• 의학교육논단
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• 제20권3호
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• pp.128-134
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• 2018

Medical education, competency, and outcome-based medical education started as part of the basic medical education curriculum in advanced countries 20 years ago, and such an approach was adopted in residency training. General competency training is at the core of residency training in advanced countries, and it goes beyond competency and outcome-based training to the extent that in a milestone training system, competency development is expected and measured with set competency achievements at each level. Recently, for the purpose of ensuring that doctors uphold patient safety and fulfill their obligations, entrustable professional activities (EPA) were applied at the beginning of residency when doctors move away from clinical trials and start actual care. The adoption of EPA in all residency training curriculum has spread very rapidly in the United States, United Kingdom, and Canada. Presently, Korea lags behind other countries significantly as the adoption of competency and outcome-based medical education in residency training has just begun. It is time to identify the current state of the Korean residency training system, and then design and practice a well-established system with a long-term view based on cooperation across the whole medical industry.

• 의학교육논단
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• 제20권1호
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• pp.51-59
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• 2018

Psychiatry residency training in South Korea currently has many limits in developing proper competencies of residents. To address this problem, the Korean Neuropsychiatric Association has been developing a new competency-based training program since 2015, using the educational systems of advanced countries such as Canada, the United Kingdom, the United States, and Australia as references. It was found that within the referenced countries' residency training systems, objectives based on competencies are stated in detail by psychiatric topics as well as various assessment methods and feedback about the resident's competency level. In addition, we surveyed psychiatric resident training hospitals, and found that more than 80% of the respondents answered positively in reference to the new training program. This paper briefly reviews competency-based residency training systems of advanced countries and compares them to the current training program in South Korea. Many resources are needed to run a new competency-based training program, and governmental supports are essential to improve the quality of the residency training system.

• Journal of Preventive Medicine and Public Health
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• 제39권2호
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• pp.110-114
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• 2006

From the start of the residency trainingship in 1963, the residency training programs have been contributed much on the establishment and development of preventive medicine in Korea. But these programs are now have several problems to update the changes in health service needs of the population that were caused by a rapid epidemiologic transition from the acute infectious diseases to chronic diseases in last a few decades. Strengthening in medical practice, not just in knowledge is urgently required. Must have more concentrate on preventive service for the individual, as in clinical preventive medicine. Training residents by the systematic and well scheduled programs, not just 'teacher' assistant' in the academic facilities. Trying the change in the system of Specilty of Preventive Medicine to the well established several subspecialty, so more specific competency can be gained through the training. These approach and reformation may not only contribute for the better future of the preventive medicine, but also improve in disease prevention and health promotion, which required by the society in Korea.

• 의학교육논단
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• 제20권3호
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• pp.135-140
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• 2018

In clinical clerkships, residents function as trainees, workers, and teachers for other medical students. Although residents care for patients in harsh environments and encounter precarious patient-safety situations, they are working towards becoming competent specialists. Residency education programs are very important in cultivating specialists able to adapt to the rapidly-changing medical environment, and are also necessary to improve the quality of specialist training. Competent specialists not only need clinical competency, but also a wide range of abilities including professionalism, leadership, effective communication, cooperation, and attention to continuous professional development/continuing medical education activities. Each Korean association of specialties has its own educational goals and standardized education programs to help residents learn specific techniques and competencies related to medical care for patients, though the training environment of each residency is different within each trainee hospital. Although it is also important to evaluate residency education programs, currently there is only an examination of knowledge and assessment of skills based on mini-clinical evaluation exercises or direct observation of procedural skills. In order to develop an objective and estimable evaluation tool that can assess the overall achievement level within each training course, it is necessary to evaluate the knowledge, skills, and attitudes of residents. Residency education programs need further attention and reform.

• 대한예방한의학회지
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• 제12권1호
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• pp.61-72
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• 2008

With the start of the residentship of Korean preventive medicine in 2008, the residency training programs should be established and also operation plan for the residentship of Korean preventive medicine should be setup. This residency training program need to contain the future oriented study objective to be an expert of the preventive medicine and could be updated the changes in health service needs of the population. Specially in the part of Health Promotion(YangSaeng) in Korean Medicine, strengthening in medical practice, not just in knowledge is urgently required. And we should have more concentrations on preventive service for the individual, as in clinical preventive medicine. Training residents by the systematic and well scheduled programs, not just teacher..and assistant..in the academic facilities. These approach may not only contribute for the better future of the preventive medicine, but also improve in disease prevention and health promotion.

• 보건행정학회지
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• 제9권2호
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• pp.139-156
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• 1999

Recent changes in the health care environment have directed increasing attention to the number and specialty mix of practicing physicians. A major concern identified in Korean health care system is the serious oversupply of specialists and a relative lack of primary care physicians. Currently only 21% of Korean physicians are primary care physicians(general practitioners and family physicians), and less than 10% of recent medical school graduates are choosing to enter primary care. More primary care physicians are needed to deal with major problems in the current health care system, such as cost and access. The infrastructure that relies on primary care physicians is needed to deliver cost-effective and efficient care. To achieve a better balance of primary care to non-primary care physicians. more medical students need to choose careers in one of the primary care specialties(family medicine. internal medicine and pediatrics). This paper suggests the necessity of reforming the Korean graduate medical education system, that is, establishing the path of training primary care physicians in internal medicine and pediatrics residency training programs.

• 의학교육논단
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• 제19권2호
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• pp.70-75
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• 2017

In order to adapt to the rapidly changing medical environment, it is important to advance not only the basic medical education in medical schools but also that of residents. The quality of the training environment and educational goals for residency must also be improved for specialists. Although each institute including internal medicine, general surgery, family medicine, etc., strives to standardize, sets educational goals, and develops content to train capable specialists, the education programs focus on special techniques and competency of medical care for patients. The training environment of each residency program is different in each trainee hospital, and hospitals are making an effort to set education goals for the residents and improve their education programs. In Korea, there is no common core education program for residents, while in the United States, the Accreditation Council for Graduate Medical Education is responsible for the development and evaluation of a standardized curriculum for residents, and in Canada, CanMEDs presents a basic curriculum to help residents develop competency. Fully capable specialists have more than just clinical competency; they also need a wide range of abilities including professionalism, leadership, communication, cooperation, in addition to taking part in continuous professional development/continuing medical education activities. We need to provide a core curriculum for residency to demonstrate attention to and knowledge about health problems of the community.

• 한국병원경영학회지
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• 제25권4호
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• pp.60-75
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• 2020

Purpose: This study aims to develop a cost model for NRP (Nursing Residency Program) operation and ultimately provide evidence for financial factors for NRP operation in the future by simulating a cost model. Methodology: This study developed a model for the NRP education cost calculation model based on the review of Hansen's model, which has systematically reported on the development and operation of NRP, and discussions with nursing education experts at a university-affiliated hospital. With the simulation, it was intended to predict nurses' supply and demand in the long term and to calculate changes in long-term education costs. Findings: Firstly, turnover model, term model, cost model necessary for calculating a model for the NRP education cost calculation model was set up. Secondly, the simulation showed the following results; 1) the proportion of newly graduated nurses less than 5 years of working decreases gradually over time, which will make the composition of nurses more balanced. 2) In the first year of the partial introduction of NRP, the cost of training new nurses was about 2.1 times higher than before. After the introduction, the training cost in the 13th year began to be lesser than before the introduction, and in the 25th year, it decreased by 28.1% compared to before the introduction. Practical Implications: Firstly, NRP would be an effective way to solve the higher turnover and frequent departure of new nurses and the imbalance of nurses' composition. Secondly, although the costs of NRP are incurred in the early stages, in the end, NRP training costs are reduced compared to before the introduction of NRP. It is necessary to systematically understand the contribution effect of NRP by analyzing the economic value of NRP considering financial and non-monetary returns in the future and providing a basis for decision-making related to NRP implementation.

• Archives of Plastic Surgery
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• 제45권5호
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• pp.395-402
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• 2018

Increased emphasis on competency-based learning modules and widespread departure from traditional models of Halstedian apprenticeship have made surgical simulation an increasingly appealing component of medical education. Surgical simulators are available in numerous modalities, including virtual, synthetic, animal, and non-living models. The ideal surgical simulator would facilitate the acquisition and refinement of surgical skills prior to clinical application, by mimicking the size, color, texture, recoil, and environment of the operating room. Simulation training has proven helpful for advancing specific surgical skills and techniques, aiding in early and late resident learning curves. In this review, the current applications and potential benefits of incorporating simulation-based surgical training into residency curriculum are explored in depth, specifically in the context of plastic surgery. Despite the prevalence of simulation-based training models, there is a paucity of research on integration into resident programs. Current curriculums emphasize the ability to identify anatomical landmarks and procedural steps through virtual simulation. Although transfer of these skills to the operating room is promising, careful attention must be paid to mastery versus memorization. In the authors' opinions, curriculums should involve step-wise employment of diverse models in different stages of training to assess milestones. To date, the simulation of tactile experience that is reminiscent of real-time clinical scenarios remains challenging, and a sophisticated model has yet to be established.

• Archives of Plastic Surgery
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• 제43권5호
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• pp.451-456
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• 2016

Background Comprehensive aesthetic surgery training continues to be a challenge for residency programs. Our residency program developed a rhinoplasty-based objective structured clinical examination (OSCE) based upon validated methods as part of the residency education curriculum. We report our experience with the rhinoplasty-based OSCE and offer guidance to its incorporation within residency programs. Methods The encounter involved resident evaluation and operative planning for a standardized patient desiring a rhinoplasty procedure. Validated OSCE methods currently used at our medical school were implemented. Residents were evaluated on appropriate history taking, physical examination, and explanation to the patient of treatment options. Examination results were evaluated using analysis of variance (statistical significance P<0.05). Results Twelve residents completed the rhinoplasty OSCE. Medical knowledge assessment showed increasing performance with clinical year, 50% versus 84% for postgraduate year 3 and 6, respectively (P<0.005). Systems-based practice scores showed that all residents incorrectly submitted forms for billing and operative scheduling. All residents confirmed that the OSCE realistically represents an actual patient encounter. All faculty confirmed the utility of evaluating resident performance during the OSCE as a useful assessment tool for determining the Next Accreditation System Milestone level. Conclusions Aesthetic surgery training for residents will require innovative methods for education. Our examination showed a program-educational weakness in billing/coding, an area that will be improved upon by topic-specific lectures. A thoroughly developed OSCE can provide a realistic educational opportunity to improve residents' performance on the nonoperative aspects of rhinoplasty and should be considered as an adjunct to resident education.