• Korean Journal of Health Education and Promotion
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• v.26 no.5
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• pp.97-113
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• 2009

Objectives: This study was conducted to identify the intervention effects on health efficacy and health knowledge related to health behaviors for improving cardiovascular health in elementary school children. Methods: A repeated measure, pre-post-test design was used to identify the intervention effect on health efficacy and health knowledge among 5th grade school children. Intervention consisted of a curriculum classroom intervention and parent intervention. Health efficacy, health knowledge, and perceived parental monitoring were measured for testing intervention effect. A sample of 219 participants completed a baseline pre-test and two tests during intervention and after intervention from March to July 2004. Results: Mental health efficacy improved significantly from baseline test to the test after intervention (F = 32.88, p < 0.0001). Physical health efficacy also significantly increased during intervention (F = 50.51, p < 0.0001), but did not significantly change after parent intervention. Health knowledge increased significantly from baseline test to the test after education (F =10.23, p < 0.0001), but decreased after parent intervention. Perceived parental monitoring had a significant impact on mental health efficacy and physical health efficacy. Conclusion: The findings support school-based cardiovascular health promotion intervention as effective in improving health efficacy and health knowledge. Parental influence should also be considered to maintain improved health efficacy and health knowledge by thinking process in the intervention for elementary school children.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.12 no.12
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• pp.5797-5804
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• 2011

Recently, the medical education is undergoing system transition from a medical college to a medical graduate school and introduction of performance test in the doctor license state examination. Therefore, To deal with these challenges, it is needed that medical faculty prepare the education programs for considering student's personal characteristics and improving Clinical performance. So, The purpose of this study was to understand relation among Stress, ego-resilience, self-efficacy and Clinical performance in graduate medical student, and for this study, We conducted a survey of 97 medical graduate school students in D city during the period from August 19st to 20st. 2011. The study found a negative correlation between Stress and Ego-Resilience, a positive correlation of stress with confidence at low region in Self-Efficacy. Ego-Resilience correlates positively with CPX at low region in Clinical performance, Preference for difficulty level of the task at low region in Self-Efficacy correlates negatively with OSCE. OSCE and CPX at low region in Clinical performance are positively correlated. Therefore, Stress reduction of students can improve Self-Efficacy, Furthermore, improve ultimately Clinical performance. According to this study, To improve Clinical performance competence, student's personal characteristics should be considered and education programs for self-efficacy and ego-resilience advancement be reflected in curriculum.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.3
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• pp.407-416
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• 2019

This study is about a Customized Nursery School where working women can support work - life balance and a reduction in retirement or turnover. The research method is to identify the current status of Customized Nursery services and to recognize the recognition and need of the operation of Customized Nursery School. The importance of securing skilled nurses and preventing them from changing their jobs for the health and safety of people cannot be emphasized enough. A Customized Nursery School must be opened to reduce the retirement or change of jobs of working women nurses and to provide care for continuous work in three shifts from 365days to support the balance between the working mother and family. It is considered that nurses will put their children in relief when using retired nurses who have the ability to work 24hour rotation in a Customized Nursery School and when a Customized Nursery School be ran suited for the condition and demand of working women nurses, it is expected to reduce retirement and the change of jobs, also to give positive effect on marrige and family planning which would make improvement in low birthrate. To activate the Customized Nursery School, Creating a secure learning environment and qualification of educators great effort should be put. A program curriculum based on 'basic life and habits' should be the center of education. Continuous management and effort will need to be placed in continuous development of educators.

• Journal of Korea Entertainment Industry Association
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• v.14 no.8
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• pp.203-211
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• 2020

This study is a similar experimental study using parallax design before and after the non-equality control group conducted to investigate the effects of the Mental health guardian program for mentally disabled people on the awareness of rights, empowerment, and resilience of mentally disabled people. The mentally handicapped persons who participated in the mental health guardian program were significantly higher in the awareness of the rights of the handicapped compared to the mentally handicapped persons who did not participate. In terms of empowerment, there was no significant difference between the two groups. In terms of resilience, the experimental group significantly increased compared to the control group. Among the sub-areas of resilience, excluding spirituality, difficulty overcoming, self-competence, learning and self-financing, basic functions, overall life satisfaction, new potential, advocacy and fullness all significantly increased. It has been shown to be effective in increasing the resilience of the disabled. In this study, the reason why mental health guardian program is effective for awareness of rights and resilience is not a one-way education, but a participatory curriculum in which a person with mental disabilities who participated in the education finds and corrects the wrong news and creates a card news again. It seems to be because it did. As a result of this study, it seems that the mental health guardian program has contributed to enhancing the recognition of the rights of the mentally impaired and enhancing resilience.

• Journal of Korean Academy of Nursing
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• v.15 no.1
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• pp.59-75
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• 1985

Accepting the health as the fundamental human right, the nation and society came to admit the duty to give it to all the people. Korean government is expanding the Primary Health Care as one of the policies for developing the people's health by the lead of community. Like this current situation the School Health Service which is the center of community Health Service schould be active to keep, promote and maintain the health of students and teachers. This investigation was attempted to help to establish the basis of the Health Education Program which would perform the health education efficiently and bring the reforming of student's health control, by measuring the degree of junior high school student's practice concerning health care and con-firming the relationship of knowledge, concern and level of health. The subjects for this study were made up 296 boys at the third grade in a school, located in Seoul. The tool for this study was questionaire. Data were collected for five days, September 22∼26, 1983. The investigators explained the students how to answer the questions of the survey questionaire and then collected the survey cards immediately. The data were analyzed by means of percentages, Pearson Correlation Coefficient and Stepwise Multiple Regression. The results of this study are as follows. 1. The subjects' reaction to the practice concerning Health Care; According to the average proportion of practice concerning health care, subjects' practice in the aspect of Infectious Disease Care is the highest 82.4％ and they showed their practice in the aspect of the accident prevention by 77.5% and in the aspect of mental health by 74.8%. Their practice in the aspect of personal hygiene and daily lifehabit is the lowest 71.2%. 2. Health Knowledge; The whole mark distribution of health knowledge is ranged from the lowest 4 point to the highest, 30 point, therefore point range is 26.0. The Average point is 16.58. 11.2% of students solved more than two thirds of personal knowledge levels. 81.4% of students did more than one third of them. 7.415 of students did less than one third of them. 3. Health Concern; The Students of the average 3.99 point respond positively to the question about the health concern, ‘They think health is more important than money’, this is the highest rate. The students of the average 2.78 respond“when they are sick, they enter the appointed hospital where they own choose”, while it is the lowest. 4. Subjects' response to the health level are at follow: Very healthy 26.0%, healthy 47.0%, less healthy 10.5%, 34.9% of them have ever been sick within two weeks, the number of symptoms they reported amount to 114 and the number of cases poi one person is 0.35. 5. The hypotheses test about the practice concerning health care and the factor which effect on it. 1) The main first hypothesis:“The more knowledge of health the subjects have, the better they practice health care.”was accepted. (r=0.1582, p <0.05) 2) The minor first hypothesis:“The more interest in health subjects have, the better they practice”was accepted. (r=0.4354, p ＜0.001) 3) The minor second hypothesis;“The healthier subjects are, the better they practice health care”was accepted. (r=0.1069, p＜0.05) As other test, partical correlation test is performed in other refine whether health knowledge, a fact influencing the students practice concerning health care, is associated with the practice after controlling the third variables. First, after controlling health concern, the correlation of health knowledge and practice concerning health care was kept. (r=0.1347, p <0.005) Second, after controlling health level, the correlation of health knowledge and practice concerning health care was kept. (r=0.1526, p <0.005) And finally, after controlling economic state, the correlation of health knowledge and practice concern-ing health care was kept. (r=0.1413, p <0.05) Additionally Stepwise Multiple Regression between practice concerning health care and variables. 1.6591 of compliance was explained with the know-ledge (F=5.584, p <0.05), 20.0% of compliance was explained with the health concern added to knowledge. (F=63,213, p <0.005) As the above, health knowledge obviously have effects on the practice about the health care. But, contrary to researcher's expectation, health concern has more affects than health knowledge. Therefore, we must grope the plan to enhance health concern through the regular curriculum and systematic health education for students. Besides, we must study further on, to find the factors which have affect on the practice concerning health care.

• Journal of Korean Academy of Nursing
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• v.3 no.3
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• pp.36-49
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• 1973

This study was carried out for the objectives to collect the basic informations on the health behaviors of the elementary school children in an urban area in Korea. Seven hundred students were drawn to fill in the designed questionnaire which carries variety of Questions on health re-lated behaviors in general, eating habits, disease history, mental health, and sex education. Questionnaire were filled in by their parents. Major findings are as follows: ① 55.7% had habits of washing the hands before eating whereas 59.8% trashing their hands after toilet. The others had no idea of washing hands before eating and after toilet. ② 26,5% had habits of brushing the teeth twice a day 54.7% only once in the morning, and 2.6% once only in the evening. Thus, the idea of prevention from decayed teeth seems to be lacking among the school children. ③ Bathing habits were also inquired to get 40.3% of bathing more than once a week, 43.1% once every two weeks, and the rest of 16.6% once every one to three months. ④ 41.7% keep the regular bedding time whereas 58.3% irregular. Physical exercises were con-ducted by 76.6% on the ground while 23.5% did not practice any physical exercises at all. Of those physical exercises, rope skipping occupied 37.5%, and the other 66.9% consisted of 14 different kinds of individual type physical exercises such as gymnastic exercise. The main reasons for not enjoying exercises were different by sex; boys largely complained the inadequacy and lack of gymnastic facilities and girls felt in short of friends who could join the exercises. ⑤ 31.9% of the school children had been taking not much of food while 28.3% had unbalanced diets. Of these unbalanced diets, meat occupied 33.2% to be the priority to have an order of the following items such as vegetables, bread or noodle, and fishes as next to each. For eating habits, 88.5% take simple snack such as bread (38.4%, cookies, fruits, and candies in order. 25.8% of the children were provided such snacks or their parents regularly. Breakfast was sufficiently taken by 45.0% whereas 8.4% had never sufficiently. As to the lunch, 63.6% had sufficiently while 16.8% insufficiently. 70.6% take breakfast with all family members together and 30.4% separately. Correlation of sufficient taking of breakfast and eating together of tile family member's seems to be significant when we compare 72.5% of sufficient takers who enjoy breakfast together with the family members with 55.6% of insufficient takers who enjoy it with the family. This finding allows the investigator to point out the importance of table circumstances for children's eating. ⑥ The most common disease was catching a cold (38.8%), and the second was stomach trouble to be followed by the frequency of car sickness, headache, and skin infection. Doctors are consulted only by 23.9% when they are sick whereas 59.7% resorted to the drug stores. The lower the educational attainment of the parents, the lower the rate of visiting clinics. ⑦ 36.7% of their parents pointed out the problems of personality guidance as the most difficult thing at home 71.3% of their parents worried about and unsatisfied with their children's personality traits. Of these complains of the parents, impatience stood at the top to be tabulated at 24.1%, and 21.1% indicated narrow-mindedness. In line with this primary socialization at home, the most crucial problem seems to be related with the lack or recognition of the parents'own role when we find only 43.1% of the parents understood the importance of their own role for the home education of children; the latter group attributed tile responsibility of personality formation to the children themselves. ⑧ As to the sex educational aspects, 30.9% of children have ever asked about the physiology of reproduction or sexual matters to their parents, of those parents only 17.0% could give the constructive responses to the inquiries of the children. In companies on with these data, 25.6% recognized their own role in sex education for their own children while the large segments of the parents (51.1%) attributed the responsibility of sex education to tile low level of 38.3% who recognized the importance of sex education in the school curriculum and 25.1% of the parents insisted to wait until they get to know naturally about sex. 38.1% of the parents said they had some knowledge on sex from books while 16.9% through mass media. The next groups had common senses of sex from their own parents, school friends and other sources.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.12
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• pp.292-300
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• 2016

The purpose of this study was to investigate the effects of case-based learning about infants and toddlers on healthcare department students, using a video in an emergency care environment. A total of 57 students from a healthcare department of D university in J city were enrolled. They were divided into two groups: The experimental group (n=29) and the control group (n=28). This study is pre-post designed with a non-equivalent control group. The experimental group received a 1-week education for a duration of 3 weeks (3 sessions in total) with 180 minutes per session. The control group received a traditional curriculum of lecture. Before and after the education, we measured the knowledge and skill confidence of emergency care toward infants and toddlers, the academic self-efficacy, and problem solving ability. Data collection and intervention were carried out from November to December of 2014. Data were analyzed with x2-test, paired t-test, unpaired t-test with SPSS version 20.0 Program. The experimental group showed a significantly higher improvement of skill confidence of emergency care toward infants and toddlers (P<001), as well as preferred task difficulty among sub-items of academic self-efficacy (p=.029), approach avoidance style (P=.001), and problem solving confidence (p=.040) among sub-items of problem solving ability on preference compared with the control group. In this study, a case-based learning was verified to be an effective teaching method to enhance professional competency of healthcare department students. The findings from this study suggest that a case-based learning using various educational contents should be developed, expanded, and carried out to promote better learning.

• Journal of Hospice and Palliative Care
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• v.9 no.1
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• pp.11-16
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• 2006

Purpose: This study is aimed to confirm nurse's attitudes and to investigate the factor analysis on organ donation in brain dead donors. Methods: This survey were collected from 198 nurses in three university hospitals and four general hospitals in B city with questionnaires developed by the author. The consent for this research was obtained from nursing managers, head nurses, and staff nurses after explaining the purpose of this research. Results: In questionnaires, 45 items about attitudes were included and positive and negative attitude were analyzed. The contents of factors are 'legal permission of brain death', 'one's will of organ donation at the brain death', 'need for educational program about brain dead during college curriculum', 'organ donation is good presents for others', 'connection with professional institutes', 'necessity of brain death', 'convenient to control of brain death' and 'the goods for organ transplantation in brain dead donors' as positive attitudes. Meanwhile, 'contrast to certain religion and dignity to life', 'negative dangers on brain dead permission', 'unbelief to the medical teams', 'burdens to ask organ donation to brain deads/families' and 'economical compensation' are factors as negative attitudes about organ donation in brain dead. The total mean point score of positive attitudes about organ donation in brain dead donors was $3.753{\pm}3.398$. The total mean point score of negative attitudes about organ donation in brain dead donors was $2.915{\pm}0.472$. Conclusion: The results of this study may be of help for the nurses who concern organ sharing and make effective interventions and educations to facilitate the decision making process for organ donation in brain dead donors or families.

• The Korean Nurse
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• v.20 no.4 s.112
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• pp.50-59
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• 1981

간호학생들이 당연하고 있는 문제점 미래의 간호학생들이 교육문제를 논하기 위하여는 간호학생들이 가지고 있는 문제점을 파악하고 또 이해하는 것이 우선순위가 될 것이다. 간호학생들이 문제점에 대한 연구는 한국에서 뿐아니라 미국에서도 꽤 많이 시행되어져 왔으며 특히 간호학과정에서 중간 탈락되는 중퇴자들에 대한 연구들 중에 이러한 문제점에 대해서 언급한 것이 많다. 고등학교를 졸업하고 곧 대학과정에 진학한 학생들을 대상으로 조사 보고될 Munro의 자료에 의하면 전문대학과정에서 27$\%$, 대학과정에서는 41$\%$의 간호학생들이 간호학과정에서 중간 탈락하고 있음이 보고되고 있다. 이들이 중간탈락하는 데에는 여러 가지 이유가 있으나 그 중 ''간호학에 흥미를 잃어서''가 가장 큰 이유로 보고되고 있다. 이곳 한국사회에서도 역시 비슷한 현상을 보이고 있다. 그러나 대학입시경쟁과 대학내에서의 전과가 거의 허용되지 않는 특수여건이기 때문에 학교를 중간 탈락하는 율은 미국이 보고만큼 높지는 않으나 역시 ''간호학에 흥미를 잃는다''는 것이 간호학생들의 가장 큰 문제점으로 대두되고 있다. 최근 한국에서 시행된 간호학생들에 관한 연구(표 1 참조)에 의하면 간호학생들의 학문에 대한 만족도는 조사자의 35$\~$50$\%$정도에 불과하였고 더우기 이 비율은 고학년에 올라갈수록 더욱 감소되고 있는 경향을 보이고 있다. 한국에서 시행된 어느 연구보고에 의하면 간호학에 실망했다고 생각하는 학생이 전체의 67$\%$였으며, 다른 학교로 전과를 희망한 경험이 있다는 학생이 71$\%$나 되는 것으로 보고되고 있다. 그러나 왜 흥미를 잃게 되는지 그 이유에 대하여 설명해 주는 연구는 많지 않았다. 미국의 한 저자는 간호학생들이 간호학에 흥미를 잃게 되는 원인을 간호원의 역할에 대한 이해가 정확하지 못한 것과 졸업 후 진로기회에 대한 인식부족 때문이라고 추측하고 있다. 간호학에 흥미를 잃게 되는 이유는 크게 다음의 세 가지로 분류 요약될 수 있다. 첫째, 간호학을 전공으로 택한 동기이다. 간호학의 특수성으로 인하여 학생들이 간호학을 전공으로 택한 동기도 다른 전공분야보다는 훨씬 다른 여러 종류를 보이고 있다. 즉, 종교적 이유, 다른 사람들에게 봉사할 수 있는 직업이기 때문에, 쉽게 취업을 할 수 있어서, 결혼 후에도 직업을 가질 수 있기 때문에, 외국으로 쉽게 취업할 수 있어서 등이 간호학을 선택한 이유로 보고되고 있다. 흥미나 적성에 맞다고 생각하기 때문에 간호학을 택한 학생의 수는 다른 과에 비하여 훨씬 적다. 이러한 흥미나 적성 때문이 아닌 여러 가지 다른 이유들로 인하여 간호학을 택한 경우에 특히 간호학에 쉽게 흥미를 잃어버리는 것을 볼 수 있다. 간호학에 현실적인 개념을 가지고 있는 학생들일수록 추상적이고 현실적인 개념을 가지고 있는 학생들보다 더 간호학에 지속적인 흥미를 가지며 중간에 탈락하는 율이 훨씬 적다는 것이 많은 연구에서 보고되었다. 또한 흥미나 적성 때문에 간호학을 택하였다는 학생들이 다른 과로 전과를 희망하는 율이 낮다는 것도 보고되었다. 둘째, 교과내용자체나 실습에 대한 불만족이다. 간호학에 대한 체계적인 교과내용의 결여, 과중한 과제물, 임상실습에서의 욕구불만, 실습으로 인한 부담, 지식과 실습의 차이점에 대한 갈등 등이 주요 이유로 보고되고 있다. 대부분의 연구들이 이 교과목이나 실습에 대한 불만족, 특히 실습경험에서의 갈등을 학생들이 흥미를 잃는 가장 중요한 요인이 되는 것으로 보고하고 있다. 어느 한 연구에서는 응답자의 90$\%$가 임상실습에 만족하지 못한다고 응답하였으며 그들 중의 88$\%$가 실습감독에 문제가 있다고 생각한다고 보고하였다. 셋째, 교수들에 대한 불만족이다. 대부분의 연구들이 학년이 올라가면 갈수록 교수에 대한 신뢰도가 낮아지며 또한 그에 비례하여 간호학에 대한 만족도가 낮아진다고 보고하고 있다. 교육내용에 대한 전문지식의 결여, 학생들과의 인간적인 관계의 결여, 교수법에 대한 불만족 등이 교수에 대한 불만의 주요내용으로 보고되었다. 미래의 간호에 부응할 학생교육 계속적인 사회적 변동과 더불어 급격하게 변화하고 있는 일반인들의 건강에 대한 요구도와 앞에서 기술한 문제점 등을 감안할 때 학생들에게 동기를 부여하고 간호학에 확신감을 가질 수 있도록 준비시키므로써 간호환경에서 실망하기보다는 오히려 그것을 받아들여 변화하는 사회요구에 책임감을 느낄 수 있도록 교육시키는 것이 미래의 간호학생을 준비시키는데 가장 중요한 요인이라고 할 수 있겠다. 이러한 교육을 위하여 다음의 두가지 안을 제시한다. 1. 교수와 학생간의 관계-서로의 좋은 동반자 : 교수들이 학생에게 미치는 영향, 특히 학생들의 성취도에 대한 영향에 대하여는 이미 많은 연구가 시행되었다. Tetreault(1976)가 간호학생들의 전문의식에 영향을 미치는 요인에 대하여 연구한 바에 의하면 다른 어느 것보다도 교수의 전문의식여부가 학생들의 전문의식 조성에 가장 큰 영향을 미친다고 하였다. 또한 학생들이 교수에게 신뢰감을 가지고 있을때, 교수들이 전문가로서의 행동을 하는 것을 보았을때 비로서 배움이 증가된다고 하였다. Banduras는 엄격하고 무서운 교수보다는 따뜻하고 인간적인 교수에게 학생들이 더 Role Model로서 모방하려는 경향을 나타낸다고 보고 하였다. 그러면 어떻게 학생에게 신뢰받는 교수가 될 수 있겠는가? apos;학생들의 요구에 부응할 때apos;라고 한마디로 표현할 수 있을 것이다. Lussier(1972)가 언급한 것처럼 학생들의 요구에 부응하지 못하는 교육은 Piaget이 언급한 교육의 기본 목표, 즉 개인에게 선배들이 한 것을 그대로 반복하여 시행하도록 하는 것이 아니라 새로운 것을 시도할 수 있는 능력을 가지게 하는 목표에는 도달할 수 없으며 이러한 목표는 간호학에도 가장 기본이 되어야 할 기본목표이기 때문이다. 학생들이 현재 어떤 요구를 가지고 있으며 또 어떤 생각을 하고 있는지 계속 파악하고 있는 것이 학생요구에 부응하는 교육을 할 수 있는 기본조건이 될 것이다. 의외로 많은 교수들이 학생들을 이해하고 있다고 생각하고 있으나 잘못 이해하고 있는 경우가 많다. 표 2는 현 간호학생들이 생각하고 있는 가치관과 문제점을 파악하고 또 교수가 그 가치관과 문제점을 어느 정도 파악하고 있는지 알아보기 위하여 일개 4년제 대학 200여명의 학생과 그 대학에 근무하는 18명의 교수진을 대상으로 질문한 결과를 간략하게 보고한 것이다. 또한 여기에서 학생이 보고하는 가치관, 문제점, 교수에게 바라는 점이 교수가 이해하고 있는 것과 차이가 있다는 것도 보여주고 있다. 우리가 학생들의 요구를 파악할 수 있도록 귀를 기울이고 이해하며, 그 요구에 부응하려고 노력할때 진정한 교수와 학생간의 관계가 이루어질 수 있을 것이며 이때 비로서 우리는 apos;partnershipapos;을 이룰 수 있을 것이다. 이때 간호학에 대한 실망은 줄어들 수 있을 것이며 우리도 학생들에게 전문가적인 태도를 함양시켜줄 수 있는 기회를 부여할 수 있을 것이다. 이렇게 될때 앞으로 기다리고 있는 미지의 의무에 효과적으로 또 적극적으로 대처할 수 있는 자질을 형성한 학생들을 준비해 낼 수 있을 것이다. 2. 간호모델에 의한 교과과정의 확립과 임상실습에의 적용 : 교과과정이 학생들의 모양을 만들어주는 하나의 기본틀이라고 말할 수 있다면 미래의 요구에 부응하는 학생들을 준비시키기 위하여 지금까지와는 다른 새로운 방향의 교과과정이 필요하다는 것은 재론할 필요가 없을 것이다. 이미 진취적인 간호대학에서는 guided design systems approach 또는 integrated curriculum 등의 새로운 교과과정을 시도하고 있음은 알려진 사실이다. 물론 간호모델에 준한 교과과정을 발전시키는데 대한 장점과 이에 수반되는 여러가지 새로운 문제점에 대하여 많은 논란이 있으나 모든 교과과정이 처음 시도될 때부터 완전한 것이 있을 수 없으며 시간이 지남에 따라 성숙되는 것임을 감안해 볼 때 이러한 새로운 교과과정에의 시도는 미래의 새로운 간호방향에 필수적인 사업이라고 하겠다. 이러한 교과과정을 개발하는데 몇가지 게안점을 첨부하려 한다. (1) 새로운 교과과정의 개발은 처음부터 끝까지 모든 교수진의 협력과 참여로 이루어져야 한다. (2) 비록 처음에는 어렵고 혼란이 있더라도 교과과정은 의학모델이 아닌 간호모델을 중심으로 이루어져야 한다. (3) 간호모델에서 다루어지는 개념들은 모두 직접 간호업무에 적용될 수 있는 것으로 선택되어야 한다. (4) 교과과정의 결과로 배출되는 학생들의 준비정도는 그 지역사회에 적합하여야 한다. (5) 그 지역사회의 고유한 문화적 요소가 포함되어야 한다. 아직 우리는 간호분야 내부의 갈등을 해결하지 못하고 있는 시기에 있다. 우리 내부의 문제점을 잘 해결할 수 있을때 외부와의 갈등에 잘 대처할 수 있을 것이다. 내부의 갈등을 잘 해결하기 위한 힘을 모으기 위하여는 동반자, 즉 교수와 학생, 간호교육자와 임상간호원 등이 서로 진정한 의미의 동반자 될때 가장 중요한 해결의 실마리가 될 것이다.