• The Journal of Korean Physical Therapy
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• v.24 no.6
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• pp.409-413
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• 2012

Purpose: Rehabilitative devices are used to enhance sensorimotor training protocols, for improvement of motor function in the hemiplegic limb of patients who have suffered a stroke. Sensorimotor integration feedback systems, included with these devices, are very good therapeutic frameworks. We applied this approach using electrical stimulation in stroke patients and examined whether a functional electric stimulation-assisted biofeedback therapy system could improve function of the upper extremity in chronic hemiplegia. Methods: A prototype biofeedback system was used by six subjects to perform a set of tasks with their affected upper extremity during a 30-minute session for 20 consecutive working days. When needed for a grasping or releasing movement of objects, the functional electrical stimulation (FES) stimulated the wrist and finger flexor or extensor and assisted the patients in grasping or releasing the objects. Kinematic data provided by the biofeedback system were acquired. In addition, clinical performance scales and activity of daily living skills were evaluated before and after application of a prototype biofeedback system. Results: Our findings revealed statistically significant gradual improvement in patients with stroke, in terms of kinematic and clinical performance during the treatment sessions, in terms of manual function test and the Purdue pegboard. However, no significant difference of the motor activity log was found. Conclusion: Hemiplegic upper extremity function of a small group of patients with chronic hemiparesis was improved through two weeks of training using the FES-assisted biofeedback system. Further research into the use of biofeedback systems for long-term clinical improvement will be needed.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.12
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• pp.7639-7644
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• 2013

Background: Breast cancer is the most common cancer diagnosed among women in Sri Lanka. Early detection can lead to reduction in morbidity and mortality. The objective here was to identify perceptions of public health midwives (PHMs) on the importance of early detection of breast cancer and deficiencies of and suggestions on improving existing breast cancer early detection services provided through Well Woman Clinics. Materials and Methods: A qualitative study using four focus group discussions (FGDs) were conducted among 38 PHMs in the Gampaha district in Sri Lanka and the meetings were audio-recorded, transcribed and analyzed using constant comparison and identifying themes and categories. Results: All the PHMs had a firm realization on the need of breast cancer early detection. The four FGDs among PHMs revealed non-availability of guidelines, inadequacy of training, lack of skills and material to provide health education, inability to provide privacy during clinical examination, shortage of stationery, lack of community awareness and motivation. The suggestions for the improvements of the programme identified in FGDs were capacity building of PHMs, making availability of guidelines, rescheduling clinics, improving the supervision, strengthening the monitoring, improving coordination between clinical and preventive sectors, and improving community awareness. Conclusions: Results of the FGDs can provide useful information on components to be improved in breast cancer early detection services. Study recommendations were training programmes at basic and post basic levels on a regular basis and supervision for the sustainance of the breast cancer early detection program.

• Korean Medical Education Review
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• v.22 no.3
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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.

• Korean Journal of Adult Nursing
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• v.14 no.2
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• pp.296-305
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• 2002

Purpose: The purpose of this research was to describe how nurses in intensive care units (ICU) work. Method: A total of 18 ICU nurses participated in the research. The data was collected through individual in-depth interviews and analyzed by grounded theory method using NUDIST 4.0 software program. Results: Three different patterns regarding nursing performance among ICU nurses were identified. These are 1) nursing performance of nurses who perform excellently, 2) nursing performance of nurses who do not perform well because of their lack of experience, and 3) nursing performance of nurses who do not perform well in spite of their good years of experience. These three different nursing performances were described in terms of seven different categories; 1) assessing and monitoring nursing problems, 2) clinical decision making, 3) interpersonal relationships, 4) holistic care, 5) technical skills, 6) problem solving, 7) working independently and creatively. This study also identified two intervening factors that influenced the advancement of their expertise. Conclusion: The results of this study might help nurse managers in developing continuing educational programs for inexperienced nurses or those nurses not performing well to become experts by a deeper understanding of the nature of nursing performance and the factors that influence nursing performance in ICU settings.

• The Journal of Korean Obstetrics and Gynecology
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• v.32 no.2
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• pp.100-118
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• 2019

Objectives: The purpose of this study is to analyze clinical performance examination (CPX) ability using standardized patient (SP) in Korean traditional medical school. Methods: Standardized middle-aged female patients were used for clinical examination of 53 medical students, grade 6. The SP and professors assessed their communication skills and level of medical interviews. Results: 1. There is no statistically significant difference between SP score, communication skill score, medical skill score and inter-test score at the extracurricular activities level. 2. There is no statistically significant difference between SP score, communication skill score, medical skill score and inter-test score at number of medical service. 3. There is no statistically significant difference between SP score, communication skill score, medical skill score and inter-test score at personality type. 4. There is a statistically significant positive correlation between SP score, communication skill score and medical skill score. Conclusions: A variety of educational programs and practices should be conducted to improve the level of medical care and communication of Korean traditional medicine students.

• Journal of Korean Physical Therapy Science
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• v.28 no.1
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• pp.33-45
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• 2021

Background: Children with cerebral palsy have difficulty acquiring motor skills through motor learning due to lack of motor planning of the central nervous system and musculoskeletal dysfunction. Motor learning is the acquisition or modification of movements with the aim of developing skilled movements and behaviors. Cerebral palsy improve motor function through motor learning, and effective motor learning mainly depends on practice parameters such as learning feedback. Therefore, we investigate the effect of motor learning in children with cerebral palsy and try to present the possibility of clinical application. Design: A systemic review. Methods: Research papers were published from Jan, 2010 to Dec, 2020 and were searched using PubMed and Medline. The search terms are 'task specific training' OR 'motor learning' OR 'feedback(Mesh term)' OR 'goal activity' AND 'cerebral palsy(Mesh term)'. A total of eight papers were analyzed in this study. The paper presented the quality level based on the research evidence, and also presented PEDro (Physiotherapy Evidence Database) scores to evaluate the quality of design studies in randomized clinical trials. Results: The results showed that motor learning coaching in children with cerebral palsy improved motor function in post and follow up tests. Also, self-control feedback of motor learning is more effective than external control feedback. 100% external control feedback of motor learning is effective in the acquisition phase and 50% external feedback of motor learning is effective in the retain phase. Conclusion: These results suggest that it will be an important data for establishing evidence on the effect of motor learning arbitration methods in children with cerebral palsy to develop clinical applicability and protocols.

• The Journal of Korean Academy of Sensory Integration
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• v.6 no.1
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• pp.47-62
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• 2008

Introduction : Sensory Integration(SI) theory, science it is developed by an occupational therapist A. Jean Ayres, is the one of the most popular frames of reference used in occupational therapy(OT) intervention. It has been proved as a scientific theory especially in neuroscience discipline through abundant research and practice. Occupational therapists apply the SI therapy with strong clinical reasoning to improve adaptive behaviors of their clients and try to link the adaptive behaviors with occupational performance in the clients' everyday life. One of the manners regarding clinical reasoning is Top-down approach. In occupational therapy discipline, Top-down approach is well-reflected within two evaluation tools; Canadian Occupational Performance Measure(COPM) and Assessment of Motor and Process Skills(AMPS) and two models of practice; Canadian Model of Occupational Performance(CMOP) and Occupational therapy intervention process model(OTIPM). Objective : The purpose of this paper demonstrates how SI therapy can be employed within OTIPM and how the OT process (evaluation-intervention-outcome) can be structuralized based on the Top-down approach. This single-case study recognizes the impact of a SI therapy for a male adolescent on his occupational performance. Intervention Examined : "P" was 16 years old male adolescent with no diagnosis and junior of the high school when he was referred. P was always with mouth opened, showed difficulties in gathering things need to be prepared and managing and paying money for shopping, and his colleges dislike getting close to him because he can't was his body well. AMPS was administrated in initial evaluation and reevaluation of P's occupation performance, Bruininks-Oserestky Test of Motor Proficiency-2(BOT-2) was carried out to assess motor functions and perception skills related in sensory integration, and occupational therapist performed clinical observation in order to complement the evaluation quantitatively and quantitatively. Based on the evaluation, it is concluded that the SI therapy is primary means to improve P's occupational performance, and three therapeutic approaches were constructed; restorative, acquired and compensatory approach. P showed improved motor and process skills in occupational performance after undergone the occupational therapy. Conclusions : The sensory integration therapy was practical enough to build the bridge between the occupational performance(Top) and the underlying component problems (Bottom). The OTIPM was helpful to identify meaningful occupation for P and P's family within P's contexts, and the AMPS was valuable to analyze and clarify the cause of difficulties in the chosen occupational performance.

• The Journal of Korean Academic Society of Nursing Education
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• v.4 no.2
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• pp.220-235
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• 1998

The revolution of nursing curriculum has been focused on clinical competency for nursing graduates to flexibly respond to changes in societal health needs and disciplinary requirements. In this trend, the study was designed to identify basic concepts of nursing education that reflects the changes in societal needs and nursing discipline, and to develop the instrument to measure performance level in each dimension of clinical competency. The study was conducted in two phases. In phase 1, principal concepts consisted of nursing education were determined through literature review as well as series of discussion sessions on nursing philosophies and educational objectives among researchers. Though the process, the conceptual framework of competency based nursing curriculum was constructed with nursing process and professional role as horizontal threads, client, health needs, and nursing interventions as vertical threads. Then, items were developed to represent each dimension of competency : client and health need, nursing process, professional role, and nursing interventions. The total of 273 items were included as to represent clinical competency required for BSN graduates. In phase 2, questionnaires were distributed to nursing faculties of 41 BSN programs to validate the 273-item Instrument developed to measure competency. The total of 34 subjects returned the questionnaire with 81% of response rates. The subjects of the study had an average of 42 months of clinical experience and 13 years of education experience in various nursing areas with an age range of 30 to 52 years. The data were analyzed by utilizing SPSSWIN and the results are as follows. 1) The mean score of the nursing process dimension was supported most with the mean of 3.60(SD=0.32) compared to client and health need dimension(M=3.49, SD=.40), professional role(M=3.41, SD=.44), and nursing interventions(M=3.57, SD=.34). 2) The dimensions of competency were moderately correlated to each other with a range of r=.433 to r=.829, confirming that four dimensions of competency were related but distinct concepts. 3) The items of each dimension were analyzed based on its appropriateness. 'Assessing risk factors of the clients' were most highly supported in client and health need dimension. Most items of nursing process dimension were considered appropriate, while items related to efficient communication were well supported in professional role dimension. In nursing intervention dimension, items on basic nursing skills were highly supported while items on specific nursing interventions such as music therapy or art therapy were considered relatively inappropriate to competency for BSN graduates. The findings clearly showed that the current nursing education more emphasizes nursing interventions based on nursing process than other dimensions of competency. There is a need to reconceptualize nursing curriculum that is able to reflect more of nursing professional role and client/health need dimensions. Further research to validate the instrument by confirming competency dimensions of nursing graduates who are currently working at the hospital has been suggested.

• Korean Journal of Clinical Pharmacy
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• v.27 no.3
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• pp.119-126
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• 2017

Background: As the demands of pharmacist's role and quality performance have increased, the verification of pharmacist's ability has been required. In this study, we aimed to select appropriate items for assessment of pharmacist's knowledge, attitude and performance. Methods: Based on the pharmacist job analysis, we selected duties and tasks in consideration of applying pharmacy practical examination through brainstorming of internal researchers and group discussion with experts. Survey was conducted to evaluate the tasks according to the criteria detailed below: Realistic, Understandable, Measurable, Behavioral and Achievable (RUMBA). The subjects included professors at colleges of pharmacy and instructors of institutional or community pharmacy settings. Results: Nine duties including 41 tasks were drawn for the survey through primary internal researchers. Of the 90 respondents, 95.6% were professors or preceptors who was engaged in practical training, and 62.2% had more than five years of practical experience. As a result of survey and discussion with expert panel, selected seven duties were selected as followings: 'Patient (customer) reception', 'Drug preparation and distribution', 'Patient care', 'Administration', 'Patient counseling', 'Non-prescription medication counseling', and 'Provision of drug information'. The final 20 tasks from seven duties were chosen to assess skills that a pharmacist should be able to perform. Conclusion: This is the first study to select the items that can be included in pharmacist practical examination in the future, based on the RUMBA criteria. As a next step, it is necessary to study how to implement these items.

• The Journal of Korean Academy of Sensory Integration
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• v.16 no.1
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• pp.14-24
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• 2018

Objective : The purpose of this study was to identify the effect of Interactive Metronome (IM) training on postural control and hand writing performance of children with Attention Deficit Hyperactivity Disorder (ADHD). Methods : Participant was a third grade elementary school student diagnosed with ADHD. ABA design was used and a total of 30 sessions were held for 3 sessions every week for a total of 10 weeks. In the intervention period, IM training was conducted for 40~50 minutes before intervention for writing, and the writing task was carried out. We evaluated the handwriting legibility and speed. Before baseline A and within a month after A' phase, Clinical Observation of Motor and Postural Skills (COMPS) was evaluated to examine the changes in postural control of the student. Results : After the IM intervention, the postural control of the student improved in the score of slow movement, finger-nose touching, and asymmetrical tonic neck reflex. The handwriting legibility and speed has also tended to increase during the intervention period, but it has not significantly changed. Conclusion : This study could be used as an evidence that the IM training aimed at postural control and handwriting ability could enhance the ability to improve postural control and thereby provide fundamental knowledge for future studies.