After Yeungnam University's College of Medicine was established in 1979, the curriculum for a preclinical medical education course was developed and implemented. Several modifications have since been made to the curriculum which was driven by changes in national policies and in the medical education environment. In recent years, it has become necessary to complement the weaknesses or shortcomings in the curriculum that were discovered during the basic medical education assessment process of the medical college. Since 2009, Yeungnam University has run two medical courses: a 6-year college of medicine course and a 4-year medical school course. However, as a result of changes in national policy, Yeungnam University decided to offer only the 6-year college of medicine course with an entirely new curriculum which will be implemented in 2017. The new curriculum for the preclinical medical education course consists of 36 credits of cultural essentials courses, 44 credits of major required courses, and 2 credits of major elective courses. The curriculum development requires the support of the university and/or college, the ensured independence of the curriculum development organization, and the cooperation and attention of fellow professors. Continuous efforts are needed to check, evaluate, and improve the curriculum.
Kim, Do-Hwan;Choi, Young-Hyu;Han, Sang Yun;Shin, Jwa-Seop;Lee, Seunghee
Korean Medical Education Review
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v.19
no.2
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pp.90-100
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2017
The necessity of embracing selective courses in medical curriculum is increasing due to the expansion of medical knowledge and changes in the health care environment. In contrast to the abundant evidence regarding elective or selective courses during the clinical phase, articles focusing on the preclinical period are relatively scarce. This study aims to explore the development, implementation, and evaluation of newly-adopted selective courses in the first-year medical curriculum in a medical school which recently underwent a major curricular revision. First of all, the Curriculum Committee established goals and operating principles of the courses, and then the committee encouraged all participating professors to attend a related faculty development workshop after finalizing the list of courses. A survey was conducted at the end of each course for evaluation. Of the 36 courses opened in 2016, the overall satisfaction of students was $4.98{\pm}1.06$ (out of 6) and showed a strong correlation with students' previous expectations, reasoning- and participation-oriented teaching, and outcome of the courses including increased motivation. In the open-ended responses, students and professors described not only intended outcomes such as acquisition of medical knowledge and increased interest in new topics, but also unintended outcomes including positive impression for selective courses and even high satisfaction and rewarding experiences, especially from the teachers' perspective. Although long-term outcomes remain to be seen, the results of this study show the feasibility and impact of selective courses and will contribute to effective implementation in other medical schools.
When participating in problem-based learning (PBL), it is important for medical students to generate claims and provide justifications for their claims in small group discussions. This study aimed to investigate the effect of argumentation instruction on medical student learning experiences with PBL. A total of one hundred first-year preclinical students from Inje University College of Medicine, who had attended argumentation instruction, participated in this study. All of the participants completed a 5-point Likert scale questionnaire regarding their learning experiences with PBL, before and after the argumentation instruction. The questionnaire comprised 22 items with eight subcategories: argumentation activity, reflection, integration of basic and clinical science, identification of lack of knowledge, logical thinking, self-directed study, communication, and attitude toward discussion. The collected data were analyzed through a paired-sample t-test. The results of this study found that the argumentation instruction promoted the preclinical students' experiences with argumentation activities, reflection, an integration of basic and clinical science, the identification of their lack of knowledge, logical thinking, and self-directed study, and it increased positive attitudes toward group discussion. The findings suggest argumentation instruction can enhance medical student group discussions and help students achieve the objectives of PBL, including acquisition of basic and clinical science knowledge and development of clinical reasoning and self-directed learning abilities, which can highlight the meaningful learning experiences students have with PBL.
This study is a narrative review introducing global trends in patient safety education within medical schools and exploring the status of Korean education. Core competences for patient safety include patient centeredness, teamwork, evidence- and information-based practice, quality improvement, addressing medical errors, managing human factors and system complexity, and patient safety knowledge and responsibility. According to a Korean report addressing the role of doctors, patient safety was described as a subcategory of clinical care. Doctors' roles in patient safety included taking precautions, educating patients about the side effects of drugs, and implementing rapid treatment and appropriate follow-up when patient safety is compromised. The Korean Association of Medical Colleges suggested patient safety competence as one of eight essential human and society-centered learning outcomes. They included appropriate attitude and knowledge, human factors, a systematic approach, teamwork skills, engaging with patients and carers, and dealing with common errors. Four Korean medical schools reported integration of a patient safety course in their preclinical curriculum. Studies have shown that students experience difficulty in reporting medical errors because of hierarchical culture. It seems that patient safety is considered in a narrow sense and its education is limited in Korea. Patient safety is not a topic for dealing with only adverse events, but a science to prevent and detect early system failure. Patient safety emphasizes patient perspectives, so it has a different paradigm of medical ethics and professionalism, which have doctor-centered perspectives. Medical educators in Korea should understand patient safety concepts to implement patient safety curriculum. Further research should be done on communication in hierarchical culture and patient safety education during clerkship.
Students must be familiar with clinical skills before starting clinical practice to ensure patients' safety and enable efficient learning. However, performance is mainly tested in the third or fourth years of medical school, and studies using the validity framework have not been reported in Korea. We analyzed the validity of a performance test conducted among second-year students classified into content, response process, internal structure, relationships with other variables, and consequences according to Messick's framework. As results of the analysis, content validity was secured by developing cases according to a pre-determined blueprint. The quality of the response process was controlled by training and calibrating raters. The internal structure showed that (1) reliability by generalizability theory was acceptable (coefficients of 0.724 and 0.786, respectively, for day 1 and day 2), and (2) the relevant domains had proper correlations, while the clinical performance examination (CPX) and objective structured clinical examination (OSCE) showed weaker relationships. OSCE/CPX scores were correlated with other variables, especially grade point average and oral structured exam scores. The consequences of this assessment were (1) making students learn clinical skills and study themselves, while causing too much stress for students due to lack of motivation; (2) reminding educators of the need to apply practical teaching methods and to give feedback on the test results; and (3) providing an opportunity for faculty to consider developing support programs. It is necessary to develop the blueprint more precisely according to students' level and to verify the validity of the response process with statistical methods.
Since the emergence of coronavirus disease 2019 (COVID-19), medical schools have experienced a sudden, full-scale transition to online classes. As the COVID-19 pandemic continues, it is important to evaluate current educational programs and to assess their implications. This study explored perceptions of online classes and learning behavior among medical students. Twenty preclinical medical students were interviewed in focus groups for 2 months. They generally expressed positive perceptions about online classes, and in particular, positively assessed the ability to lead their individual lifestyles and study in comfortable environments with fewer time and space constraints. Students thought that the online environment provided a fair chance of facilitating positive interactions with the professor and considered communication with the professor to be an important factor only when it was related to the class content or directly helped with their grades and careers. Students also had negative views, such as feeling uncertain when they could not see their peers' learning progress and assess themselves in comparison and feeling social isolation. Learning behaviors have also changed, as students explored their learning styles and adapted to the changed learning environment. Students expanded their learning by using online functions. However, students sometimes abused the online class format by "just playing" the lecture while not paying attention and relying on other students' lecture transcripts to study. The results of this study are hoped to provide a useful foundation for future research on online class-based teaching and learning.
Lee, Kee-Hang;Nam, Hyun;Won, Jeong-Seob;Hwang, Ji-Yoon;Jang, Hye Won;Lee, Sun-Ho;Joo, Kyeung Min
Journal of Korean Neurosurgical Society
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v.61
no.4
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pp.434-440
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2018
Objective : The purpose of this study was to find an optimal delivery route for clinical trials of intrathecal cell therapy for spinal cord injury in preclinical stage. Methods : We compared in vivo distribution of Cy5.5 fluorescent dye in the spinal cord region at various time points utilizing in vivo optical imaging techniques, which was injected into the lateral ventricle (LV) or cisterna magna (CM) of rats. Results : Although CM locates nearer to the spinal cord than the LV, significantly higher signal of Cy5.5 was detected in the thoracic and lumbar spinal cord region at all time points tested when Cy5.5 was injected into the LV. In the LV injection Cy5.5 signal in the thoracic and lumbar spinal cord was observed within 12 hours after injection, which was maintained until 72 hours after injection. In contrast, Cy5.5 signal was concentrated at the injection site in the CM injection at all time points. Conclusion : These data suggested that the LV might be suitable for preclinical injection route of therapeutics targeting the spinal cord to test their treatment efficacy and biosafety for spinal cord diseases in small animal models.
Standard oral and maxillofacial three-dimensional model was developed with patients' medical data while virtual reality (VR) simulator was developed in conjunction with head mount display (HMD) and Haptic device. The objective of this study was to evaluate the preclinical use of a VR training simulator in tooth preparation practice. Eighty-nine dental students were trained how to operate the simulator. The participants were then given sufficient time on the simulator to practice dental preparation. The students experience and opinion was then taken in through filling of questionnaires. On average content received 1.8 points, anatomy had 2.5 points, 2.6 points for the applicability, and 2.0 for the usability. As for the detailed items scores, queries about the possible development of the simulator and the interest of the learning process through the simulator were the highest at 3.1 and 3.0 points, respectively. Question about the benefit of the HMD and the haptic device during the practice had 1.5 and 1.6 points, respectively. The average total score was 2.2 points. VR tooth preparation simulator in the field of clinical dental education has powerful potential in regard to realistic models, environments, vision, posture, and economical efficiency.
The purpose of this study was to classify the courses of the dental-hygiene curricula into several categories by field, to incorporate the subjects in the same category into an integrated course, and to suggest how to ensure the successful phase-in application of integrative education according to Ronald M. Harden's 11-stage integrative ladder model. The findings of the study were as follows: 1. When the existing curricula were analyzed, it's found that many credits were provided to the courses in the area of basic dentistry that offered both theory and practice. In particular, the subjects tested by the national examination were offered by every college. In the field of public oral health, the largest number of credits was allocated to theory of oral prophylaxis and practice courses. In clinical area, clinical practice, in the area of dental office management, dental insurance course was given the largest credit. There were 31 to 61 major subjects in the colleges, which indicated that the major subjects were segmented in detail. 2. It seemed necessary to incorporate the subjects in the field of basic dentistry into oral biology, and theory of oral prophylaxis/practice, preventive dentistry/practice, preclinical stage, emergency treatment and introduction to dental hygiene should be integrated in to clinical dental hygiene. The courses in clinical area should be combined into clinical dentistry, and in the field of medical management, dental insurance, hospital management and medical relation law should be incorporated into management of dental clinic. 3. In the 11-stage integrative ladder, the subjects in the same field could perfectly be incorporated as the stages advanced. Each of the subjects was less emphasized, and communication and joint plans among teachers who were respectively in charge of the courses were increasingly considered important. Specifically, there should be a consensus among the teachers in regard to the outline of teaching programs, order of education. objects and objectives of programs and what and how to evaluate.
Neuropathic pain is a complex chronic pain state caused by the dysfunction of somatosensory nervous system, and it affects the millions of people worldwide. At present, there are very few medical treatments available for neuropathic pain management and the intolerable side effects of medications may further worsen the symptoms. Despite the presence of profound knowledge that delineates the pathophysiology and mechanisms leading to neuropathic pain, the unmet clinical needs demand more research in this field that would ultimately assist to ameliorate the pain conditions. Efforts are being made globally to explore and understand the basic molecular mechanisms responsible for somatosensory dysfunction in preclinical pain models. The present review highlights some of the novel molecular targets like D-amino acid oxidase, endoplasmic reticulum stress receptors, sigma receptors, hyperpolarization-activated cyclic nucleotide-gated cation channels, histone deacetylase, $Wnt/{\beta}-catenin$ and Wnt/Ryk, ephrins and Eph receptor tyrosine kinase, Cdh-1 and mitochondrial ATPase that are implicated in the induction of neuropathic pain. Studies conducted on the different animal models and observed results have been summarized with an aim to facilitate the efforts made in the drug discovery. The diligent analysis and exploitation of these targets may help in the identification of some promising therapies that can better manage neuropathic pain and improve the health of patients.
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