• Korean Medical Education Review
• /
• v.21 no.1
• /
• pp.13-21
• /
• 2019

Patient safety and medical errors have emerged as global concerns and error disclosure has been established as standards of practice in many countries. Disclosure of medical errors to patients and their families is an important part of patient-centred medical care and is essential to maintaining trust. However, physicians still hesitate to disclose errors to patients despite their belief that errors should be disclosed. Multiple barriers such as fear of medical lawsuits and punishment, fear of damaging their professional reputation, and diminished patient trust inhibit error disclosure. These barriers as well as lack of training or education programs addressing error disclosure contribute to a low estimated disclosure rate in real situations. Nowadays, the importance of patient safety education including error disclosure is emphasized and related research is increasing. In this paper, we will discuss the background of medical error disclosure and studies on education programs related to error disclosure. In this regard, we will examine the content and methods currently being taught, discuss the effects or outcomes of such education programs and obstacles or difficulties in implementing them. Finally, the direction of future error disclosure education, support systems, and education strategies will also be covered.

• Journal of Korean Neurosurgical Society
• /
• v.58 no.2
• /
• pp.107-111
• /
• 2015

Objective : Patients treated with surgical clipping for anterior communicating artery (A-com) aneurysm often complain of anosmia, which can markedly impede their quality of life. We introduce a simple and useful technique to reduce postoperative olfactory dysfunction in A-com aneurysm surgery. Methods : We retrospectively reviewed the medical records of patients who underwent surgical clipping for unruptured aneurysm from 2011-2013 by the same senior attending physician. Since March 2012, olfactory protection using gelfoam and fibrin glue was applied in A-com aneurysm surgery. Therefore we categorized patients in two groups from this time-protected group and unprotected group. Results : Of the 63 enrolled patients, 16 patients showed postoperative olfactory dysfunction-including 8 anosmia patients (protected group : unprotected group=1 : 7) and 8 hyposmia patients (protected group : unprotected group=2 : 6). Thirty five patients who received olfactory protection during surgery showed a lower rate of anosmia (p=0.037, OR 10.516, 95% CI 1.159-95.449) and olfactory dysfunction (p=0.003, OR 8.693, 95% CI 2.138-35.356). Superior direction of the aneurysm was also associated with a risk of olfactory dysfunction (p=0.015, OR 5.535, 95% CI 1.390-22.039). Conclusion : Superior direction of aneurysm appears associated with postoperative olfactory dysfunction. Olfactory protection using gelfoam and fibrin glue could be a simple, safe, and useful method to preserve olfactory function during A-com aneurysm surgery.

• Tuberculosis and Respiratory Diseases
• /
• v.80 no.2
• /
• pp.136-142
• /
• 2017

Assessing response to therapy allows for prospective end point evaluation in clinical trials and serves as a guide to clinicians for making decisions. Recent prospective and randomized trials suggest the development of imaging techniques and introduction of new anti-cancer drugs. However, the revision of methods, or proposal of new methods to evaluate chemotherapeutic response, is not enough. This paper discusses the characteristics of the Response Evaluation Criteria In Solid Tumor (RECIST) version 1.1 suggested in 2009 and used widely by experts. It also contains information about possible dilemmas arising from the application of response assessment by the latest version of the response evaluation method, or recently introduced chemotherapeutic agents. Further data reveals the problems and limitations caused by applying the existing RECIST criteria to anti-cancer immune therapy, and the application of a new technique, immune related response criteria, for the response assessment of immune therapy. Lastly, the paper includes a newly developing response evaluation method and suggests its developmental direction.

• The Journal of Korean Medicine
• /
• v.39 no.3
• /
• pp.28-40
• /
• 2018

Objectives: The aim of this study is to introduce the WFME Global Standards and Recognition process and to consider Improvement direction of Korean traditional medical curriculum. Methods: To Investigate the Standards and Recognition process of WFME and the traditional medical curriculum of each country(China, Taiwan, Japan, Korea). Results: The WFME Global Standards and Recognition process aims to train doctors who are educated and active in world standard medical Curriculum. The traditional medical colleges have not received recognition, but those colleges in Korea, China and Taiwan contain a lot of standards contents, and they need to be recognized if they belong to WDMS. Conclusions: Korea University of Oriental Medicine has a lot of subjects of WFME Standards and there is a medical education recognition association, which is advantageous for the standardization process of world medical education. Therefore, it is necessary to aim at world standard medicine while preserving the tradition of Oriental medicine, WFME Global Standards should be used to reorganize the curriculum and train a world-class medical professional.

• The Korean Journal of Emergency Medical Services
• /
• v.15 no.1
• /
• pp.37-46
• /
• 2011

Purpose : This study is equivalence experiment performed to test practice effects between experimental group from both left and right direction of mannequin and control group having practice from only right direction in cardiopulmonary resuscitation education. Methods : Subject of the research were total 71 elementary and middle school teachers in J province who had not experience to have cardiopulmonary resuscitation. They were divided into experimental group of 35 participants who practiced cardiopulmonary resuscitation from both right and left direction of mannequin on Dec. 27, 2009 and control group of 36 participants who performed cardiopulmonary resuscitation from only right direction of mannequin on Dec. 28, 2009. Collected data were analyzed by SPSS/PC+(version 14.0). Results : 1. There was no statistically significant difference by sex among general characteristics of the subjects. 2. According to the quality of chest compression performed from the right direction of mannequin, experimental group showed better results in proper depth (time), insufficient depth (time), too lowered compression position (time) and inexact position (time) than control group(p<.05). In the quality of chest compression from the left side of mannequin, experimental group performed better results in proper depth (time), insufficient depth (time), inexact compression position (time) and mean chest compression depth(mm) than control group(p<.05) and also in more left-centered compression position (time) than control group(p<.001). 3. The quality of chest compression by experimental group, the right side of mannequin was superior in proper depth (time) to the left side of mannequin (p<.001) and showed better results in insufficient depth (time) and chest compression/recoil rate (p<.05). According to the quality of chest compression by control group, the right side of mannequin showed superior results in proper depth (time), insufficient depth (time), too left-centered compression position (time) and mean chest compression depth (mm) (p<.05) to the left side of mannequin. Conclusion : The group having practice from both right and left sides of mannequin was superior in the quality of chest compression to the group having practice from only right side of mannequin. How to practice cardiopulmonary resuscitation from both right and left sides of mannequin can be recommended and practice from left side of mannequin is also useful.

• Progress in Medical Physics
• /
• v.7 no.1
• /
• pp.53-64
• /
• 1996

Purpose: The purposes of this paper are to develop a theoretical basis that the beam directions should be considered when the mechanical accuracy of teletherapy machine is evaluated by the star pattern test, to develop methods using asymmetric field in length to simulate beam direction for the case that beam direction does not appear on film. Method: In evaluating mechanical rotational accuracy of the gantry of teletherapy unit by the star pattern test, the direction of radiation beams was considered. A star pattern using some narrow beams was made. Density profiles at 10cm far from estimated gantry axis on the star pattern were measured using an optical densitometer. On each profile, one coordimate of a beam axis was determined. A pair of coordinates on a beam axis form an equation of the axis. Assume that a unit vector equation omitted is with same direction as radiation beam and a vector equation omitted is a vector directing to the beam axis from the estimated gantry axis. Then, a vector product equation omitted ${\times}$ equation omitted is an area vector of which the absolute value is equal to the distance from the estimated gantry axis to the beam axis. The coordinate of gantry axis was obtained by using least-square method for the area vectors relative to the average of whole area vectors. For the axis, the maximum of absolute value of area vectors would be an accuracy of the gantry rotation axis. For the evaluation of mechanical accuracies of collimator and couch axes for which beam direction could not be depicted on a star pattern test film, narrow beams asymmetric in field length was used to simulate beam direction. Result: For a star test pattern to evaluate the mechanical accuracy of rotational axes of a telectherapy machine, the result considering beam direction was different from that ignoring beam direction. For the evaluation of mechanical accuracies of collimator and couch axes by means of a star pattern test, narrow asymmetric beams could simulate beam direction. Conclusion: When a star pattern test is used to evaluate the mechanical accuracy of a teletherapy unit, beam direction must be considered or simulated, and quantitatively evaluated.

• Korean Medical Education Review
• /
• v.22 no.3
• /
• pp.173-188
• /
• 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.

• Journal of Acupuncture Research
• /
• v.20 no.1
• /
• pp.191-201
• /
• 2003

Objective : To research the trends of study related to tension-type headache and migrain with acupuncture in PubMed, and to establish the hereafter direction of acupuncture. for tension-type headache and migrain. Methods : We searched in PubMed, with tension-type headache, migrain and acupuncture limitted by abstract and enterz data 10 years. Results : 1. The pattern of the study was as follows: Review article(18), Clinical Trials(23), meta analysis(2) and rondomized controlled trials(16). We further estimated 23 articles. 2. Many of these studies provide equivocal results because of designs, sample size and the others, but in the majority of the trials were concludes that acupuncture offers benefits in the treatment of headache. 3. Acupuncture methods need individualization, a carefully selected placebo and cross-over design must have adequate time between the two treatment periods.

• The Korean Journal of Emergency Medical Services
• /
• v.17 no.1
• /
• pp.21-39
• /
• 2013

Purpose : The purpose of this study is to provide the basic data to improve pre-hospital phase emergency care for acute myocardial infarction (AMI) patients by analyzing AMI patients' clinical characteristics and emergency care situations. Methods : Data were collected through medical records of 385 AMI patients including ambulance records of 107 AMI patients transferred to the emergency medical center for three and a half years. Results : Regarding emergency care for AMI patients in pre-hospital phase, 47% of the care revealed moderate level or higher, and appropriateness of pre-hospital phase emergency care for cardiopulmonary complaints practiced by paramedics showed statistically significant improvement in recent years (p<.001). The time from onset of symptom to ballooning intervention by 119 emergency services was shorter than that in other cases. However, emergency care by paramedic was mainly basic life support. Conclusion : Since prognosis of AMI shows vast differences depending on prompt detection and medical intervention, cooperation between pre-hospital and in-hospital phase is highly required. 119 paramedics should be trained focusing on the accurate assessment and emergency care, and medical direction should be activated. In addition, regulation on 12-lead EKG, cardiac enzyme analysis, use of analgesics and thrombolytic agents should be legally implemented.

• Radiation Oncology Journal
• /
• v.18 no.2
• /
• pp.114-119
• /
• 2000

Purpose : To evaluate the e지ent and frequency of the inter- and intra-treatment isocenter deviations of the whole pelvis radiation field in using small bowel displacement system (SBDS). Methods and Materials : Using electronic portal imaging device (EPID), 302 postero-anterior 232 lateral portal images were prospectively collected from 11 patients who received pelvic radiation therapy (7 with cervix cancer and 4 with rectal cancer). All patients were treated in prone position with SBDS under the lower abdomen. Five metallic fiducial markers were placed on the image detection unit for the recognition of the isocenter and magnification. After aligning the bony landmarks of the EPID images on those of the reference image, the deviations of the isocenter were measured in right-left (RL), cranio-caudal (CC), and PA directions. Results : The mean inter-treatment deviation of the isocenter in each RL, CC, and PA direction was 1.2 mm ($\pm$ 1.6 mm), 1.0 mm ($\pm$3.0 mm), and 0.9 mm ($\pm$4.4 mm), respectively. Inter-treatment isocenter deviations over 5 mm and 10 mm in RL, CC, and PA direction were 2, 12, 24$\%$, and 0, 0, 5$\%$, respectively. Maximal deviation was detected in PA direction, and was 11.5 mm. The mean intratreatment deviation of the isocenter in RL, CC, and PA direction was 0 mm ($\pm$0.9 mm), 0.1 mm ($\pm$ 1.9mm), and 0 mm ($\pm$1.6 mm), respectively. All intra-treatment isocenter deviations over 5 mm in each direction were 0, 1, 1$\pm$, respectively. Conclusions : As the greatest and the most frequent inter-treatment deviation of the isocenter was along the PA direction, it is recommended to put more generous safety margin toward the PA direction on the lateral fields if clinically acceptable in pelvic radiotherapy with SBDD.