• Clinical Psychopharmacology and Neuroscience
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• 제16권4호
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• pp.415-421
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• 2018

Objective: Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by impairment in social skills and communication with repetitive behaviors. Etiology is still unclear although it is thought to develop with interaction of genes and environmental factors. Oxytocin has extensive effects on intrauterine brain development. Vitamin D, affects neural development and differentiation and contributes to the regulation of around 900 genes including oxytocin receptor gene. In the present study, the contribution of D vitamin receptor and oxytocin receptor gene polymorphisms in the development of ASD in Turkish community was investigated. To our knowledge, this is the first study examining these two associated genes together in the literature. Methods: Eighty-five patients diagnosed with ASD according to DSM-5 who were referred to outpatient clinics of Child and Adolescent Psychiatry of Başkent University and Mersin University and 52 healthy, age and gender-matched controls were included in the present study. Vitamin D receptor gene rs731236 (Taq1), rs2228570 (Fok1), rs1544410 (Bsm1), rs7975232 (Apa1) polymorphisms and oxytocin receptor gene rs1042778 and rs2268493 polymorphisms were investigated using real time polymerase chain reaction method. Results: No significant difference between groups in terms of distribution of genotype and alleles in each of polymorphisms for these genes could be found. Conclusion: Knowledge of genes and polymorphisms associated with the development of ASD may be beneficial for early diagnosis and future treatment. Further studies with larger populations are required to demonstrate molecular pathways which may play part in the development of ASD in Turkey.

• Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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• 제61권12호
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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.

• 의학교육논단
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• 제21권1호
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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.

• 의학교육논단
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• 제21권3호
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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.

• 산업융합연구
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• 제17권1호
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• pp.17-24
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• 2019

본 연구는 간호대학생을 대상으로 강의자동녹화시스템을 통해 발생한 녹화강의콘텐츠를 학습관리시스템에 연계하여 반복학습하도록 제시한 수업설계를 적용한 후 아동간호학 교과목의 학습성과에 미치는 효과를 확인하기 위한 것이다. 본 연구는 비동등성 대조군 전후 유사실험 연구로 D광역시 일 대학 간호대학생을 대상으로 하였으며, 실험군과 대조군 각각 52명으로 총 104명이었다. 자료는 SPSS 22.0을 이용하여 ${\chi}^2$ test와 independent t-test로 분석하였다. 강의 자동녹화시스템을 사용한 수업설계를 적용받은 실험군의 제1학습성과(다양한 교양지식과 전공지식에 근거한 간호술을 통합적으로 실무에 적용한다)의 효과는 확인되지 않았으나, 제5학습성과(비판적 사고에 근거한 간호과정을 적용하고 임상적 추론을 실행한다)의 효과는 대조군에 비해 통계적으로 유의하게 높았다. 본 연구는 핵심역량을 갖춘 간호 인재를 양성을 위한 학습성과 기반 교육과정을 운영하고 있는 현 시점에서 간호대학생의 학습성과를 향상시키기 위한 수업설계방안을 발전시키기 위한 자료를 제시하였다는데 의의가 있다.

• 의학교육논단
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• 제21권2호
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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.

• 디지털융복합연구
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• 제19권1호
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• pp.229-237
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• 2021

본 연구의 목적은 시뮬레이션 기반 흉관배액관리 간호교육이 간호학생의 시나리오 경험에 대한 반응, 학습에 대한 자신감 및 문제해결능력에 미치는 효과를 검증하는 것이다, 본 연구는 단일군 전후설계 실험 연구로 133명의 3학년 간호학생을 31개조로 시뮬레이션 교육 중재를 시행하였다. 연구결과, 시뮬레이션 실습교육 시행 전보다 시행 후에 시나리오 경험에 대한 반응은 긍정적인 결과로 나타났고, 학습에 대한 자신감 및 문제해결능력은 유의하게 향상된 것으로 나타났다. 이는 간호학 실습교육에 있어서 시뮬레이터를 이용한 시뮬레이션 교육이 효과적임을 보여주는 결과라고 할 수 있다. 본 연구는 현장중심의 실습교육 및 임상실무의 질을 향상시키는데 기여할 수 있을 것이다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제25권4호
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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.

• 의학교육논단
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• 제24권2호
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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.

• 의학교육논단
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• 제24권2호
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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.