• 의학교육논단
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• 제22권3호
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• pp.173-188
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• 2020

Medical humanities education (MHE) is as essential as basic medical sciences and clinical medicine education. Despite the importance of MHE, MHE curriculum development (CD) has proven to be challenging. This critical review examines the MHE CD at one medical school. The critical review methodology was developed based on Kern's six step CD model to systematically examine the CD of "Doctoring and Medical Humanities (DMH)" at the Yonsei University College of Medicine. Five review questions were developed related to (1) necessity, (2) direction and purpose, (3) design, (4) operation, and (5) evaluation of CD based on Kern's model. The review showed that the process of DMH CD mapped to components of Kern's model. The DMH curriculum content selected was closely related to medical practice and aimed to combine the acquisition of understanding and skills by designing a student-participatory curriculum based on clinical cases. Assessment methods that emphasized students' reflections were actively introduced in the evaluation section. Since the regular committee for DMH continued the work of the special ad hoc committees for DMH CD, the CD was effectively completed. However, the planning and evaluation functions and responsibilities of the DMH committee need to be strengthened. Despite the apparent limitations, the fact that students showed a high satisfaction rate and preferred small group discussions based on clinical cases has significant implications in the instructional design of MHE, where changes in self-awareness and attitude are more important than the acquisition of information. It is necessary to systematically review and study students' reflection results produced by the changed assessment methods and to develop assessment indicators for MHE that reflect the achievements of the MHE competencies of students.

• 대한의용생체공학회:의공학회지
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• 제41권1호
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• pp.8-13
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• 2020

To develop cardiovascular simulator capable of implementing pulse waves similar to the human body, accurate information about reflection wave is required. However, the conclusion is still not clear and various discussions are underway. In this study, the pulse wave velocity of the tube used in the experiment was first determined by measuring the pressure waves at two points in a single tube system with the experimental device to implement the pulse wave transmission of blood vessels, and the superposition time and characteristics of the reflection wave were confirmed. After that, an air chamber was set at the reflection site, and the effect of the change of air volume on the reflection wave was investigated. Finally, the effect of the number of branches connected to a single tube on the reflection wave was investigated. The superposition time of the reflection wave can be controlled by the air volume of the air chamber, and the magnitude of the reflection wave is influenced by the number of reflection sites that generate the reflection wave. The results of this study may be of practical assistance to simulator researchers who want to implement pulse wave similar to clinical data. It is expected that the more results similar to clinical are provided, the greater the scope of the simulator's contribution to clinical cardiovascular research.

• Clinical and Experimental Pediatrics
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• 제63권11호
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• pp.433-437
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• 2020

Background: Indonesia is one of the countries with the highest preterm birth rate. Preterm infants are more likely than term and normal weight infants to experience neonatal mortality and morbidity due to acute respiratory, gastrointestinal, immunologic, central nervous system, hearing, and vision problems. Kangaroo mother care (KMC) is a proven cost-effective intervention to help reduce mortality rates among preterm infants; however, it has not been fully implemented in hospitals. Purpose: Assess KMC knowledge and perceptions among health providers. Methods: This qualitative study was conducted from December 2015 to April 2016 and consisted of 21 in-depth interviews and 3 focus group discussions (FGDs). The 3 categories of health personnel in the study were clinical providers, hospital management representatives, and Indonesian Midwife Association members. Results: Most health providers know about the benefits of KMC including stabilizing temperatures, weight gain, and maternal-infant bonding and reducing human resources and labor costs. They were also aware of which newborns were eligible for KMC treatment. Their knowledge was mostly gained from observation or obtained from pediatricians and personal experience. They believed that a low birth weight infant in an incubator could not be treated with KMC and that it could only be practiced if a special gown was used when holding the baby. This perception could be caused by a lack of formal KMC training, leading to misunderstanding of its aspects. Conclusion: In conclusion, KMC knowledge of clinical providers in the 2 hospitals was sufficient, primarily due to their health-related educational background. Some perceptions could be potential barriers to or facilitate the implementation of KMC practice. These perceptions should be considered in future KMC training designs.

• 한국산학기술학회논문지
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• 제21권2호
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• pp.74-84
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• 2020

본 연구는 간호대학생의 임상입문실습 경험의 의미와 본질적 구조를 밝히기 위해 진행된 현상학적 연구이다. 자료수집은 2019년 7월 15일부터 31일까지 진행되었으며, U광역시에 소재한 일개 대학교의 간호학과 학생 중 임상입문실습을 마친 8명을 대상으로 하여 포커스 그룹 토론과 심층면담을 통해 이루어졌다. 참여자들은 비구조화된 질문을 통해 실습의 전반적인 과정 중에 겪은 상황과 환경, 감정 등을 구체적으로 진술하였다. Colaizzi의 현상학적 방법을 이용하여 분석한 간호대학생의 임상입문실습 경험은 의미 있는 진술로부터 41개의 주제와 17개의 주제모음, 5개의 범주인' 걱정과 기대가 함께 함', '병원이 현실로 다가옴', '감정의 혼재 끝에 적응함', '되어감의 첫 단계', '미래를 준비함'으로 구성되었고, 도출된 범주는 실습 중 시간의 흐름에 따라 하나의 맥락 속에서 전개되었다. 연구결과 밝혀진 간호대학생의 임상입문실습 경험은 기대와 걱정되는 상태에서 실습을 시작하여 다양한 상황과 감정을 경험하면서 적응하고 미래를 준비하게 되는 본질적 구조로 이루어졌다. 연구는 1,000시간 이상 시행되어야 하는 임상실습의 시작 시점에서 시행되었으므로 그 결과는 앞으로 이루어질 간호대학생의 임상실습 적응을 위한 유용한 정보를 제공할 것으로 판단되며, 이를 기반으로 간호대학생의 실습을 위한 교육 프로그램 개발 및 적용이 이루어져야 할 것이다.

• 대한한방부인과학회지
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• 제23권1호
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• pp.42-52
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• 2010

Purpose: This report aims to administer methodologic issues around recently conducted multicenter study for evaluating the effects of acupuncture on menopusal hot flashes and discuss practical issues for further implementation of acupuncture clinical trial for hot flashes. Methods: Study process were mentioned, and issues related to avoiding risk of bias, designing appropriate control group, optimal outcome measurement, potential different effects of menopausal status on study outcomes, and suggestions for developing future clinical trials are discussed. Results: Shortcomings of our multicenter study include lack of allocation concealment and assessor blinding, subjective outcome measurement, short-term follow-up, and fixed acupuncture regimen despite pragmatic purpose of this study. Improving trial design, using objective or validated outcomes, assessing long-term effects of acupuncture, and individualizing acupuncture regimen are needed in future clinical trials. Conclusion: We expect these practical discussions to enable researchers to plan and develop future well-designed clinical trials for evaluating the effects of acupuncture on hot flashes or other women's health issues.

• 실천공학교육논문지
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• 제12권1호
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• pp.109-116
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• 2020

멘토링의 효과는 멘티의 역량강화, 지식향상, 적극적 태도 등 긍정적 효과를 가져온다. 간호대학생들이 임상실습에서 겪는 가장 큰 어려움은 현장적응, 자신감 부족 등으로 보고되었다. 따라서 본 연구는 간호대학생에게 임상실습 전 문제해결능력, 학습태도, 간호술기에 대한 자신감을 향상시키고자 멘토링 프로그램을 개발하여 효과를 평가하였다. 멘토링 프로그램을 개발하기 위해 연구책임자를 포함한 교수 및 임상간호사로 구성된 전문가 집단이 임상실습에서 가장 많이 요구되는 간호행위 및 지식 등에 대한 논의를 거쳐 11개의 주제를 선정한 후 내용을 구성하였다. 프로그램 운영에는 14명의 멘토가 투입되어 2일동안 9~10명으로 구성된 그룹에게 실습, 상담, 동영상, 상황별 토론 등을 운영하였다. 자료수집기간은 2018년 12월부터 2019년 1월까지이고, 프로그램의 효과는 문제해결능력, 학습태도, 간호행위 수행자신감 도구로 평가하였다. 연구결과는 프로그램 참여 후 학습태도, 간호술기 수행자신감이 유의하게 증가하였지만, 문제해결능력은 통계적으로 유의한 차이가 없었다. 본 연구는 정형화된 교내실습교육에서 벗어나 멘토링 방법을 사용하여 교육효과를 향상시켰다는 점에서 의의가 있다. 추후 멘토링 교육프로그램이 단기간이 아닌 임상실습 전, 중, 후에 적용하여 간호학생의 문제해결능력에 영향을 미치는지 평가할 필요가 있을 것이다.

• 여성건강간호학회지
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• 제17권3호
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• pp.225-242
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• 2011

Purpose: The purpose of this study was to identify students' experiences of performance and their satisfaction with clinical nursing practice in Women's health nursing. Methods: Data was collected using questionnaire consisting of 104; 89,; and 82 nursing activities with 12; 10; and 7 domains for delivery floor, obstetric, and gynecologic wards retrospectively. Five hundred ninety nursing students from 10 four year and one three year colleges, were recruited and selected for data collection. Results: Site specific core nursing activities among top 15 items of performed experience were: interpreting fetal monitoring; massage for pain reduction; breathing technique; perineal pad change; non stress test; manual check for uterine contraction; and position change for the delivery floor. Experiences of clinical nursing practice for the obstetric ward and the gynecologic ward were identified and ranked as well. Observation of delivery, measurement & test during labor and observation of anesthesia and operation were the highest ranked activity domains of satisfaction for delivery floor, obstetric and gynecologic wards retrospectively. Conclusion: Discussions are needed to standardize curriculum for clinical practice in women's health nursing initiated at the level of Korean Society of Womens' Health Nursing by reflecting this result. Strategic approaches are emphasized in order to enhance a collaboration between clinical fields and colleges.

• 한국콘텐츠학회논문지
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• 제18권5호
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• pp.175-190
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• 2018

본 연구는 임상시험코디네이터 간호사의 근무환경, 직무만족, 조직몰입이 이직의도에 미치는 영향을 확인하고자 한 서술적 조사연구이다. 연구 결과 조직몰입이 임상시험코디네이터 간호사의 이직의도에 유의한 영향을 미치는 요인임이 파악되었다. 반면 근무환경, 직무만족이 임상시험코디네이터 간호사의 이직의도에 미치는 영향은 통계적으로 유의하지 않았다. 본 연구의 결과를 토대로 다음과 같은 주요 논의점을 도출하였다. 조직몰입을 높이기 위해서는 병원 운영 및 행정에 대한 참여 기회 증가, 소속감 향상을 위한 소속기관 확립과 같은 제도적인 개선이 필요하다. 또한 각 병원마다 자체적으로 근무환경 향상을 위한 복지 및 임금체계 기준 마련이 필요하다. 실제 연구 수행자이면서 동시에 연구 지원자인 임상시험코디네이터 간호사의 조직몰입이 간과된다면, 임상시험의 성과와 질은 저하될 수밖에 없을 것이다. 따라서 고용형태를 계약직에서 보다 안정적인 고용형태로 전환하여 업무 지속성과 조직에 대한 헌신도를 높여 임상시험 전 과정에 있어 중추적인 역할을 수행할 수 있도록 개선해 나가야 할 것이다.

• 대한임상전기생리학회지
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• 제9권1호
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• pp.41-49
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• 2011

This study purposes to conduct visual feedback and body posture control training on stroke patients with pusher syndrome in order to reduce their pusher syndrome. This study also examines changes resulting from the training and applies the guidelines necessary for documentation of patient/customer management. The participant for this study was one patient with pusher syndrome. The study progressed from a medical examination of the subject followed by evaluation, diagnosis, prognosis, intervention and treatment plan, and finally re-examination in order of precedence. Problems in the participant's functional activities, difficulties in changes from sitting postures into standing postures, and maintaining standing postures were determined as primary restrictions on activities and the improvement of these activities was set up as a goal through discussions with the patient. Interventions were mainly implemented to reduce the pusher syndrome with visual feedback provided using mirrors and exercises focusing on leaning in order to maintain posture while sitting. Changes from supine postures to sitting postures and the degree of changes in maintaining standing postures were compared between before and after the intervention by measuring times in the same environment and the degree of pusher syndrome was measured using the SCP tool. The process of this clinical practice was documented. The SCP score that indicates the degree of changes in the participant's pusher syndrome changed from 3.75 points to 0.8 point indicating a decrease in pushing. Among functional activities, posture changes from sitting postures to standing postures and maintaining standing postures were improved. In addition, since the patient could maintain standing postures, the patient could walk indoors. In this case study, mirrors and body posture control training used as interventions to relieve pusher syndromes can be easily applied in clinics to examine the form of functional recovery. The results indicated that these intervention methods were effective and thus it is thought that the results can be used as basic data to utilize these intervention methods diversely. In addition, the documentation of patient/client management was applied as actual documentation in Korean and based on the results, we could show decision making processes for patients' functional goals and objectively explain problems, prognoses and changes made through the interventions.

• 동의생리병리학회지
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• 제24권6호
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• pp.1094-1098
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• 2010

With the high prevalence of functional dyspepsia in the world, it was difficult to get objective diagnosis, treatment and assessment for the reason that there were many different symptoms and signs. The purpose of this study is to develop a standard instrument of pattern identification for functional dyspepsia which will be applied to clinical research. The items and structure of the instrument were based on review of published literature. The advisor committee on this study was organized by 11 oriental division of gastroenterology professors of oriental medical colleges nationwide. The experts discussed developing the instrument, and we also took professional advices by e-mail. We divided the symptoms and signs of functional dyspepsia into 6 pattern identification, such as disharmony of liver and stomach, retention of undigested food, damp-heat in the spleen and stomach, simultaneous occurrence of cold and heat syndromes, deficiency and cold of the spleen and the stomach, and insufficiency of stomach eum. We got the mean weights to each symptom of six pattern identification which had been scored on a 5-point scale ranging from 1 to 5 by the 11 experts. We made out the Korean instrument of the pattern identification composed of 45 questions for functional dyspepsia. Although there are some limitations in our study, the instrument is meaningful and certain worth of its own. We hope to improve the instrument through the further clinical studies and discussions.