• Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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• v.61 no.12
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• pp.650-657
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• 2018

Background and Objectives The present study aimed to compare receptive and expressive language development in children who have undergone simultaneous bilateral cochlear implantation (SCI) and those who have undergone bimodal stimulation (unilateral CI+ hearing aid). Subjects and Method In a retrospective analysis of clinical data, 15 pediatric patients who have received SCI and nine patients who have received bimodal stimulation (BM group) were enrolled. CI was performed for all patients at 24 months of age. Category of Auditory Performance (CAP) scores, Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS) scores, and developmental quotients (DQ) for expressive and receptive language were compared between the groups at 12 month of follow-up. The Percentage of Consonants Correct (PCC) of children evaluated at 4 years old was also compared. Results At 12 months of follow-up, significantly greater improvements in CAP scores (${\Delta}4.25{\pm}0.5$) were noted in the SCI group compared to the BM group (${\Delta}3.56{\pm}0.88$, p=0.041). Significantly greater improvements in IT-MAIS scores were also noted in the SCI group (${\Delta}36.17{\pm}4.09$) than in the BM group (${\Delta}30.17{\pm}2.91$, p=0.004). The DQ of receptive language was higher in the SCI group than in the BM group ($87.6{\pm}15.4%$ vs. $75.5{\pm}12.0%$, p=0.023) at 12 months of follow-up. Moreover, early SCI was associated with better receptive language skills. PCC index of children at 4 years old was higher in the SCI group than in the BM group ($88.5{\pm}13.2%$ vs. $62{\pm}15.8%$, p=0.014). Earlier SCI was associated with even greater improvements. Conclusion Bilateral SCI is associated with significant improvements in language development when compared with bimodal stimulation. Earlier SCI was associated with better outcomes.

• Korean Medical Education Review
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• v.21 no.1
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• pp.1-12
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• 2019

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.

• Korean Medical Education Review
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• v.21 no.3
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• pp.150-154
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• 2019

When standardized patients (SPs) are used for educational purposes, the authenticity of role play and the quality of feedback are essential requirements of SPs. This study was conducted to investigate medical students' assessment of SPs and to identify the components of SPs' performance that were most strongly correlated with patient-physician interaction score. One hundred and forty-two fourth-year medical students were asked to complete the Maastricht Assessment of Simulated Patients (MaSP) at the end of a clinical performance examination. SPs evaluated the patient-physician interactions using a 4-point Likert scale (1=poor to 4=excellent). Medical students' assessment of SPs using the MaSP was positively correlated with patient-physician interactions (r=0.325, p<0.01). Items addressing the authenticity of role play (e.g., "SPs appear authentic," "SPs might be real patients," and "SPs answer questions in a natural manner") were closely correlated with patient-physician interactions (p<0.001, p=0.027, and p=0.017, respectively). These results showed that the MaSP appears to be a useful instrument for evaluating SPs' performance and that the authenticity of SPs' performance was positively correlated with medical students' interactions. In order to improve patient-physician interactions, medical students should be given opportunities to practice their skills with SPs who have been trained to portray patients with a specific condition in a realistic way.

• Journal of Industrial Convergence
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• v.17 no.1
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• pp.17-24
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• 2019

The purpose of this study is to confirm the effects of the contents of the recording lectures through the automatic recording system of the nursing students on the program outcomes of the pediatric nursing. The study was designed using a nonequivalent control group pretest-posttest design. the subject of this study consisted of 104 nursing students(the experimental group of 52 and the control group of 52). Data were analyzed by ${\chi}^2$ test and independent t-test using SPSS 22.0. The effect of the first program outcome(PO1. We can integrate nursing skills based on various the liberal arts and the major knowledge into practice) of the experimental group was not confirmed, but the fifth program outcome(PO5. We can apply critical thinking based nursing processes and implement clinical inferences) was significantly higher than that of the control group. It is significant that this study presented the data to develop the class design method to improve the program outcomes of the nursing student at the present time which is operating the program outcomes based curriculum for nurse with core competency.

• Korean Medical Education Review
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• v.21 no.2
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• pp.92-99
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• 2019

The aim of this study was to use narrative inquiry to explore the experiences of medical students who faced expulsion, military service, and readmission, and their journeys of identity formation. Three medical students were recruited via snowball sampling, and each participant was interviewed twice. According to the sequence of experiences, their stories were summarized as follows: the process of being expelled, the military service experience and readmission process, and the present. Before all three students were expelled, they lived dissolute lives free of concern from the entrance examination and failed to cope well with dropping out. They felt that military experience had helped them develop interpersonal skills in the clinical setting and the strength to withstand a difficult crisis. Two students were motivated to become doctors after military service, but the other was not. They had reflected deeply over their unique experiences. The scars imprinted from their experiences became a means of stimulation, and they ultimately acquired the resilience and ability to accommodate for and counteract their weaknesses. This appears to have been an important influence on their identity formation. The narrations of their rare experiences can help medical educators more fully understand and support medical students through difficulties, specifically with regard to academic failure or expulsion. These findings may prompt medical professors to think about the kind of guidance or motivation that could help students before expulsion, rather than assuming that they are simply lacking academic ability.

• Journal of Digital Convergence
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• v.19 no.1
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• pp.229-237
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• 2021

The purpose of this study is to verify the effects of Simulation-based Chest Tube Drainage Management Nursing Education on the Nursing Students' Response to Scenario Experiences, Confidence in Learning, and Problem Solving Abilities. This study was performed with a one-group pretest-posttest design, and a total of 133 junior nursing students have participated in the research (31 teams of simulation-based education). According to the results of the study, most of the students have shown a positive response to the scenario experience after the simulation training, while their confidence in learning and problem-solving skills have improved significantly. This proves that simulation-based training using simulators can be very effective in practical nursing training. It is expected that this research could make a meaningful contribution to improving the overall quality of field-oriented practical training and clinical practice.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.25 no.4
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• pp.340-346
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• 2022

Purpose: The treatment and long term clinical outcomes of anorectal malformations (ARM) in children have always been the focus of pediatric surgeons. This study aimed at reporting our experience as far as long-term follow-up of ARM in children is concern. Methods: We enrolled patients treated between 1999 and 2019, and established selection criteria to choose appropriate subjects. A validated questionnaire was used to determine long-term quality of life outcomes. Results: Out of a total of 48 patients treated within the study period, 28 were enrolled in this study. Among the latter, more than 35% had at least one long-time complication, and more than 90% had a good lifestyle. Urinary and fecal continence was achieved in more than 95% of the patients using medical devices. Conclusion: This study aimed to bring up new concepts; taking into consideration all aspects of life in patients with ARM, from school life to sexuality, while evaluating fecal and urinary continence. This is essential for the improvement of the skills of the different specialists involved in the management of these patients, and for the implementation of strategies that can improve postoperative function. Most especially, it will also help improve communication between doctors to ensure an adequate transition of these children into adult life.

• Korean Medical Education Review
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• v.24 no.2
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• pp.128-140
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• 2022

The purpose of this study was to redesign a problem-based learning (PBL) curriculum and compare the differences between the previous and redesigned PBL based on the results of course satisfaction and student assessments. The PBL was redesigned using curriculum design guidelines (including revisions of curriculum objectives, learning components, learning environments, and assessment methods) that were developed based on previous studies and evaluation results. A comparative study was employed using course satisfaction surveys from the previous and redesigned curricula, and a total of 45 students participated. We also compared student assessment results from concept mapping, learning issue reports, modified essay questions, and reflection journals. We identified four key findings. First, we explored the possibility that the redesigned PBL could be implemented by student facilitators without professors as tutors. Second, the redesigned PBL fostered group dynamics that facilitated developing communication skills and collaborative learning through small-group discussions. Third, the new learning elements added in the redesigned PBL made a meaningful contribution to enhancing students' clinical reasoning based on hypothetico-deductive reasoning. Fourth, concept maps in redesigned PBL contained more complex and various nodes and connections, and the levels of the nodes were more appropriate. The implications of this study can provide meaningful preliminary information for redesigning PBL curricula for medical students to develop their essential competencies through PBL.

• Korean Medical Education Review
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• v.24 no.2
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• pp.103-112
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• 2022

The purpose of this study was to explore, using topic modeling, the social value of doctors and medicine demanded by society as reflected in published newspaper articles in Korea. Ultimately, this study aimed to reflect social needs in the process of developing the Patient-Centered Doctor's Competency Framework in Korea. For this purpose, a total of 2,068 newspaper articles published from 2016 to 2020 were analyzed. Through topic modeling of these newspaper articles over the past 5 years, 18 topics were derived and divided into four categories. Focusing on the derived topics and keywords, the topics derived in specific years and the proportion of topics by year were analyzed. The results of this study make it possible to grasp the needs of society projected through the press for doctors and medicine. Due to the nature of the press, topics that frequently appeared in newspaper articles were mainly social phenomena related to requirements for doctors, particularly dealing with economic and legal aspects. In particular, it was confirmed that doctors are now required to have a wider range of competencies that go beyond their required medical knowledge and clinical skills. This study helped to establish doctor's competencies by analyzing social needs for doctors through the latest research methods, and the findings could help to establish and improve doctor's competencies through ongoing research in the future.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.48 no.6
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• pp.331-341
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• 2022

This systematic review evaluates current evidence regarding the feasibility of using needleless jet injection instead of a conventional local anesthetic needle. EBSCO, ProQuest, PubMed, and Scopus databases were used to identify relevant literature published in English from 2005 to 2020. Ten studies were selected. Five of them were randomized clinical trials, 3 case-control studies, and 2 equivalence trials. Using the Critical Appraisal Skills Program checklist, 6 studies scored between 67% and 100%, and 4 studies scored between 34% and 66%. According to Jadad's scale, 2 studies were considered strong, and 8 studies were considered moderate in quality. The results of the 10 studies showed differences in patient preference for needleless jet injection. Needleless injection technique has been found to be particularly useful in uncooperative patients with anxiety and needle phobia. Needleless jet injection is not technique sensitive. However, with needleless jet anesthesia, most treatments require additional anesthesia. Conventional needle anesthesia is less costly, has a longer duration of action, and has better pain control during dental extraction. Needleless jet anesthesia has been shown to be moderately accepted by patients with a fear of needles, has a faster onset of action, and is an efficient alternative to conventional infiltration anesthesia technique.