• 한국임상약학회지
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• 제25권3호
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• pp.187-199
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• 2015

Background: Singapore has the stable healthcare system with utilizing pharmacist manpower in proper positions by demand of populations' health among Asian countries. Objective: This study aims to systematically review (1) the pharmacists' role and (2) the pharmacy education system of Singapore in comparison with Korea. Method: We searched for information about academic, medical and governmental institutions related to professional pharmacists' practice in Singapore by primarily using database such as DBpia, KISS, Google Scholar and ProQuest and the official website of the Singapore Ministry of Health. We contacted and arranged the visit schedules with National University of Singapore, National Health Group's polyclinics, Agency for Integrated Care, National University Hospital, and community chain pharmacies. During onsite visits, we interviewed pharmacists working in each institution and obtained additional documents and materials relevant to this manuscript work. Results: To become a registered pharmacist in Singapore, the pharmacy curriculum requires four full-time academic years and six additional months allotted for pre-registration training. Pharm.D. course is offered for pharmacy graduate students with additional two full-time years of study. Team teaching and inter professional education program seem the most significant method in pharmacy education. Pharmacists working at hospitals, polyclinics, and community pharmacies in Singapore take broader roles and offer more cognitive services such as smoking cessation program and medication reconciliation. Especially, pharmacists in Agency for Integrated Care fill the role of primary care providers for the continuing care of the community through the governmental support toward the patients-centered integrated care. Conclusion: Singaporean pharmacists take significant and active roles in collaboration with other healthcare providers. Efforts such as interprofessional pharmacy education and governmental endorsement of the systematic and interactive care between pharmacists and other medical providers in Singapore are needed to be urgently applied to Korea healthcare system for the promotion of population health.

• 대한방사선치료학회지
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• 제20권2호
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• pp.123-130
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• 2008

목적: 의료환경의 변화와 교육환경의 변화에 신속하게 대처하기 위하여 대학에서는 필요한 실습 장비를 갖추고 있어야 한다. 그러나 재정적인 부담과 그것들을 유지 관리하는데 생기는 어려움으로 인해 국내의 대학들이 고가의 방사선 치료 장치를 설치하기는 불가능하다. 이로 인한 실습의 제약을 해소하기 위하여 김천대학 방사선과에서는 모형 선형가속기 및 모형 부속기구를 제작하여 학생들의 실습 시간에 활용하고 있으며 그 유용성에 대해 보고하고자 한다. 대상 및 방법: 우리가 자체 제작한 모형 선형가속기(DLINAC-001)는 실제 선형가속기와 동일한 회전지지축(gantry)과 조사 head의 회전이 가능하도록 제작하였다. 또한 실습교육의 극대화를 위해 우리는 자체적으로 모형 맞춤블록, 모형 쐐기필터, 모형 전자선 조사통과 환자고정기구를 제작 하였다. 결 과: 선형가속기의 기계적인 기능과 동일하게 모형 선형가속기를 활용할 수 있으며, 다양한 용도의 모형 부속기구들을 실습 시 활용할 수 있다. 결 론: 김천대학 방사선과에서 제작된 모형 선형가속기와 부속기구를 제작하여 학생들의 실습시간에 활용함으로서 다양한 영역의 임상실습이 가능하다. 또한 현장감 있는 실습을 시행함으로서 학습 효과를 극대화 할 수 있으며, 임상에서 요구하는 실무능력을 함양할 수 있다.

• 대한물리의학회지
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• 제15권4호
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• pp.121-129
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• 2020

PURPOSE: This study aimed to propose an exercise technique that helps improve the skeletal muscle function while suppressing the symptoms of respiratory distress, by mediating squat exercises in whole-body vibration for patients with severe COPD, and comparing the post intervention pulmonary function and activity of quadriceps. METHODS: Totally, 21 patients with severe COPD were randomly assigned to two groups through clinical sampling: experimental group I included 11 patients (Squat exercise combined with whole-body vibration exercise), and experimental group II included 10 patients (Only squat exercise). Before intervention, we measured pulmonary function using a pulmonary function tester, muscle activity of quadriceps using surface EMG, and gait ability using the 6MWT. RESULTS: Comparison of intra-group changes in both experimental groups showed a significant increase in the activity of rectus femoris, vastus medialis, and vastus lateralis, and also in the 6MWT. Intra-group comparisons also revealed significant difference in the activity of rectus femoris, vastus medialis, and vastus lateralis (p < .05). CONCLUSION: Squat exercise combined with whole-body vibration significantly increased the activity of the quadriceps muscle, suggesting that this intervention helps maintain the function of skeletal muscles and prevent muscle atrophy. Therefore, studies to develop protocols using whole body vibration in clinical practice as an exercise method can safely be performed in severe COPD patients, as considered necessary.

• 보건행정학회지
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• 제11권4호
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• pp.54-69
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• 2001

This study was conducted to assess factors associated with the degree of performance of qualify improvement(QI) activities. A mailed questionnaire survey was conducted between September 15 and October 30, 2000, with the staffs being charge of QI at each of the hospitals with 400 beds or greater. Of the 108 hospitals eligible for inclusion in our study, 79 participated, yielding a response rate of 73.1%. After excluding 12 hospitals that did not perform any QI activities, 117 responses from 67 hospitals were used for the analysis. Using the Malcolm Baldrige National Quality Award Criteria(MBNQAC), perceived performance of QI was measured in terms of the improvement of the quality of clinical practice, clinical supporting department, administrative procedure of receiving care, customer satisfaction, efficiency and standardization of work process. Factors evaluated for the association were the extent of QI implementation, compliance to 5 QI principles, participation of hospital CEOs, budget allocation, history of QI, and bed size. Path analysis was performed to assess the relationship between QI performance and these factors. Major findings of this study are as follows. Hospitals showing higher degree of QI implementation (path coefficient=0.5967, p<0.001)) and better compliance with the basic principes of QI(0.5736, p<0.05) tended to achieve better performance. Path analysis results showed that interest and participation of hospital CEOs(0.1954, p<0.05) and compliance with the basic principes of QI(0.4028, p<0.0001) indirectly affected the outcomes of QI by influencing the intermediate variable of the level of QI implementation. This study results suggest that having employees have a good orientation of the basic concept and principes of QI through relevant training be the most important requirement to achieve better outcomes from QI activities. In addition, to educate leaders of hospitals the need of active implementation of QI is important to encourage their participation and draw strong support for QI programs.

• 한방재활의학과학회지
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• 제18권4호
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• pp.103-120
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• 2008

Objectives : This study aims to educate clinical doctors of the valuable practice of Manipulative Therapy(MT) as an opportunity for evidence-based medicine. Consequently it also serves to review the effectiveness and safety of MT. Methods : The literature studies of overseas were done by Cochrane Library and Medline website; those of domestic researches were completed by utilizing the sources which are gained from KERIS, KISS, DBpia, Kisti, and domestic institutes related with MT. Results : Eight papers related to the effectiveness of MT were published in South Korea, which concluded with the positive effects of MT. None of them are, however, well-designed randomized controlled trials(RCT). On the other hand, fifteen cases of nine articles indicate the adverse reaction of MT, and numbers of the researches in overseas revealed the side effects of MT in order of cervical, lumbar, and thoracic vertebrae. A vascular adverse reaction such as vertebral and carotid artery dissection was a highly reported cervical adverse reaction; in the thoracic and lumbar regions, neurological adverse reaction in terms of disc hemiation was frequently discovered. Conclusions : Henceforth, highly qualitative studies are required developing the effective outcomes and preventing any possible complications of MT. Therefore, systemic curriculums in institutions and sufficient clinical training in the filed are strongly recommended.

• 의학교육논단
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• 제19권1호
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• pp.18-24
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• 2017

This study examined the perception and readiness of nursing educators regarding interprofessional education (IPE), and discussed the validity and application of IPE in nursing. From December 2016 to January 2017, 239 nursing professors and nurses completed a structured questionnaire consisting of general characteristics, the Interdisciplinary Education Perception Scale, the Readiness for Interprofessional Learning Survey (RIPLS), and an IPE action plan. The collected data were analyzed by descriptive statistics and t-test using the IBM SPSS ver. 23.0 program (IBM Corp., Armonk, NY, USA). The analysis revealed that 91.6% of the participants had not experienced IPE, and only 11.7% knew about IPE. However, approximately 80.0% answered that IPE is necessary. The results of this study showed that the score of the perceived need for cooperation was higher in nurses than it was in professors, while the score on competency and autonomy was higher in professors than it was in nurses. With reference to the scores on the RIPLS, those of professors were high on the sub-scales of teamwork and collaboration, professional identity, and roles and responsibility. The results revealed that participants considered the upper-grade undergraduate years as the ideal time for imparting IPE, and it was deemed suitable to include communication, simulation, and clinical practice in IPE. Doctors, pharmacists, and physiotherapists were thought to require cooperation for IPE the most. Despite the presence of several barriers to IPE, the participants thought that IPE can achieve learning outcomes such as interprofessional communication and cooperation, conflict resolution, and teamwork. It is necessary to cooperate with professionals in the complex clinical environment as professional areas are specialized and subdivided. Therefore, it is necessary to examine the application of IPE in undergraduate education and in on-the-job training.

• 가정간호학회지
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• 제25권3호
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• pp.204-214
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• 2018

Purpose: This study aimed conducted to investigate biomedical ethics awareness and attitudes toward dignified death and advance directives among nursing students. Methods: Data were collected through structured questionnaires from 222 nursing students with clinical practice experience, from November 7 to 23, 2015. Data were analyzed by independent t-tests, one-way ANOVA, Kruskal-Wallis test, and Pearson's correlation coefficients using SPSS WIN 22.0. Results: The scores for biomedical ethics awareness and attitudes toward dignified death were 2.89 and 3.15, respectively. Regarding attitudes toward advance directives (ADs), most students agreed with writing ADs. The main reason given for writing ADs is "I want to receive my treatment of choice." As for the range and explanation method for ADs, 45.7% of participants responded, "do not know well." Regarding willingness toward life sustaining treatment, "only pain control, no life sustaining treatment" was indicated by 83.4% and, "all information about symptoms and prognosis" by 91.9% of participants. For willingness to write ADs, 70.0% of participants responded "yes." Conclusion: Curriculum for nursing ethics should be included in clinical training courses to improve related courses and provide an opportunity to deal with practical problems, such as biomedical ethics, death with dignity, and ADs.

• 한국의사학회지
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• 제31권2호
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• pp.91-101
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• 2018

Over the past 100 years, since the establishment of the modern medical education system in the early 1900s, the results of extensive field research and practice in North American medical schools and professional education have led the flow of medical education around the world. In this study, the direction of medical education in North America over the past 100 years were examined through major literature review, leading to implications and suggestions for Korean medicine education. The "Medical Education in the United States and Canada" published by the Carnegie Educational Foundation in 1910, which is considered to have laid the foundation for modern health care education, was reviewed. Next, "Educating physician: A Call for Reform of Medical School and Residency", published in 2010, which is known to have proposed a future-oriented goal for the training of medical professionals has been analyzed. The results of this study are as follows: 1) Acquisition and utilization of biomedical knowledge which is the basis of clinical competence, is a basic competency that should be provided to future medical professionals. 2) Beyond education to cultivate clinical competence of individuals directly affecting the medical treatment, various professionalism education programs that capture the specificity of Korean Medicine doctors should be established and strengthened.

• 근관절건강학회지
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• 제29권2호
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• pp.81-90
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• 2022

Purpose: The purpose of this study was to evaluate the efficacy of applying a defecation encouragement program for patients undergoing total knee replacement arthroplasty (TKRA). Methods: This program was based on the nursing best practice guideline: prevention of constipation in the older adult population by the National Guideline Clearing House (NGC) in 2011, which included fluid intake, bowel training, and abdominal and pelvic floor exercises. A team of one orthopaedic clinical nurse specialist and six orthopaedic nurses with a 10 years of clinical experience applied and assisted patients with the program. Formal counsel was provided by one orthopaedic doctor, one gastroenterologist, and one exercise therapist. Patients who defecated one day prior to or on the day of TKRA surgery were included. Data collected from 72 subjects were analyzed using SPSS/WIN 21.0. Results: Time until first defecation after surgery was 2.4±1.1 days in experimental group, which was significantly shorter than the 3.5±0.9 days in control group (t=4.28, p<.001). Constipation assessment scale showed significantly lower points (t=2.55, p=.013) in experimental group (1.3±1.2) compared to control group (2.6±2.6). The experimental group and control group were 17.3±7.67 and 23.7±14.43, respectively, and the experimental group used less laxatives (t=2.83, p=.021). Conclusion: A defecation encouragement program was proved to be an appropriate nursing intervention for patients undergoing TKRA. This study confirmed that constipation is a nursing problem that can be sufficiently prevented if nurses are interested and encourage defecation.

• Journal of Hospice and Palliative Care
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• 제16권1호
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• pp.1-9
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• 2013

목적: 본 연구는 간호대학생의 말기환자에 대한 생명의료윤리 인식과 죽음에 대한 태도를 파악하기 위한 서술적 조사연구이다. 방법: 대상자는 D광역시에 소재한 일개 전문대학의 3년제 간호과에 재학 중인 660명이었다. 자료는 2011년 10월부터 11월까지 수집하였다. 생명의료윤리 인식은 본 연구자가 선행연구를 근거로 개발한 도구로, 죽음에 대한 태도는 Collett와 Lester(1969)의 FODS (Fear of Death Scale)로 측정하였다. 수집된 자료는 서술통계, Wilcoxon rank sum test와 Kruskall Waills test로 분석하였다. 결과: 생명의료윤리에 대한 문제로 갈등 경험이 있고, 심폐소생술 금지가 필요하다고 생각하며, 종교가 없는 학생이 그렇지 않은 학생에 비해 죽음에 대해 부정적인 태도를 가지고 있었다. 대상자 중 말기환자의 연명치료중단이 필요하다고 생각하는 경우는 81.2%였고, 말기환자의 심폐소생술 금지가 필요하다고 생각하는 경우는 76.4%로서, 심폐소생술 금지가 필요한 이유는 '평안하고 품위있는 죽음을 위해서'가 가장 많았다. 결론: 죽음에 대한 긍정적인 태도의 형성을 위해 확고한 생명의료윤리 가치관의 확립이 요구되며, 가능하면 임상실습을 시작하기 전에 교육이 실시될 필요가 있다. 교육 프로그램을 구성할 때 종교, 학년, 생명의료윤리 갈등 경험, 심폐소생술 금지 찬성 여부가 포함되어야 하며, 말기환자 간호를 미리 경험할 수 있도록 표준화 환자를 이용한 시뮬레이션 실습의 기회를 제공하는 것이 필요하다.