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Future Direction of National Health Insurance (국민건강보험 발전방향)

  • Park, Eun-Cheol
    • Health Policy and Management
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    • v.27 no.4
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    • pp.273-275
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    • 2017
  • It has been forty years since the implementation of National Health Insurance (NHI) in South Korea. Following the 1977 legislature mandating medical insurance for employees and dependents in firms with more than 500 employees, South Korea expanded its health insurance to urban residents in 1989. Resultantly, total expenses of the National Health Insurance Service (NHIS) have greatly increased from 4.5 billion won in 1977 to 50.89 trillion won in 2016. With multiple insurers merging into the NHI system in 2000, a single-payer healthcare system emerged, along with separation policy of prescribing and dispensing. Following such reform, an emerging financial crisis required injections from the National Health Promotion Fund. Forty years following the introduction of the NHI system, both praise and criticism have been drawn. In just 12 years, the NHI achieved the fastest health population coverage in the world. Current medical expenditure is not high relative to the rest of the Organization for Economic Cooperation and Development. The quality of acute care in Korea is one of the best in the world. There is no sign of delayed diagnosis and/or treatment for most diseases. However, the NHI has been under-insured, requiring high-levels of out-of-pocket money from patients and often causing catastrophic medical expenses. Furthermore, the current environmental circumstances of the NHI are threatening its sustainability. Low birth rate decline, as well as slow economic growth, will make sustainment of the current healthcare system difficult in the near future. An aging population will increase the amount of medical expenditure required, especially with the baby-boomer generation of those born between 1955 and 1965. Meanwhile, there is always the problem of unification for the Korean Peninsula, and what role the health insurance system will have to play when it occurs. In the presidential election, health insurance is a main issue; however, there is greater focus on expansion and expenditure than revenue. Many aspects of Korea's NHI system (1977) were modeled after the German (1883) and Japanese (1922) systems. Such systems were created during an era where infections disease control was most urgent and thus, in the current non-communicable disease (NCD) era, must be redesigned. The Korean system, which is already forty years old, must be redesigned completely. Although health insurance benefit expansion is necessary, financial measures, as well as moral hazard control measures, must also be considered. Ultimately, there are three aspects that we must consider when attempting redesign of the system. First, the health security system must be reformed. NHI and Medical Aid must be amalgamated into one system for increased effectiveness and efficiency of the system. Within the single insurer system of the NHI must be an internal market for maximum efficiency. The NHIS must be separated into regions so that regional organizers have greater responsibility over their actions. Although insurance must continue to be imposed nationally, risk-adjustment must be distributed regionally and assessed by different regional systems. Second, as a solution for the decreasing flow of insurance revenue, low premium level must be increased to an appropriate level. Likewise, the national reserve fund (No. 36, National Health Insurance Act) must be enlarged for re-unification preparation. Third, there must be revolutionary reform of benefit package. The current system built a focus on communicable diseases which is inappropriate in this NCD era. Medical benefits must not be one-time events but provide chronic disease management. Chronic care models, accountable care organization, patient-centered medical homes, and other systems that introduce various benefit packages for beneficiaries must be implemented. The reimbursement system of medical costs should be introduced to various systems for different types of care, as is the case with part C (Medicare Advantage Program) of America's Medicare system that substitutes part A and part B. Pay for performance must be expanded so that there is not only improvement in quality of care but also medical costs. Moreover, beneficiaries of the NHI system must be aware of the amount of their expenditure through a deductible payment system so that spending can be profiled and monitored. The Moon Jae-in Government has announced its plans to expand the NHI system; however, it is important that a discussion forum is created so that more accurate analysis of the NHI, its environments, and current status of health care system, can take place for reforming NHI.

'Open Skies' Agreements and Access to the 'Single' European Sky;Legal and Economic Problems with the European Court of Justice's Judgment in 'Commission v. Germany'(2002) Striking Down the 'Nationality Clause' in the U.S.-German Agreement (항공(航空) 자유화(自由化)와 '단일(單一)' 유럽항공시장(航空市場) 접근(接近);유럽사법재판소(司法裁判所)의 미(美) ${\cdot}$ 독(獨) 항공운수협정(航空運輸協定)상 '국적요건(國籍要件)' 조항(條項)의 공동체법(共同體法)상 '내국민대우(內國民待遇)' 규정 위반(違反) 관련 '집행위원회(執行委員會) 대(對) 독일연방(獨逸聯邦)' 사건 판결(判決)(2002)의 문제점을 중심으로)

  • Park, Hyun-Jin
    • Journal of the Korean Society for Aviation and Aeronautics
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    • v.15 no.1
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    • pp.38-53
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    • 2007
  • In a seminal judgment of November 2002 (Case C-476/98) relating to the compatibility with Community laws of the 'nationality clause' in the 1996 amending protocol to the 1955 U.S.-German Air Services Agreement, the European Court of Justice(ECJ) decided that the provision constituted a measure of an intrinsically discriminatory nature and was thus contrary to the principle of national treatment established under Art. 52 of the EC Treaty. The Court, rejecting bluntly the German government' submissions relying on public policy grounds(Art. 56, EC Treaty), seemed content to declare and rule that the protocol provision requiring a contracting state party to ensure substantial ownership and effective control by its nationals of its designated airlines had violated the requirement of national treatment reserved for other Community Members under the salient Treaty provision. The German counterclaims against the Commission, although tantalizing not only from the perusal of the judgment but from the perspective of international air law, were nonetheless invariably correct and to the point. For such a clause has been justified to defend the 'fundamental interests of society from a serious threat' that may result from granting operating licenses or necessary technical authorizations to an airline company of a third country. Indeed, the nationality clause has been inserted in most of the liberal bilaterals to allow the parties to enforce their own national laws and regulations governing aviation safety and security. Such a clause is not targeted as a device for discriminating against the nationals of any third State. It simply acts as the minimum legal safeguards against aviation risk empowering a party to take legal control of the designated airlines. Unfortunately, the German call for the review of such a foremost objective and rationale underlying the nationality clause landed on the deaf ears of the Court which appeared quite happy not to take stock of the potential implications and consequences in its absence and of the legality under international law of the 'national treatment' requirement of Community laws. Again, while US law limits foreign shareholders to 24.9% of its airlines, the European Community limits non-EC ownership to 49%, precluding any ownership and effective control by foreign nationals of EC airlines, let alone any foreign takeover and merger. Given this, it appears inconsistent and unreasonable for the EC to demand, $vis-{\grave{a}}-vis$ a non-EC third State, national treatment for all of its Member States. The ECJ's decision was also wrongly premised on the precedence of Community laws over international law, and in particular, international air law. It simply is another form of asserting and enforcing de facto extraterritorial application of Community laws to a non-EC third country. Again, the ruling runs counter to an established rule of international law that a treaty does not, as a matter of principle, create either obligations or rights for a third State. Aside from the legal problems, the 'national treatment' may not be economically justified either, in light of the free-rider problem and resulting externalities or inefficiency. On the strength of international law and economics, therefore, airlines of Community Members other than the designated German and U.S. air carriers are neither eligible for traffic rights, nor entitled to operate between or 'free-ride' on the U.S. and German points. All in all and in all fairness, the European Court's ruling was nothing short of an outright condemnation of established rules and principles of international law and international air law. Nor is the national treatment requirement justified by the economic logic of deregulation or liberalization of aviation markets. Nor has the requirement much to do with fair competition and increased efficiency.

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E-Commerce in the Historical Approach to Usage and Practice of International Trade ("무역상무(貿易商務)에의 역사적(歷史的) 어프로치와 무역취인(貿易取引)의 전자화(電子化)")

  • Tsubaki, Koji
    • THE INTERNATIONAL COMMERCE & LAW REVIEW
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    • v.19
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    • pp.224-242
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    • 2003
  • The author believes that the main task of study in international trade usage and practice is the management of transactional risks involved in international sale of goods. They are foreign exchange risks, transportation risks, credit risk, risk of miscommunication, etc. In most cases, these risks are more serious and enormous than those involved in domestic sales. Historically, the merchant adventurers organized the voyage abroad, secured trade finance, and went around the ocean with their own or consigned cargo until around the $mid-19^{th}$ century. They did business faceto-face at the trade fair or the open port where they maintained the local offices, so-called "Trading House"(商館). Thererfore, the transactional risks might have been one-sided either with the seller or the buyer. The bottomry seemed a typical arrangement for risk sharing among the interested parties to the adventure. In this way, such organizational arrangements coped with or bore the transactional risks. With the advent of ocean liner services and wireless communication across the national border in the $19^{th}$ century, the business of merchant adventurers developed toward the clear division of labor; sales by mercantile agents, and ocean transportation by the steam ship companies. The international banking helped the process to be accelerated. Then, bills of lading backed up by the statute made it possible to conduct documentary sales with a foreign partner in different country. Thus, FOB terms including ocean freight and CIF terms emerged gradually as standard trade terms in which transactional risks were allocated through negotiation between the seller and the buyer located in different countries. Both of them did not have to go abroad with their cargo. Instead, documentation in compliance with the terms of the contract(plus an L/C in some cases) must by 'strictly' fulfilled. In other words, the set of contractual documents must be tendered in advance of the arrival of the goods at port of discharge. Trust or reliance is placed on such contractual paper documents. However, the container transport services introduced as international intermodal transport since the late 1960s frequently caused the earlier arrival of the goods at the destination before the presentation of the set of paper documents, which may take 5 to 10% of the amount of transaction. In addition, the size of the container vessel required the speedy transport documentation before sailing from the port of loading. In these circumstances, computerized processing of transport related documents became essential for inexpensive transaction cost and uninterrupted distribution of the goods. Such computerization does not stop at the phase of transportation but extends to cover the whole process of international trade, transforming the documentary sales into less-paper trade and further into paperless trade, i.e., EDI or E-Commerce. Now we face the other side of the coin, which is data security and paperless transfer of legal rights and obligations. Unfortunately, these issues are not effectively covered by a set of contracts only. Obviously, EDI or E-Commerce is based on the common business process and harmonized system of various data codes as well as the standard message formats. This essential feature of E-Commerce needs effective coordination of different divisions of business and tight control over credit arrangements in addition to the standard contract of sales. In a few word, information does not alway invite "trust". Credit flows from people, or close organizational tie-ups. It is our common understanding that, without well-orchestrated organizational arrangements made by leading companies, E-Commerce does not work well for paperless trade. With such arrangements well in place, participating E-business members do not need to seriously care for credit risk. Finally, it is also clear that E-International Commerce must be linked up with a set of government EDIs such as NACCS, Port EDI, JETRAS, etc, in Japan. Therefore, there is still a long way before us to go for E-Commerce in practice, not on the top of information manager's desk.

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Selection and Application of Evaluation Factors for Urban Regeneration Project (도시재생사업의 평가요인 선정 및 적용)

  • Jang, Cheol-Kyu
    • Journal of the Korean Institute of Landscape Architecture
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    • v.47 no.6
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    • pp.53-66
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    • 2019
  • The purpose of this study was to suggest indicator-based selection and improvement plans for evaluating urban regeneration projects. First, we selected the indicators by conducting expert surveys and analysis of the responses received. Additionally, using the selected indicators, we analyzed the residents' opinions in Wongogae Village, where urban regeneration projects were in progress. Based on these, we suggested a plan to improve Wongogae Village. According to the study, we classified the urban regeneration evaluation indicators into 'Physical environment', 'Social environment' and 'Economic environment' according to their characteristics. We selected urban regeneration evaluation factors through the first expert survey and MCB analysis. As a result, we selected six factors for the 'Physical environment' category: 'Traffic and pedestrian environment', 'Residential (housing) environment', 'Safety and security environment', 'Greenspace', 'Landscape improvement' and 'Public space', In the 'Social environment' category, four factors were chosen: 'Resident participation', 'Community activation', 'Role of the local government and support centers' and 'Resident education' while for the 'Economic environment' category three factors were selected: 'Local economic revitalization', 'Creating an economy-based environment', 'Job creation'. Next, we conducted a second expert survey and carried out an AHP analysis using the selected evaluation factors to derive the overall weight for each. Among the evaluation factors for urban regeneration, the 'Residential (housing) environment' has the highest weighted value of 0.108, followed by 'Local economic revitalization' and 'Resident participation'. Lastly, the analysis of the residents' opinions of Wongogae Village using the urban regeneration evaluation factors, Parking environment', 'Maintenance of old houses and living environment', 'Environment for founding town and social enterprises', 'Improve commercial and business environment', 'Maintain and activate existing business' and 'Vitalizing small regional economies such as domestic handicrafts and side-job' had high overall importance, but low satisfaction, which means that it is necessary to improve the focus. Therefore, in order to improve the urban regeneration project in villages, it is necessary to improve the parking environment by expanding public parking lots, eliminate close houses, and idle lands, or open a school playground in the village for the residents. In addition, it is essential to encourage economic activities, such as fostering village enterprises and social enterprises in connection with cooperatives and allow for the selling of the products through resident activities, such as neighboring markets.

A Study on the Location of Zen Buddhist Temples During the Late Silla Dynasty in Korea - from Feng-shui(風水) Perspective - (신라말 구산선문(九山禪門) 사찰의 입지 연구 - 풍수적 측면을 중심으로 -)

  • Cho, Sung-Ho;Sung, Dong-Hwan
    • Journal of the Korean association of regional geographers
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    • v.6 no.3
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    • pp.53-81
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    • 2000
  • The purpose of this study is to examine the chracteristics of the location of Zen Buddhist temples which are the Nine-Mountain Sects of Zen(九山禪門) from feng-shui perspective. A large number of temples have been built for about 1600 years since Buddhism had influenced on Korea. They have been built nationwide in different times by different sects of Buddhism. The pattern of location of Buddhist temples is different according to background of the times (political, economic, cultural aspect) and of tenet(difference in sects of Buddhism) when the temples were built. But the general location of Korean Buddhist temples is in accordance with feng-shui theory. Feng-shui is a traditional geographic thought in China and Korea. It is necessary to understand feng-shui in order to understand Korean landscape and cultural geography. It had given a tremendous impact on Korean landscape through choosing site of cities, settlements, houses, mounments, temples, pagodas, and so on. Before feng-shui was prevailing in Korea, Buddhist temples were mostly built on sacred place which was connected with folk beliefs. In the case of the late Silla Dynasty when Zen Buddhism was prevailing, feng-shui became popular and many. temples were built in accordance with feng-shui. The typical examples are found in the site of Nine-Mountain Sects of Zen temples. The interpretation of geomantic site of Nine-Mountain Sects of Zen temples will show us how feng-shui was applied to and reflected in the Korean peninsula. In Zen Buddhism, feng-shui was applied to the choice of the temple site. Also feng-shui theory was usually used to choose the site of stupa(Budo) where the remains of the founder of sect. In this study, I will interpret the geomantic characteristics of Nine-Mountain Sects of Zen temples. The geomantic interpretations of the temples are as follow. 1. The temples are located at the foot of a hill with surrounding mountains and a watercourse in front. Feng-shui texts often describe it as an ideal site. This geomantic situation is well equipped with natural drainage; protection from cold wind from the north or evil spirits; a good view with open space to the front; protection from unnecessary weather damage; and security and protection from strangers and invaders. 2. The sitting and facing direction of the temples correspond to the oncoming dragon's direction. 3. Many feng-shui texts discuss the types of Sa(surrounding mountains) in detail and morphologically describe them with certain animate and inanimate auspicious objects. In case of Nine-Mountain Sects of Zen temples, the geomantic landscape of these can be compared to auspicious objects. This is morphological marker for the description of configulation features of these temples. 4. Most auspicious places are not perfect, but the shortcomings can be overcome by many means. We can observe modification of landscape for the purpose of fulfilling the geomantic harmony of the temple.

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Constitutional Issue Review of Compensation for Inevitable Medical Accidents During Delivery (불가항력 의료사고 보상사업에 대한 헌법적 쟁점 검토)

  • JUN, HYUN JUNG
    • The Korean Society of Law and Medicine
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    • v.21 no.1
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    • pp.153-185
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    • 2020
  • In principle, even if serious consequences such as death or serious injury of a patient occur as a result of a medical accident, if the medical malpractice of a health care worker is not recognized, the health care worker is not held liable for said consequences. However, with the opening of the Korea Medical Dispute Mediation and Arbitration Agency on April 7, 2012, a system was established to compensate health care personnel for their medical malpractices only in the case of "injuries caused by medical accidents in the course of childbirth" (hereinafter referred to as "program for compensation of medical accidents"). Article 46 paragraph 1 of the current Medical Dispute Mediation Act, which is the basis of the Force Majeure Medical Accident Compensation System, stipulates that "medical accidents under delivery" claims are to be determined by the Medical Accident Compensation Review Committee are subject to the compensation project. And the details of the compensation, ratio of sharing financial resources for compensation, scope of compensation, and the guidelines and procedure for the payment of compensations are prescribed by Presidential Decree. In other words, the Presidential Decree requires the state to pay 70 percent of the compensation funds, and 30 percent of the above funds among health care providers. The Constitutional Court has decided on the 2015Hun-Ga13 that the scope of the health care institution's founders and the share of the compensation funds cannot be directly determined by the law, and that the portion delegated by the Presidential decree does not violate the Principle of Legal Protection nor Comprehensive Nondelegation Doctrine. However, this can be seen as an exclusion of accountability for force-induced delivery accidents even if there is no negligence of the medical staff. If the nature of the system is a type of social security system with a social compensatory nature, it could consider eliminating the health care innovator's cost-sharing provisions, leaving the full cost to the state. However, it is also necessary to review institutional protocols that strengthen the efforts of medical institutions in areas such as analysis of the causes of medical accidents and measures to prevent their recurrence. In addition, I think that the conclusion of the Act is in line with the purpose of the Comprehensive Wage Support Regulations that at minimum the law sets an upper limit of the compensation funds that are to be paid by health and medical institutions. Moreover, it is reasonable for the Medical Accident Compensation Review Committee to specify gestational age and weight of births, which are the criteria for compensation, under the Enforcement Decree of the Medical Dispute Mediation Act, in relation to the criteria for payment of contributions by the Medical Accident Compensation Review Committee, and to set the detailed criteria.

Wearable Computers

  • Cho, Gil-Soo;Barfield, Woodrow;Baird, Kevin
    • Fiber Technology and Industry
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    • v.2 no.4
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    • pp.490-508
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    • 1998
  • One of the latest fields of research in the area of output devices is tactual display devices [13,31]. These tactual or haptic devices allow the user to receive haptic feedback output from a variety of sources. This allows the user to actually feel virtual objects and manipulate them by touch. This is an emerging technology and will be instrumental in enhancing the realism of wearable augmented environments for certain applications. Tactual displays have previously been used for scientific visualization in virtual environments by chemists and engineers to improve perception and understanding of force fields and of world models populated with the impenetrable. In addition to tactual displays, the use of wearable audio displays that allow sound to be spatialized are being developed. With wearable computers, designers will soon be able to pair spatialized sound to virtual representations of objects when appropriate to make the wearable computer experience even more realistic to the user. Furthermore, as the number and complexity of wearable computing applications continues to grow, there will be increasing needs for systems that are faster, lighter, and have higher resolution displays. Better networking technology will also need to be developed to allow all users of wearable computers to have high bandwidth connections for real time information gathering and collaboration. In addition to the technology advances that make users need to wear computers in everyday life, there is also the desire to have users want to wear their computers. In order to do this, wearable computing needs to be unobtrusive and socially acceptable. By making wearables smaller and lighter, or actually embedding them in clothing, users can conceal them easily and wear them comfortably. The military is currently working on the development of the Personal Information Carrier (PIC) or digital dog tag. The PIC is a small electronic storage device containing medical information about the wearer. While old military dog tags contained only 5 lines of information, the digital tags may contain volumes of multi-media information including medical history, X-rays, and cardiograms. Using hand held devices in the field, medics would be able to call this information up in real time for better treatment. A fully functional transmittable device is still years off, but this technology once developed in the military, could be adapted tp civilian users and provide ant information, medical or otherwise, in a portable, not obstructive, and fashionable way. Another future device that could increase safety and well being of its users is the nose on-a-chip developed by the Oak Ridge National Lab in Tennessee. This tiny digital silicon chip about the size of a dime, is capable of 'smelling' natural gas leaks in stoves, heaters, and other appliances. It can also detect dangerous levels of carbon monoxide. This device can also be configured to notify the fire department when a leak is detected. This nose chip should be commercially available within 2 years, and is inexpensive, requires low power, and is very sensitive. Along with gas detection capabilities, this device may someday also be configured to detect smoke and other harmful gases. By embedding this chip into workers uniforms, name tags, etc., this could be a lifesaving computational accessory. In addition to the future safety technology soon to be available as accessories are devices that are for entertainment and security. The LCI computer group is developing a Smartpen, that electronically verifies a user's signature. With the increase in credit card use and the rise in forgeries, is the need for commercial industries to constantly verify signatures. This Smartpen writes like a normal pen but uses sensors to detect the motion of the pen as the user signs their name to authenticate the signature. This computational accessory should be available in 1999, and would bring increased peace of mind to consumers and vendors alike. In the entertainment domain, Panasonic is creating the first portable hand-held DVD player. This device weight less than 3 pounds and has a screen about 6' across. The color LCD has the same 16:9 aspect ratio of a cinema screen and supports a high resolution of 280,000 pixels and stereo sound. The player can play standard DVD movies and has a hour battery life for mobile use. To summarize, in this paper we presented concepts related to the design and use of wearable computers with extensions to smart spaces. For some time, researchers in telerobotics have used computer graphics to enhance remote scenes. Recent advances in augmented reality displays make it possible to enhance the user's local environment with 'information'. As shown in this paper, there are many application areas for this technology such as medicine, manufacturing, training, and recreation. Wearable computers allow a much closer association of information with the user. By embedding sensors in the wearable to allow it to see what the user sees, hear what the user hears, sense the user's physical state, and analyze what the user is typing, an intelligent agent may be able to analyze what the user is doing and try to predict the resources he will need next or in the near future. Using this information, the agent may download files, reserve communications bandwidth, post reminders, or automatically send updates to colleagues to help facilitate the user's daily interactions. This intelligent wearable computer would be able to act as a personal assistant, who is always around, knows the user's personal preferences and tastes, and tries to streamline interactions with the rest of the world.

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A Comparative Study of Korean Home Economic Curriculum and American Practical Problem Focused Family & Consumer Sciences Curricula (우리나라 가정과 교육과정과 미국의 실천적 문제 중심 교육과정과의 비교고찰)

  • Kim, Hyun-Sook;Yoo, Tae-Myung
    • Journal of Korean Home Economics Education Association
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    • v.19 no.4
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    • pp.91-117
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    • 2007
  • This study was to compare the contents and practical problems addressed, the process of teaching-learning method, and evaluation method of Korean Home Economics curriculum and of the Oregon and Ohio's Practical Problem Focused Family & Consumer Sciences Curricula. The results are as follows. First, contents of Korean curriculum are organized by major sub-concepts of Home Economics academic discipline whereas curricular of both Oregon and Ohio states are organized by practical problems. Oregon uses the practical problems which integrate multi-subjects and Ohio uses ones which are good for the contents of the module by integrating concerns or interests which are lower or detailed level (related interests). Since it differentiates interest and module and used them based on the basic concept of Family and Consumer Science, Ohio's approach could be easier for Korean teachers and students to adopt. Second, the teaching-learning process in Korean home economics classroom is mostly teacher-centered which hinders students to develop higher order thinking skills. It is recommended to use student-centered learning activities. State of Oregon and Ohio's teaching-learning process brings up the ability of problem-solving by letting students clearly analyze practical problems proposed, solve problems by themselves through group discussions and various activities, and apply what they learn to other problems. Third, Korean evaluation system is heavily rely on summative evaluation such as written tests. It is highly recommended to facilitate various performance assessment tools. Since state of Oregon and Ohio both use practical problems, they evaluate students mainly based on their activity rather than written tests. The tools for evaluation include project documents, reports of learning activity, self-evaluation, evaluation of discussion activity, peer evaluation in a group for each students for their performance, assessment about module, and written tests as well.

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Application and Effectiveness of a Preceptorship for the Improvement of Clinical Education (임상실습 교육개선을 위한 일 실습지도자 활용모델 (preceptorship model)의 적용 및 효과에 관한 연구 -암센타, 재활센타, 중환자실 실습을 중심으로-)

  • 이원희;김소선;한신희;이소연;김기연
    • Journal of Korean Academy of Nursing
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    • v.25 no.3
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    • pp.581-596
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    • 1995
  • Clinical practice in nursing education provides an opportunity for students, through the process of ap-plying theoretical knowledge to practice, and to learn nursing skills as well as being socialized into nursing and as such decrease the reality shock of actual nursing practice. Because of a shortage of nursing faculty, the job of achieving the objectives of the clinical practice had been turned over to the head nurses. This resulted in many problems, such as, unclear location of responsibilities and inadequate feedback from head nurses. Therefore this study was done to introduce and evaluate the use of preceptors as a way to minimize the above problems, and to maximize the achievement of the clinical practice objectives. Using an adaptation of Zerbe's (1991) three-tiered team model, clinical practice was done using a preceptor, a head nurse and a clinical instructor, each with different and well defined roles. The subjects of this study were 67 senior students of the College of Nursing of Y University in Seoul whose clinical practice in adult nursing was carried out between May 1, 1994 and December 8, 1994. There were 22 preceptors who had at least two years of clinical experience and who were recommended by their head nurses. They were given additional education on the philosophy and objectives of the College of Nursing, on communication skills, on the theory and practice of education, and on nursing diagnosis and education evaluation. The role of the preceptor was to work one-to-one with students in their practice. The role of the head nurse was to supervise and evaluate the preceptors. The role of the clinical instructor was to provide the education program for the preceptors, to provide ad-vice and suggestions to the preceptors and to maintain lines of communication with the college. With each of these roles in place, it was thought that the effectiveness and efficiency of the clinical practice could be increased significantly. To evaluate the effectiveness of the preceptorship, the three - tiered model, Lowery's Teacher Evaluation Opinion Form translated and adapted to Korea was used to measure student statisfaction. The Clinical Practice Compentency Evaluation Tool developed by Lee et ai was also used to measure student competencies. The results of this study are as follows 1. The satisfaction with clinical practice was higher with the introduction of the perceptors than it was before they were used. (t=-5.96, p=<.005) 2. The clinical practice competencies were higher with the introduction of the preceptors than it was before they were used(t=-5.l3, p<.005) 3. In order to analyze areas not measured by the quantitative tools additional analysis of the open questions was done. The results of this analysis showed that : 1) The students felt positive about their sense of security, confidence, handling of responsbility, and being systematic. They also felt positive about improvements in knowledge, opportunities for direct care, and socialization. 2) The students felt negative about the technical part of their role, lack of knowledge by the preceptor, unprofessional attitudes on the part of the preceptor, difficulty in the role of the professional nurse(student). 3) The preceptors felt positive about their responsibility, motivation, and relationship with the college. 4) The preceptors felt negative about their bur-den. Introduction of the preceptorship model will lead to change and improvement in the negative factors discussed above, solve problems in the present clinical education system, increase continuity in the education of the students, help with socialization of the students and motivation of the preceptors to up-grade their education and increase their confidence. These objectives must be obtained to further the development of professional nursing, and thus, making the preceptorship a reality is our job for the future.

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Personalized Recommendation System for IPTV using Ontology and K-medoids (IPTV환경에서 온톨로지와 k-medoids기법을 이용한 개인화 시스템)

  • Yun, Byeong-Dae;Kim, Jong-Woo;Cho, Yong-Seok;Kang, Sang-Gil
    • Journal of Intelligence and Information Systems
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    • v.16 no.3
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    • pp.147-161
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    • 2010
  • As broadcasting and communication are converged recently, communication is jointed to TV. TV viewing has brought about many changes. The IPTV (Internet Protocol Television) provides information service, movie contents, broadcast, etc. through internet with live programs + VOD (Video on demand) jointed. Using communication network, it becomes an issue of new business. In addition, new technical issues have been created by imaging technology for the service, networking technology without video cuts, security technologies to protect copyright, etc. Through this IPTV network, users can watch their desired programs when they want. However, IPTV has difficulties in search approach, menu approach, or finding programs. Menu approach spends a lot of time in approaching programs desired. Search approach can't be found when title, genre, name of actors, etc. are not known. In addition, inserting letters through remote control have problems. However, the bigger problem is that many times users are not usually ware of the services they use. Thus, to resolve difficulties when selecting VOD service in IPTV, a personalized service is recommended, which enhance users' satisfaction and use your time, efficiently. This paper provides appropriate programs which are fit to individuals not to save time in order to solve IPTV's shortcomings through filtering and recommendation-related system. The proposed recommendation system collects TV program information, the user's preferred program genres and detailed genre, channel, watching program, and information on viewing time based on individual records of watching IPTV. To look for these kinds of similarities, similarities can be compared by using ontology for TV programs. The reason to use these is because the distance of program can be measured by the similarity comparison. TV program ontology we are using is one extracted from TV-Anytime metadata which represents semantic nature. Also, ontology expresses the contents and features in figures. Through world net, vocabulary similarity is determined. All the words described on the programs are expanded into upper and lower classes for word similarity decision. The average of described key words was measured. The criterion of distance calculated ties similar programs through K-medoids dividing method. K-medoids dividing method is a dividing way to divide classified groups into ones with similar characteristics. This K-medoids method sets K-unit representative objects. Here, distance from representative object sets temporary distance and colonize it. Through algorithm, when the initial n-unit objects are tried to be divided into K-units. The optimal object must be found through repeated trials after selecting representative object temporarily. Through this course, similar programs must be colonized. Selecting programs through group analysis, weight should be given to the recommendation. The way to provide weight with recommendation is as the follows. When each group recommends programs, similar programs near representative objects will be recommended to users. The formula to calculate the distance is same as measure similar distance. It will be a basic figure which determines the rankings of recommended programs. Weight is used to calculate the number of watching lists. As the more programs are, the higher weight will be loaded. This is defined as cluster weight. Through this, sub-TV programs which are representative of the groups must be selected. The final TV programs ranks must be determined. However, the group-representative TV programs include errors. Therefore, weights must be added to TV program viewing preference. They must determine the finalranks.Based on this, our customers prefer proposed to recommend contents. So, based on the proposed method this paper suggested, experiment was carried out in controlled environment. Through experiment, the superiority of the proposed method is shown, compared to existing ways.