Journal of the Korean Institute of Landscape Architecture
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v.44
no.6
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pp.1-12
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2016
There is growing concern about landscape agreement with regard to a variety of activities within resident-based agreements in Korea. This study aims to investigate the communication method of the agreement contacting process and its essential role as a bottom-up resident-based process. The study site is Gobuk Market in Suwon city, where a resident-based landscape agreement was successfully made. In this study, the author implemented in-depth interviews and a literature review to understand the meaning of the agreement contracting process and participants' opinions regarding the Gobuk Market case. During the landscape contracting process, the level of participation of residents, experts and the government changed. The study found that diverse communication methods, such as training, agreement information sessions and seminars were conducted during the process of the resident-based landscape agreement and it is crucial to construct healthy relationship among stakeholders. Furthermore, the experts' role is crucial in establishing agreement among residents initially. However, as local empowerment and the willingness of local people grow, each stakeholder's role is changed by stage. Therefore the Central and Local Government have the necessary task of providing institutional strategy. This study has offered practical information on how each stakeholder played their individual role within the landscape agreement.
Kim, Young-Jun;Roy, Frederick;Lee, Seung-Bin;Seo, Joon-Ho;Lee, Deuk-Hee;Park, Se-Hyung
Korean Journal of Computational Design and Engineering
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v.17
no.5
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pp.303-311
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2012
Laparoscopic surgery is a surgical procedure which uses long laparoscopic instruments through tiny holes in abdomen while watching images from a laparoscopic camera through umbilicus. Laparoscopic surgeries have many advantages rather than open surgeries, however it is hard to learn the surgical skills for laparoscopic surgery. Recently, some virtual simulation systems for laparoscopic surgery are developed to train novice surgeons or resident surgeons. In this study, we introduce the techniques that we developed for laparoscopic surgical training simulator for cholecystectomy (gallbladder removal), which is one of the most frequently performed by laparoscopic surgery. The techniques for cholecystectomy simulation include modeling of human organs (liver, gallbladder, bile ducts, etc.), real-time deformable body calculation, realistic 3D visualization of surgical scene, high-fidelity haptic rendering and haptic device technology, and so on. We propose each simulation technique for the laparoscopic cholecystectomy procedures such as identifying cystic duct and cystic artery to clamp and cut, dissecting connective tissues between the gallbladder and liver. In this paper, we describe the techniques and discuss about the results of the proposed cholecystectomy simulation for laparoscopic surgical training.
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.
Background As the coronavirus disease 2019 virus made its way throughout the world, there was a complete overhaul of our day-to-day personal and professional lives. All aspects of health care were affected including academics. During the pandemic, teaching opportunities for resident training were drastically reduced. Consequently, medical universities in many parts across the globe implemented online learning, in which students are taught remotely and via digital platforms. Given these developments, evaluating the existing mode of teaching via digital platforms as well as incorporation of new models is critical to improve and implement. Methods We reviewed different online learning platforms used to continue regular academic teaching of the plastic surgery residency curriculum. This study compares the four popular Web conferencing platforms used for online learning and evaluated their suitability for providing plastic surgery education. Results In this study with a response rate of 59.9%, we found a 64% agreement rate to online classes being more convenient than normal classroom teaching. Conclusion Zoom was the most user-friendly, with a simple and intuitive interface that was ideal for online instruction. With a better understanding of factors related to online teaching and learning, we will be able to deliver quality education in residency programs in the future.
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.
Lee, Joon Woo;Lee, Guen Young;CHONG, Le Roy;Kang, Heung Sik
Investigative Magnetic Resonance Imaging
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v.22
no.1
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pp.10-17
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2018
Purpose: To evaluate interpretation errors involving spine MRIs by residents in their second to fourth year of training, classified as minor, intermediate and major discrepancies, as well as the types of commonly discordant lesions with or without clinical significance. Materials and Methods: A staff radiologist evaluated both preliminary and final reports of 582 spine MRIs performed in the emergency room from March 2011 to February 2013, involving (1) the incidence of report discrepancy, classified as minor if there was sufficient description of the main MR findings without ancillary or incidental lesions not influencing the main diagnosis, treatment, or patients' clinical course; intermediate if the correct diagnosis was made with insufficient or inadequate explanation, potentially influencing treatment or clinical course; and major if the discrepancy affected the main diagnosis; and (2) the common causes of discrepancy. We analyzed the differences in the incidence of discrepancy with respect to the training years of residents, age and sex of patients. Results: Interpretation discrepancy occurred in 229 of the 582 cases (229/582, 39.3%), including 146 minor (146/582, 25.1%), 40 intermediate (40/582, 6.9%), and 43 major cases (43/582, 7.4%). The common causes of major discrepancy were: over-diagnosis of fracture (n = 10), missed cord lesion (n = 9), missed signal abnormalities associated with diffuse marrow (n = 5), and failure to provide differential diagnosis of focal abnormal marrow signal intensity (n = 5). No significant difference was found in the incidence of minor, intermediate, and major discrepancies according to the levels of residency, patients' age or sex. Conclusion: A 7.4% rate of major discrepancies was found in preliminary reporting of emergency MRIs of spine interpreted by radiology residents, probably related to a relative lack of clinical experience, indicating the need for additional training, especially involving spine trauma, spinal cord and bone marrow lesions.
Kim, Hyuk;So, Eunsun;Karm, Myong-Hwan;Kim, Hyun Jeong;Seo, Kwang-Suk
Journal of Dental Anesthesia and Pain Medicine
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v.17
no.4
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pp.297-305
/
2017
Background: Fiberoptic nasotracheal intubation (FNI) is performed if it is difficult to open the mouth or if intubation using laryngoscope is expected to be difficult. However, training is necessary because intubation performed by inexperienced operators leads to complications. Methods: Every resident performed intubation in 40 patients. Success of FNI was evaluated as the time of FNI. First intubation time was restricted to 2 min 30 s. If the second attempt was unsuccessful, it was considered a failed case, and a specialist performed nasotracheal intubation. If the general method of intubation was expected to be difficult, awake intubation was performed. The degree of nasal bleeding during intubation was also evaluated. Results: The mean age of the operators (11 men, 7 women) was 27.8 years. FNI was performed in a total of 716 patients. The success rate was 88.3% for the first attempt and 94.6% for the second attempt. The failure rate of intubation in anesthetized patients was 4.9%, and 13.6% in awake patients. When intubation was performed in anesthetized patients, the failure rate from the first to fifth trial was 9.6%, which decreased to 0.7% when the number of trials increased to > 30 times. In terms of awake intubation, there was no failed attempt when the resident had performed the FNI > 30 times. The number of FNIs performed and nasal bleeding were important factors influencing the failure rate. Conclusion: The success rate of FNI increased as the number of FNI performed by residents increased despite the nasal bleeding.
The purpose of this study is to analyze the effects of the simulation-based professional cardiac resuscitation training on the performance of professional cardiac resuscitation performed by paramedics in the pre-hospital stage and to provide basic data for effective cardiac resuscitation. This study is an experimental study of the design before and after the control of non-equality. The subjects of this study were 16 newly recruited paramedics from K firefighting school. The simulation training program and evaluation papers used as the evaluation tool were reviewed and commented by 6 ACLS simulation experts (2 emergency medical doctor, 2 emergency medical professors, 2 KALS instructors)Respectively. The training consisted of 30 minutes of theory and 150 minutes of practical training. The lecturer first demonstrated for 5 minutes, and after training by individual debriefing after individual training, individual and team education was conducted The evaluation scale was given a 5 - point Likert scale. The SPSS 22.0 program for Windows was used. The general characteristics of the subjects were analyzed for frequency, the examination of homogeneity between the experimental group and the control group wasfulfilled by t test, and the difference test between the groups of the two groups was performed using the paired t-test. The homogeneity test was able to confirm the homogeneity between experimental group and control group. In the evaluation of six ACLS techniques, it was proven that the experimental group that received the simulation training had better performance in all aspects than the non - training control group. The following are the technical items to be performed. 1. Electrocardiogram 2. Specialized instrument 3. Treatment of fluid 4. Leadership and teamwork 5. Medical guidance 6. Evaluation during transfer. It was proved that paramedics who received simulation training were improved on their job performance ability than general lecture and training group. Therefore, if simulation training and education are applied to a student in the synthetic course or an emergency resident who is engaged in clinical practice, he / she will be able to perform his / her duties more proficiently. It is expected that emergency services provided to patients with cardiac arrest will be improved.
Introduction : The purpose of this study was to analyze the safety, pullout strength and radiographic characteristics of unicortical and bicortical screws of cervical facet within cadaveric specimens and evaluate the influence of level of training on the positioning of these screws. Methods : Twenty-one cadavers, mean 78.9 years of age, underwent bilateral placement of 3.5mm AO lateral mass screw from C3-C6(n=168) using a slight variation of the Magerl technique. Intraoperative imaging was not used. The right side(unicortical) utilized only 14mm screws(effective length of 11mm) while on the left side to determine the length of the screw after the ventral cortex had been drilled. Three spine surgeons(attending, fellow, chief resident) with varying levels of spine training performed the procedure on seven cadavers each. All spines were harvested and lateral radiographs were taken. Individual cervical vertebrae were carefully dissected and then axial radiographs were taken. The screws were evaluated clinically and radiographically for their safety. Screws were graded clinically for their safety with respect to the spinal cord, facet joint, nerve root and vertebral artery. The grades consisted of the following categories : "satisfactory", "at risk" and "direct injury". Each screw was also graded according to its zone placement. Screw position was quantified by measuring a sagittal angle from the lateral radiograph and an axial angle from the axial radiograph. Pull-out force was determined for all screws using a material testing machine. Results : Dissection revealed that fifteen screws on the left side actually had only unicortical and not bicortical purchase as intended. The majority of screws(92.8%) were satisfactory in terms of safety. There were no injuries to the spinal cord. On the right side(unicortical), 98.9% of the screws were "satisfactory" and on the left side(bicortical) 68.1% were "satisfactory". There was a 5.8% incidence of direct arterial injury and a 17.4% incidence of direct nerve root injury with the bicortical screws. There were no "direct injuries" with the unicortical screws for the nerve root or vertebral artery. The unicortical screws had a 21.4% incidence of direct injury of the facet joint, while the bicortical screws had a 21.7% incidence. The majority of "direct injury" of bicortical screws were placed by the surgeon with the least experience. The performance of the resident surgeon was significantly different from the attending or fellow(p<0.05) in terms of safety of the nerve root and vertebral artery. The attending's performance was significantly better than the resident or fellow(p<0.05) in terms of safety of the facet joint. There was no relationship between the safety of a screw and its zone placement. The axial deviation angle measured $23.5{\pm}6.6$ degrees and $19.8{\pm}7.9$ degrees for the unicortical and bicortical screws, respectively. The resident surgeon had a significantly lower angle than the attending or fellow(p<0.05). The sagittal angle measured $66.3{\pm}7.0$ degrees and $62.3{\pm}7.9$ degrees for the unicortical and bicortical screws, respectively. The attending had a significantly lower sagittal angle than the fellow or resident(p<0.05). Thirty-three screws that entered the facet joint were tested for pull-out strength but excluded from the data because they were not lateral mass screws per-se and had deviated substantially from the intended final trajectory. The mean pull-out force for all screws was $542.9{\pm}296.6N$. There was no statistically significant difference between the pull-out force for unicortical($519.9{\pm}286.9N$) and bicortical($565.2{\pm}306N$) screws. There was no significant difference in pull-out strengths with respect to zone placement. Conclusion : It is our belief that the risk associated with bicortical purchase mandates formal spine training if it is to be done safely and accurately. Unicortical screws are safer regardless of level of training. It is apparent that 14mm lateral mass screws placed in a supero-lateral trajectory in the adult cervical spine provide an equivalent strength with a much lower risk of injury than the longer bicortical screws placed in a similar orientation.
This study aimed at examining the factors affecting citizen engagement in community health promotion program that a local government offered for residents. A descriptive study was conducted with a sample of 418 participants who completed 10,000-Step Walking Program, sponsored by the local government of B city. Data were collected, using a self-reported questionnaire, and analyzed with statistical methods, including T-test, ANOVA, and multiple regression. There were significantly different in the number of participation days in the program by material support(pace counter(p<.001), exercise notebook(p<.001), piggy bank((p=.002)), informational support(Walking training, leadership training)(p<.001), promotion events and meetings, and membership of exercise club(p<.001). Using exercise notebook(p<.001) and exercise club membership(p<.001)) were the supporting factors affecting citizen engagement in the walking program. This research shows that various political plans for providing material and social supports including walking activity aids, community club forming are needed to encouraging citizens' participation in health promotion programs.
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