Purpose: Recently medical dispute about plastic surgery is increasing rapidly as result of growing surgery itself due to high interest in appearance and advertisement of plastic surgery. So we want to find a way to prevent similar medical accident by making better solution of plastic surgery through case analysis of medical dispute. Method: 161 cases about plastic surgery asked for aid at Korea Consumer Agency and 41 cases judged at the court was surveyed and gender, location and kind of hospital, goal and kind of operation, making operation agreement or not, kind of damage, result of process, result of lawsuit was studied from 2004.1.1. to 2006.12.31. Result: Medical doctor have to explain about symptoms of disease, method of treatment, possibility of complication, prognosis to patients before therapy so they can make decision if they take operation by doctor or not. On this survey, among the patients who underwent re - operation or had complication, 88.1%(96 from 109 cases) of them didn't get enough explanation about possibility of complication before surgery They brought lawsuit insisting they would not undergo operation if they got enough explanation about possibility of complication and result of operation before surgery. Conclusion: It is advisable that doctor must observe the duty of explanation before surgery and respect the right to decide of patient, make operation agreement and put down concrete progress note and store the pre and post operative photo to avoid medical accident. It is also needed to have guideline of therapy, Code of ethics, organization which deals with medical dispute, reconsideration of law to control that.
Kim, Dongsu;Ryu, Jiseon;Lee, Byungwook;Lim, Byungmook
The Journal of Korean Medicine
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v.37
no.3
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pp.112-122
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2016
Objectives: This study aimed to assess the validity of 'Korean Diagnosis Related Groups-Korean Medicine (KDRG-KM)' which was developed by Health Insurance Review & Assessment Service (HIRA) in 2013 Methods: Among inpatient EDI claim data issued by hospitals and clinics in 2012, the data which included Korean medicine procedures were selected and analyzed. We selected control targets in the Korean medicine hospitals which had longer Episodes-Costliness index (ECI) and Lengthiness index (LI) than average of total Korean medicine hospitals, and compared the results of selection between the major diagnosis-based patient classification system and the KDRG-KM system. Finally, the explanation power (R2) and coefficient of variation (CV) of the KDRG-KM system using practice expenses were calculated. Results: The numbers of control target in Korean medicine hospitals changed from 36 to 32 when patient grouping adjustment method was changed from major diagnosis to KDRG-KM. For expenses of all outpatient claim data on Korean medicine, explanation power of KDRG-KM system was 66.48% after excluding outliers. CVs of expenses of patient groups in Korean medicine hospitals were gathered from under 70% to under 90%, and those in long-term care hospitals mostly belonged under 70%. Conclusions: The validity of KDRG-KM system was assured in terms of explanation power. By adapting KDRG-KM system, fairness of control targets selection for costliness management in Korean medicine hospitals can be enhanced.
In 2012, the major jurisdictions regarding medical cases caused the controversial issues towards medical and legal fields by getting the judgments from the Supreme Court, which admitted the exceptional admissibility on discretionary grant. By regarding the serial negligence of medical organizations as a separate tort, the sentences which made up irrationality, were spoken by the court. As a result, if the treatment was made, which did not follow the entered matters in medical documents attached, the court announced the jurisdiction that presumes the negligence, which provided the evidence of negligence; on the other hand, this gave had the burden to medical branch to take great care for medicinal treatment. To be applicable for the Principle of Trust, the doctors have to give and take the necessary information for the treatment process and symptom decisions, which also commented in the court. Thus, this case made it difficult to apply the Principle of Trust and considered all the conditions as tough ones, which eventually induced lesser faults for patients' care. Moreover, the court confirmed that the medical ads sending the emails to the members belong to the internet portal sites, are not the inducing behavior by considering that the actions are only medical ads. Furthermore, in the case of Namsu Kim, the court's interpretation was rather limited the definition for medical practice that announced limited Erweiterung der Strafbarkeit cases by lower courts. As a consequence, it is very interesting whether the Supreme Court may change their position and concerning the duty of explanation, the trend to expand the contents and scopes for the duty of explanation continues by admitting instruction explanation obligation and all the compensations and so on.
In this study, the effects of concept mapping with feedbacks providing explanatory comments on students' achievement, science learning anxiety, and science learning motivation were investigated in the undergraduate general chemistry course. The aptitude-treatment interactions between students' level of mastery goal orientation and the concept mapping with explanation feedback treatment were also examined. Sixty-seven freshmen from an university of education were assigned to a control group and a treatment group. The tests of mastery goal orientation, science anxiety, and science learning motivation were administered as pretests. For the treatment group, feedback providing students with explanatory comments through whole class discussion was presented after each concept mapping. Whereas the control group students were presented with opportunities solving excercise problems followed by explanation feedback. The intervention was lasted for 10 weeks (30 class periods). After the instructions, a researcher-made achievement test, the science learning anxiety test, and the science learning motivation test were administered. The results indicated that no statistically significant difference was found in students' achievement. In the science learning anxiety, however, the scores of the treatment group was significantly lower than those of the control group. The scores of the treatment group also tended to be higher, though not significant, than those of the control group in the science learning motivation. However, no significant aptitude-treatment interactions were found in all dependent variables.
Journal of The Korean Association For Science Education
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v.23
no.6
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pp.634-649
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2003
The aim of this paper was to diagnose Korean sixth graders' understanding for scientific evidence and explanation. The instrument constructed by Jeong, Songer, and Lee (2002) was used to assess students' understanding for priority of scientific evidence, objectivity of data, relevance of evidence, data interpretation, coordination of theory and evidence, and repeated observation. Results showed that although many students recognized certain features of scientific inquiry such as objectivity of data, few of them understood why such features are valued and how to collect and use such data. In particular, students experienced difficulty in formulating explanation from evidence, not knowing, for example, that repeated observations are needed before making a general statement. The results of this study suggest that efforts to foster students' inquiry abilities need to be based on careful analyses of students existing inquiry skills and understanding.
This study was carried out on hospitalized patients receiving diet therapy satisfaction and awareness of nutrition education in small and medium-sized hospitals in southern Gyeonggi area. By the face-to-face interview with questionnaire method, the survey was carried out on 150 subjects (99 males and 51 females). The patients (64.7% of males, 52.9% of females) heard the description of diet therapy without the aid of written manual. Patients were moderately satisfied by food that was rated based on these indicators: tastiness (2.45), saltiness (2.23), smelliness (2.23), and appetizing appearance (2.39) as a 4 point scale. Most of the patients (80.8% of males, 69.8% of females) wanted to continue diet therapy. The importance of diet was correlated with the tastiness, saltiness, and appetizing appearance of diet. And the help of dietitians' explanation was correlated with appetite. 55.6% of males and 35.4% of females received nutrition education before (p<0.05). The number of times nutrition education was received was once for male (33.3%) and three times for female (44.4%). Most nutrition education satisfaction that was calculated on a 4 point scale was well understood (3.03), recognized importance (3.44 for males, 2.78 for females) and help for disease management (p<0.01). Also they were satisfied with the explanation of disease (3.20). Nutrition education satisfaction was correlated positively with explanation about food related to disease, the current dietary treatment, how to prepare diet recipes, and dietitian's kindness, but negatively with satisfaction with explanation of diet therapy, and the description and help for disease management. In conclusion, the most important factor in practicing diet therapy was meeting with the dietitian. Intensive nutrition education after the patient's discharge is necessary for patients to continue diet therapy.
The Journal of Korean Association of Computer Education
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v.22
no.3
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pp.79-87
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2019
This study examined the effect of e-learning contents with different dual-coding, media-richness, and cognitive-load degree on learning. To do so, after dividing summary and explanation presentation methods in e-learning contents according to information's quantity and kind, the effects on teaching presence and academic achievement were examined. The summary presentation method was produced as text type and text+illustration type and the explanation presentation method as audio type and audio+video type. The results of this study are as follows. First, in the summary method, the text+illustration type had significantly higher teaching presence than text type. Second, in the explanation method, the audio type was found to be significantly higher than the audio+video type. Third, the interaction between the summary method and explanation method was found to be significant in teaching presence and academic achievement.
Purpose: To assess parent perspectives of the current and potential future tests for their child with inflammatory bowel disease (IBD). Methods: New Zealand parents of a child with IBD were invited to complete an anonymous online survey. Experiences relating to their child's blood or faecal tests, medical imaging (abdominal ultrasound [US], abdominal computerised tomography [CT] and magnetic resonance enterography) and colonoscopy were collected. Perceived attitudes to potential future testing of urine, saliva, and breath, were sought. Results: Twenty-eight parents, 93% female completed the survey, and 86% were aged between 35 and 54 years. Baseline information was provided by parents for 27 of 28 children, 70.3% had Crohn's disease with a mean disease duration of 2.67 years. Blood tests were the most requested and completed tests, while CT was the least ordered and most refused test. Colonoscopy was rated as the least comfortable and generated the most worry. Explanation of test significantly improved parent's levels of understanding when their child had blood, faecal, imaging (US) or colonoscopy tests. Providing an explanation, test invasiveness and the impact of the blood results may have on their child's treatment significantly improved parents' comfort levels. However, explanation of colonoscopy generated a significant parental concerns. Saliva, urine and blood tests were chosen as the most preferred disease monitoring tests. Conclusion: Parents preferred any tests less invasive than colonoscopy for monitoring their child's IBD. Although providing explanation of their child's tests enhanced parents' understanding, it can also affect parents' levels of concern and comfort.
There are various machine learning techniques such as Reinforcement Learning, Deep Learning, Neural Network Learning, and so on. In recent, Large Language Models (LLMs) are popularly used for Generative AI based on Reinforcement Learning. It makes decisions with the most optimal rewards through the fine tuning process in a particular situation. Unfortunately, LLMs can not provide any explanation for how they reach the goal because the training is based on learning of black-box AI. Reinforcement Learning as black-box AI is based on graph-evolving structure for deriving enhanced solution through adjustment by human feedback or reinforced data. In this research, for mutually exclusive decision-making, Mutually Exclusive Learning (MEL) is proposed to provide explanations of the chosen goals that are achieved by a decision on both ends with specified conditions. In MEL, decision-making process is based on the tree-based structure that can provide processes of pruning branches that are used as explanations of how to achieve the goals. The goal can be reached by trade-off among mutually exclusive alternatives according to the specific contextual conditions. Therefore, the tree-based structure is adopted to provide feasible solutions with the explanations based on the pruning branches. The sequence of pruning processes can be used to provide the explanations of the inferences and ways to reach the goals, as Explainable AI (XAI). The learning process is based on the pruning branches according to the multi-dimensional contextual conditions. To deep-dive the search, they are composed of time window to determine the temporal perspective, depth of phases for lookahead and decision criteria to prune branches. The goal depends on the policy of the pruning branches, which can be dynamically changed by configured situation with the specific multi-dimensional contextual conditions at a particular moment. The explanation is represented by the chosen episode among the decision alternatives according to configured situations. In this research, MEL adopts the tree-based learning model to provide explanation for the goal derived with specific conditions. Therefore, as an example of mutually exclusive problems, employment process is proposed to demonstrate the decision-making process of how to reach the goal and explanation by the pruning branches. Finally, further study is discussed to verify the effectiveness of MEL with experiments.
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