• 대한예방한의학회지
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• 제26권2호
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• pp.37-53
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• 2022

Objectives : This study analyzed the concordance between student self-assessment and peer-evaluation in a role play using the Clinical Performance Examination (CPX) scenario developed based on Korean medical syndrome differentiation. Methods : The subjects of this study are first-year-students majoring in Korean Medicine. The role play based on clinical case was performed in the class of Korean Medicine Classics. Feedback on clinical skill competency got through student self-assessment and peer-evaluation, and this study was compared and analyzed of result. Results : A simple comparison of the results of self-assessment and peer-evaluation in the evaluation results of clinical skill competency may appear to be consistent. However, it was not statistically significant. It is necessary to enhance the discriminative ability in the evaluation of clinical skill competency. It will be possible to improve a bit by relatively increasing the weight of the scores on the items that students expect to respond differently among the evaluation items. In addition, in order to dramatically improve the systemicity and reliability of the evaluation of clinical skill competency itself, it is necessary to introduce the Introduction to Clinical Traditional Korean Medicine (ICTKM) course. Conclusions : Student's self-assessment and peer-evaluation as feedback on clinical skill competency are suitable for the purpose of education and training. However, the reliability of the evaluation was not statistically significant.

• 한국응급구조학회지
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• 제28권2호
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• pp.7-19
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• 2024

Purpose: To adjust item numbers in a national test, this study used item response theory to examine changes in average scores, reliability, difficulty, and discrimination according to the adjustment of item numbers. Methods: We analyzed the dichotomous coding of correct and incorrect answers of 473 examinees in a mock test conducted in 2023. Additionally, as an explanatory pilot study, we used an online questionnaire to survey experts on their perceptions of the appropriate item numbers for each test subject from January 18, 2024, to February 15, 2024. Results: Regarding the item numbers on the national exam, experts preferred to reduce the number of management of emergency patients (33.14±6.09, p<.05) and advanced emergency medical care: subtopics (104.49±11.55, p<.05), and the total number of questions (217.82±20.95, p<.05). In a simulation set in which items with low item fit were removed after fitting a two-parameter item response theory model, reliability was maintained at .910 until the 5th test consisting of 185 questions with little loss of difficulty, discrimination, and average score, and there was no correlation between item numbers and average score. Conclusion: Experts responded that reducing the number of items on the national exam was appropriate. As a result of the item reduction simulation, there was no significant loss in the average score, difficulty, discrimination, or reliability. More reliable results could be obtained if the results were based on a validity analysis and analyzed using actual national exams.

• 한국병원경영학회지
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• 제24권4호
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• pp.1-12
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• 2019

Purposes: The purpose of this study, was to identify similar factors between reasons for unscreening and unmet health care needs through prior research, and based on this, we wanted to figure out the relevance between the medical screening and unmet health care needs. Methodology: The analysis was conducted using data from 9,640 adults aged 19 or older who don't have a missing value from 16,277 participants in the 7th, 1st&2nd Year (2016&2017) of the National Health and Nutrition Examination Survey (KNHANES). Unmet health care needs were investigated as a self-reported questionnaire of whether medical service was required but not received. And the analysis was performed through the Chi-Square Test and Multi-logistic Regression analysis. Findings: As a result of the analysis, unmet healthcare needs were higher who received only one type of screening comparative to who screened both. and were highest who screened neither. Practical Implications: Unmet health care needs are the center of a vicious cycle, such as morbidity and mortality, which is detrimental to the quality of life, and continues to increase. Therefore, it is necessary to find ways of realizing health care that guarantees the health rights of all citizens by policy guarantee and support for the subjects to recognize the importance of thorough education of screenings rather than only health screening or cancer screening.

• 동의생리병리학회지
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• 제23권3호
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• pp.534-539
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• 2009

Deficiency and excess pattern differentiation is unique characteristic of traditional oriental medicine on diagnosis and treatment. This differentiation is accomplished through pulse, tongue diagnosis and question examination, but most of these processes need to be objectified for efficacious treatment and traditional medicine development. In this study, we developed the deficiency and excess pattern questionnaire for objectification of question examination. The deficiency and excess pattern questionnaire was made out through The Traditional Oriental Medical Literature with Delphi Technique. Patients who visited oriental medical hospital filled out the questionnaire by themselves. Diagnosis of deficiency and excess pattern are conducted separately by oriental medical doctors with more than 5 years' clinical experience. Various physical condition factors were derived for the deficiency and excess pattern questionnaire. (Ordinary health degree, pain pattern, fatigue, weight change, sweating, uncomfortable awareness on chest and abdomen) Deficiency symptoms group acquired internal consistency, but excess symptoms group did not. (Cronbach's ${\alpha}$ > 0.6) There were significant associations between doctor's diagnosis and deficiency and excess symptoms in 'ordinary heath degree', 'voice weakening', and 'chest distress' (p-value < 0.1) There were significant differences between deficiency and excess syndrome patients groups in deficiency questionnaire score but there were no significant differences between deficiency and excess syndrome patients groups in excess questionnaire score. We acquired the internal consistency and significant result of deficiency pattern questionnaire, but we can find out some difficulties in development of the excess pattern questionnaire. These difficulties are associated with insufficiency description of traditional literature and small number of patients diagnosed as excess pattern.

• 동의생리병리학회지
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• 제27권2호
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• pp.268-272
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• 2013

This study is designed as pilot study to report the efficacy and safety of long term medication of Oncheongeum-gamibang on atopic dermatitis. The patient of atopic dermatitis was asked to take Oncheongeum-gamibang for 3 months. Every end of month, he had gotten hematological test and SCORAD Index examination. After the clinical trial was done, he had additional examination to see the changes and duration of medicinal effect. During the period of taking Onchung-um, estimation of symptoms by SCORAD Index examination showed little bit of improvement while taking medicine and after one month, the improvement was maintained. There were no significant changes in hematologic test and liver function test during and at the end of the clinical trial. We were able to find out that it is effective and safe to take long term medication of Oncheongeum-gamibang for an individual. However, due to deficiency of the cases and immunological values, there will be additional study to make up for better result.

• 핵의학기술
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• 제27권1호
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• pp.11-22
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• 2023

Bone densitometry is a disease in which bones are easily broken due to metabolic bone disease, and DXA is used as a clinical standard test. Although DXA is a good method with good accuracy and reproducibility, it is frequently subject to test errors in testing and result analysis and analysis. Therefore, it is important to recognize the error issues that radiologists should basically be aware of when performing bone density tests, prevent erroneous diagnoses and treatments resulting from the results, and reduce the unnecessary costs associated with them. aim. The inspection must be carried out if the quality control of the equipment is basically continuously performed well before the inspection. Before starting the examination, the patient's age, sex, race, weight, pregnancy status, and any foreign objects that can be removed should be checked, and the examination should be performed in the correct posture. In addition, it is important to analyze results consistently. Radiologists, who play the most important role in ensuring accurate examinations, need to be aware of the potential for errors in advance and develop the ability to deal with the potential for errors in each examination. For that reason, regular education is considered essential.

• 한국산학기술학회논문지
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• 제12권5호
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• pp.2149-2162
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• 2011

현행 실기시험의 형태가 실기능력 평가'라는 제 기능을 해내지 못함으로써 방사선사 면허시험에 합격하여도 임상적응(training) 과정을 이수해야 하는 모순이 발생되고 있다. 본 연구는 이러한 단점을 개선하기 위하여 현행 방사선사 실기시험제도 도입이 타당한지, 개선점은 무엇인지를 분석하여 가장 합리적인 개선 방안을 도출하고자 하였다. 연구대상은 임상에 근무 중인 방사선사 634명과 방사선(학)과 교수 56명을 대상으로 하였으며, 주요 선진국의 방사선사 실기시험의 실태를 조사하여 비교 분석하였다. 연구결과, 방사선선사 실기시험은 선진국과 국내 여건상 차이가 있어 임상실습으로 대체가 어려우며, 실기시험제도 도입이 필연적인 것으로 나타났다. 그러나 현행 실기시험 방식은 실기능력을 평가할 수 있는 시험 형태가 아니므로 객관적 임상능력 시험(OSCE; objective structured clinical examination)의 형태로 전환이 필수적이라는 결론을 얻었다. 향후 새로운 방사선사 실기시험 제도의 유형별 모델 제시 및 실행 방안에 관한 심도 있는 연구가 필요할 것으로 사료된다.

• 대한방사선기술학회지:방사선기술과학
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• 제27권4호
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• pp.37-41
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• 2004

목 적 : 측정을 통한 장치의 성능관리 평가로 임상실무에서의 능력배양과 정확한 관전압, 조사시간, 출력선량을 측정하는 기술을 익히고 병원에서 사용 중인 간접촬영용 X-선 발생장치 성능현황을 파악하기 위함이다. 재료 및 방법 : 관전압, 조사시간, 출력선량 측정기를 이용하여 10개 대학병원 간접촬영용 X-선 발생장치(원내,외 각 10대)를 이용하였다. 결 과 : 관전압 정확도 시험 PAE 판정에 의해 부적합한 간접촬영기는 3대가 나왔으며, 조사시간의 정확도 시험에서는 2대, 또한 조사선량의 재현성 시험에서도 조사선량에 대한 변동계수를 계산한 결과 3대가 나왔다. 3가지 성능검사에서 원외(이동차량)의 부적합한 간접촬영기는 5대, 원내는 3대로 원외(이동차량)의 간접촬영기가 원내보다 부적합한 것이 높게 나타났다. 결 론 : 간접촬영기의 성능을 일정하게 유지함으로서 방사선 피폭경감, 화질관리, 재촬영 감소 등에 의해 환자에게 양질의 의료서비스를 제공할 수 있는 여건을 마련할 수 있을 것이다. 따라서 정기적인 성능검사가 필요하다고 사료된다.

• 한국임상수의학회지
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• 제31권1호
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• pp.57-60
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• 2014

6개월령의 한국토종단모고양이가 발열, 빈호흡, 식욕부진, 체중감소로 내원하였다. 고양이는 10일 전 Fellocel$^{(R)}$ 백신을 접종받은 이후 증상을 보였다. 신체검사 결과 공막의 황달과 호흡곤란을 호소했다. 혈액혈구검사와 혈액화학검사에서 빈혈, 혈소판감소증, 백혈구증가증, 고빌리루빈혈증이 관찰되었다. 혈액도말 검사와 기타 검사를 통해 심한 용혈을 확인할 수 있었고 고양이 용혈성 빈혈을 감별진단 하기위해 Erhlichia, Hemobartonella, FeLV, FIV, Anaplasma PCR 검사를 의뢰하였다. PCR 검사 결과 Mycoplasma haemofelis 특이 208 bp의 양성밴드가 확인되었고, 다른 질병은 음성으로 진단되었다. 고양이는 4주 동안 Doxycycline을 사용하였고 급성기 1주 동안에는 prednisolone을 같이 사용하였다. 임상증상은 약물투여 4일째부터 호전되기 시작하였고 이후 PCR 재검을 통해 완치를 확인하였다. 이것은 M. haemofelis 감염 고양이의 진단을 확인하고 완치한 국내 첫 증례이다.

• 보건행정학회지
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• 제30권2호
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• pp.185-191
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• 2020

Background: From January 2018, a policy was applied to differentially apply the co-payment for medical expenses of 15,000 won or more from 30% to 10%-30% for each medical fee. This policy lowers the burden on the medical use of the elderly, and it is necessary to analyze the effect of the policy by confirming changes in medical use and supply behavior after 2 years. Methods: The National Health Insurance Service's national medical use database was used. As for the analysis method, first, the medical use and medical supply behavior change over the age of 65 years were confirmed, and second, in order to check the net effect of the policy, the 66-year-old as the experimental group and the 63-year-old as the control group were selected as the control group. The propensity score matching was performed using the variables of age, living alone, income quartile, residence, disability, chronic disease, and co-morbid disease scores, and then it was analyzed using the difference in difference analysis method. Results: The share of the number of treatments under 15,000 won decreased from 37.0% in 2017 to 20.2% in 2018, while the share of the number of treatments under 15,001-20,000 won increased from 8.0% to 22.7%. It was confirmed that the reason for the increase in the cost of treatment per treatment was the result of the increase in the amount of physical therapy and examination. As a result of the policy effect, the burden of co-payment per person was reduced, and as a result, the number of hospital visits per person and the total medical cost per person increased. Conclusion: The self-pay rate differential policy reduced the burden of medical expenses for the elderly and confirmed the increase in medical use. However, the interpretation of the increase in medical use was not able to distinguish whether the unsatisfactory medical care was satisfied or the inducement demand. Efficient allocation of resources is a more important point in the future when the super-aged society is in front. It is necessary to prepare a plan to induce rational medical use within a range that does not impair the medical accessibility of the elderly.