment-based, including self-reflective reports and presentations. In addition, a portfolio-based career guidance program is implemented in phases 3 and 4 (clinical clerkship). It is expected that this case study will serve as a practical example for developing comprehensive career guidance programs for medical schools.

• The Journal of KAIRB
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• 제5권2호
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• pp.51-58
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• 2023

Purpose: To validate the effectiveness of obtaining consent education on errors in the consent process and to develop the education program for researchers. Methods: From February 2019 to February 2022, a 30-minute, 1:1 face-to-face consent education developed using the ADDIE model was conducted on 78 nurses as principal investigators. An informed consent audit tool, which includes 6 items developed by Asan Medical Center Human Research Protection Center, was used to analyze errors in obtaining informed consent process. Data analysis was performed using the SPSS ver. 25.0, and the Mann-Whitney U-test and χ²-test were utilized to verify the difference in errors between the experimental and control groups. Results: The participants consisted of 42 in the experimental group and 36 in the control group, with no statistically significant difference between the 2 groups. Both 2 groups showed the highest frequency of documentation errors, followed by format errors, errors related to a suitability of investigator, participant, or participant's legally acceptable representative, witness and confidentiality issues. After education, there was a significant decrease in both format errors (p=0.002) and documentation errors (p<0.001) in the experimental group. The proportion of participants without any errors in all items was higher in the experimental group (35.7%) compared to the control group (5.6%), and this difference was statistically significant (p=0.001). Conclusion: The obtaining consent education program was found to be effective in reducing informed consent errors. This study emphasizes the importance of education, suggesting the need for its expansion and accessibility, as well as the necessity for all researchers conducting clinical studies to receive the obtaining consent education.

• Journal of Korean Medical classics
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• 제33권4호
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• pp.33-56
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• 2020

Objectives : The objective of this paper is to develop a standardized patient program with a focus on diagnosis and treatment of internal damage fever in Korean Medical education. Methods : First, cases of diagnosis and treatment of internal damage fever were collected from various classical texts, then a module was developed according to pre-existing standardized patient program's protocols based on selected cases. Careful consideration was given to developing evaluation criteria on history taking and physical examination that are necessary to accurately differentiating the 9 types. Results : Nine types of differentiation models on internal damage fever were selected, which are qi deficiency from overexertion/fatigue and famish; blood deficiency from overexertion/fatigue, famish and fullness; fire stagnation from excessive eating and cold foods; food damage; yang deficiency; yin deficiency; phlegm; stagnated blood; liver qi stagnation. For each type, evaluation criteria in regards to history taking, physical examination, communication with patient, and patient education were developed. Conclusions : When developing a standardized patient program using internal damage fever cases, it would better reflect the characteristics of Korean Medicine in clinical education of Korean Medicine if the program is based on classical texts. It would also be useful in evaluating students' graduation competence in exams such as CPX.

• Asian Pacific Journal of Cancer Prevention
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• 제15권11호
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• pp.4643-4650
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• 2014

Background: For decades, studies have been performed to evaluate the association between ABO blood groups and risk of cancer. However, whether ABO blood groups are associated with overall cancer risk remains unclear. We therefore conducted a meta-analysis of observational studies to assess this association. Materials and Methods: A search of Pubmed, Embase, ScienceDirect, Wiley, and Web of Knowledge databases (to May 2013) was supplemented by manual searches of bibliographies of key retrieved articles and relevant reviews. We included case-control studies and cohort studies with more than 100 cancer cases. Results: The search yielded 89 eligible studies that reported 100,554 cases at 30 cancer sites. For overall cancer risk, the pooled OR was 1.12 (95%CI: 1.09-1.16) for A vs. non- A groups, and 0.84 (95%CI: 0.80-0.88) for O vs. non-O groups. For individual cancer sites, blood group A was found to confer increased risk of gastric cancer (OR=1.18; 95%CI: 1.13-1.24), pancreatic cancer (OR=1.23; 95%CI: 1.15-1.32), breast cancer (OR=1.12; 95%CI: 1.01-1.24), ovarian cancer (OR=1.16; 95%CI: 1.04-1.27), and nasopharyngeal cancer (OR=1.17; 95%CI: 1.00-1.33). Blood group O was found to be linked to decreased risk of gastric cancer (OR=0.84; 95%CI: 0.80-0.88), pancreatic cancer (OR=0.75; 95%CI: 0.70-0.80), breast cancer (OR=0.90; 95%CI: 0.85-0.95), colorectal cancer (OR=0.89; 95%CI: 0.81-0.96), ovarian cancer (OR=0.76; 95%CI: 0.53-1.00), esophagus cancer (OR=0.94; 95%CI: 0.89-1.00), and nasopharyngeal cancer (OR=0.81; 95%CI: 0.70-0.91). Conclusions: Blood group A is associated with increased risk of cancer, and blood group O is associated with decreased risk of cancer.

• Asian Pacific Journal of Cancer Prevention
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• 제15권12호
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• pp.4929-4932
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• 2014

Objective: To compare the mammogarphic appearance between breast cancer patients aged <40 and ${\geq}40$ years. Methods: Needle localization and biopsy of suspicious mammographic lesions identified 1,959 breast carcinomas in a single institution from Jun 2012 to Apr 2013. According to the age, we divided patients into two groups: <40 and ${\geq}40$ years old, and analyzed mammographic appearance separately. Results: Young patients had 44.2% foci with calcification, but old patients only had 39.4% (P<0.001). In younger group, the ratios of cases according to mass density were 41.8% or higher, 58.2% equivalent and lower. In older group, the ratios were 55.5 % and 44.5%, respectively. There were statistical differences between high density and others (P<0.05). The ratios of cases according to mass margin were 13.9% circumscribed and microlobulated, 86.1% indistinct and spiculated in the younger group, as compared to 6.5% and 93.5%, respectively, in the older group (P<0.05). Conclusions: Mammographic findings differ between young and old patients with breast cancer, for example regarding mass density, mass margin and microcalcification ratios.