• 제목/요약/키워드: school doctor

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과학영재교육원 생물반 중학생들의 특성: 자가조절학습능력에 따른 개인적 성향 및 학습선호도 (Characteristics of Middle School Students in a Biology Special Class at Science Gifted Education Center: Self-regulated Learning Abilities, Personality Traits and Learning Preferences)

  • 서혜애
    • 영재교육연구
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    • 제19권3호
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    • pp.457-476
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    • 2009
  • 본 연구에서는 2009년도 대학교 부설 과학영재교육원 생물 영재반에 재학하고 있는 중학교 2학년 학생 20명을 대상으로 자기조절학습능력의 수준을 분석하고, 자기조절 학습능력의 수준에 따른 학생들의 개인적 성향과 이들의 학습선호도를 조사하였다. 생물 영재반에 소속된 중학교 2학년 학생들의 자기조절학습능력은 인지전략, 메타인지, 동기차원에서 선행연구의 영재들보다 높은 수준을 보인 반면, 환경차원에서는 상대적으로 낮은 수준으로 나타났다. 자기조절학습능력의 구성요소인 인지전략은 메타인지 및 동기차원과, 메타인지는 환경차원과 높은 상관관계를 가지는 것으로 나타났다. 연구대상 학생들 가운데 자기조절학습능력이 상위권에 속하는 학생들의 개인적 성향은 서로 다른 것으로 나타났다. 섬세하고 여리며 신중한 성격을 지닌 학생으로 의학계의 성향에 치우치며 장래 의사를 희망하는 반면, 과학자로서의 높은 포부를 표현한 학생은 자연계 성향으로서 추상적이고 창의적이며 확산적으로 사고하는 특성이 두드러졌다. 자기조절학습능력은 높으나 개인적 성향이 서로 다른 것으로 나타났지만 공통적으로 가장 싫어하는 과학수업은 암기위주 이론중심 강의수업이며, 생각하지 않고 필기만 하는 것이었다. 학생들은 실험과 토론, 실험, 또는 토론중심 과학 수업을 선호하는 것으로 나타났다. 토론을 선호하는 이유에는 다른 사람의 의견을 듣기 위한 것이 있는 반면, 자신의 의견을 발표하고자 하는 이유도 제시되었다. 가장 선호하는 과학교사는 질문하고 흥미를 일깨워주는 친근하고 활동적인 사람이었다. 결론적으로 과학영재교육은 우선적으로 개별학생들의 개인적 성향을 상세히 파악하고, 학생들이 선호하는 실험활동 중심 토론식 수업에서 개별학생이 흥미있어 하는 개별 맞춤식 주제 관련 질문을 강화하는 수업이 효율적임을 시사한다.

치과건강보험 요양급여비용 청구에 관한 교육요구도 조사 -대전·충청지역을 중심으로- (The investigation of the degree of the request of the education about the claim for the medical expenses in the dentistry health insurance - mainly in the Daejeon, Chungcheong area -)

  • 남용옥;김성희;김민자
    • 한국치위생학회지
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    • 제11권3호
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    • pp.325-341
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    • 2011
  • Objectives : This research has investigated the reality of the education of the claim and the degree of the education for the claimed of the dentistry recuperation organization in the Daejeon and Chuncheong are for the improvement of the problem in the medical expenses. Methods : It use as a basic data for the vitalizations of the education and performed the survey in the dentistry recuperation organization in the Daejeon and ChungCheong Nam BukDo which are registered in the evaluating organization for judging the health insurance in the present May 2010, and concluded just like the below. Results : 1. The education of the claim in the requirer in the dentistry recuperation organization, and the education of the claim was especially lacking when the dentist was studying in the university, and the dental hygienist had the similar educational experience in the school and the clinic (p<0.05) 2. Most of the requirer in the dental recuperation organization was hoping to get the education related to the claim work, but the dentist and the nurse's aid was relatively low (p<0.05) 3. For fixing the error of the claim, the participation and the extension of the judging standard of the insurance was the highest among the university subordinate dental hospital/dental hospital, but the health center was relatively low (p<0.05). 4. The dentist feels the economic burden in employing the special employee because the raising of the special judging people, compared to others, but the staffs such as the dental hygienist preferred it as one of ways to fix the error of the claim of the dental insurance (p<0.05) 5. Both dentists and the dental hygienist said proper time to teach the insurance was all needed in the school, and the clinic, but other workers relatively believed it should be held in the clinic (p<0.05). 6. The important factors to decide the participation of the lecture was in order of the contents of the lecture, the place of the lecture, the amount for the lecture, the superintendent of the lecture, whether it has gone through the educational score, and whether it has passed the conserving educational score was relatively less important in the university subordinate dentist/dentist, but the medical center was very effective as 4.50 (p<0.05) 7. Health Insurance Review and assessment service was very high as the managing department for supplying the lecture and the information, 70.5%, and the next was the Korean Dental Association/ Korean dental hygiene association, but dentists were preferring the association to manage in than the Health Insurance Review and assessment service to manage (p<0.05) 8. In preferring lecture for the inquiring the insurance, periodontal surgery was the highest as 4.51, the diagnosis standard for injection was high in the university subordinate hospital/dentists, and the more the year of the insurance inquiry, the less the doctor who was hoping for the lecture about the basic treatment. Conclusions : Taken together, it is decided that the inquiry education about the medical expense in the dentist, so the consistent and systematic education should be held to the related people, and from this, it is thought to reduce the problem of the inquiry of the medical expenses by fostering the knowledge and supplying the information which are related to the inquiry of the dentists.

병원 단위비용 결정요인에 관한 연구 (Analyses of the Efficiency in Hospital Management)

  • 노공균;이선
    • 한국병원경영학회지
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    • 제9권1호
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    • pp.66-94
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    • 2004
  • The objective of this study is to examine how to maximize the efficiency of hospital management by minimizing the unit cost of hospital operation. For this purpose, this paper proposes to develop a model of the profit maximization based on the cost minimization dictum using the statistical tools of arriving at the maximum likelihood values. The preliminary survey data are collected from the annual statistics and their analyses published by Korea Health Industry Development Institute and Korean Hospital Association. The maximum likelihood value statistical analyses are conducted from the information on the cost (function) of each of 36 hospitals selected by the random stratified sampling method according to the size and location (urban or rural) of hospitals. We believe that, although the size of sample is relatively small, because of the sampling method used and the high response rate, the power of estimation of the results of the statistical analyses of the sample hospitals is acceptable. The conceptual framework of analyses is adopted from the various models of the determinants of hospital costs used by the previous studies. According to this framework, the study postulates that the unit cost of hospital operation is determined by the size, scope of service, technology (production function) as measured by capacity utilization, labor capital ratio and labor input-mix variables, and by exogeneous variables. The variables to represent the above cost determinants are selected by using the step-wise regression so that only the statistically significant variables may be utilized in analyzing how these variables impact on the hospital unit cost. The results of the analyses show that the models of hospital cost determinants adopted are well chosen. The various models analyzed have the (goodness of fit) overall determination (R2) which all turned out to be significant, regardless of the variables put in to represent the cost determinants. Specifically, the size and scope of service, no matter how it is measured, i. e., number of admissions per bed, number of ambulatory visits per bed, adjusted inpatient days and adjusted outpatients, have overall effects of reducing the hospital unit costs as measured by the cost per admission, per inpatient day, or office visit implying the existence of the economy of scale in the hospital operation. Thirdly, the technology used in operating a hospital has turned out to have its ramifications on the hospital unit cost similar to those postulated in the static theory of the firm. For example, the capacity utilization as represented by the inpatient days per employee tuned out to have statistically significant negative impacts on the unit cost of hospital operation, while payroll expenses per inpatient cost has a positive effect. The input-mix of hospital operation, as represented by the ratio of the number of doctor, nurse or medical staff per general employee, supports the known thesis that the specialized manpower costs more than the general employees. The labor/capital ratio as represented by the employees per 100 beds is shown to have a positive effect on the cost as expected. As for the exogeneous variable's impacts on the cost, when this variable is represented by the percent of urban 100 population at the location where the hospital is located, the regression analysis shows that the hospitals located in the urban area have a higher cost than those in the rural area. Finally, the case study of the sample hospitals offers a specific information to hospital administrators about how they share in terms of the cost they are incurring in comparison to other hospitals. For example, if his/her hospital is of small size and located in a city, he/she can compare the various costs of his/her hospital operation with those of other similar hospitals. Therefore, he/she may be able to find the reasons why the cost of his/her hospital operation has a higher or lower cost than other similar hospitals in what factors of the hospital cost determinants.

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의료법학 20주년 회고와 전망(의료형법 분야) (Retrospect and Prospect of Medical Law 20th Anniversary (Medical Criminal Law))

  • 하태훈
    • 의료법학
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    • 제20권3호
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    • pp.47-79
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    • 2019
  • 대한의료법학회는 지난 20년 동안 의료법 관련 학회의 향도로서, 학술활동과 그 축적된 업적, 그리고 학회 회원 구성의 다양성 및 전문성, 학계에 미치는 영향력 면에서 전문학술단체의 역할을 충실히 수행해 왔다. 대한의료법학회의 활동과 학술지 『의료법학』은 의료법학 관련 학술정보 및 의견교류의 플랫폼으로 기능하고 있다. 의료과오로 인한 갈등과 분쟁이 잦아지고 증가하는 상황, 의료에 대한 법제화와 법적 강제가 의료인을 직업수행에 압박으로 다가오는 상황 속에서 『의료법학』은 시작되었다. 의학과 법학의 조우와 융합을 통해서 서로 상생하는 방안을 찾고자 노력했던 것이다. 의료형법은 생명 및 신체보호의 영역에서 발생하는 전통적인 범죄에서 더 나아가 생명의료기술의 발전에 따른 생명윤리위반 행위와 의료영역에서의 부패 및 경제범죄 등으로 넓어지고 있다. 의료법학은 의료, 보건, 생명윤리, 생명과학기술 등에서 제기되는 법적 문제를 다루는 포괄적 법영역으로 발전하였다. 법적인 측면에서 보면 민법, 행정법, 형법, 사회법, 민·형사소송법 등 전통적인 법영역이 독립적이거나 중첩적으로 관련된 영역으로서 독자적인 법영역은 아니다. 그러나 이제는 법학 내에서의 여러 분야뿐만 아니라 의학, 생명윤리, 생명과학 등과의 융합법학으로서 자리하게 되었다. 법학, 의학, 윤리학, 사회학, 경제학 등 협업이 필요한 영역이 되었다. 의료형법은 지난 20년간 역동적인 발전을 거듭했다. 의학과 의료기술발전에 따라 새롭고 혁신적인 진단 및 치료방법을 제공하고 있다. 생명공학·유전공학과 의학의 혁명적 발전이 가져온 성과와 위험은 병존한다. 질병퇴치와 건강개선이라는 인류가 바라던 눈부신 성과가 있는 반면 원치 않은 부수적 효과와 인간에 대한 위험이 야기된다. 윤리적 및 법적 원칙들을 재고해야 할 필요성이 대두된다. 환자의 주체성과 자율성의 발견과 발전은 의사와 환자의 관계를 변화시켰다. 더 나아가 환자·의사·보험이라는 삼각관계로 법적인 문제도 복잡해진 것이다. 법제화의 필요성이 대두되는 이유다. 형사처벌 규정도 필요하다. 의료법 및 (생명)의료관계법령은 충분한 제·개정절차가 진행되기보다는 사회적 이슈와 시민의 요구, 의료인 등 이익단체의 요구가 있을 때마다 행해지는 모자이크식 입법으로 체계성과 정합성이 흠결되어 있다. 재정비가 필요한 부분인데, 이것이야말로 학회의 장점인 학제 간 협업으로 가능한 일이다.

종합병원(綜合病院)의 간호행위양상(看護行爲樣相)에 따른 간호원가(看護原價) 산정(算定)에 관(關)한 연구(硏究) (A Study on Accounting for Nursing Cost by Korean Diagnosis Related Groups (K - DRGs))

  • 오효숙
    • 한국보건간호학회지
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    • 제3권2호
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    • pp.5-46
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    • 1989
  • The current medical payment Insurance Rates in Korea stipulate charges for medical treatment by the doctor, pharmaceutist, medical technician and maternity nurse. But unfortunately didn't specify those charges for nursing done by the professional nurse. Only basic nursing fee is accounted insufficiently in current medical insurance fee schedule. therefore, Being face with covering entire people by medical insurance by 1991, It seems that the problems pertaining to operating the hospital and medical insurance system would be incessantly expanded in that no mention is made of medical charges rendered by major medical producer service in the current system, For that reason, this study made an attempt to clarify the importance the professional nursing puts of the current medical payment. The purpose of this study was to accounting nursing fee which diveded into the current medical fee schedule. (Method) 1. Data collection; Importance and difficulties in nursing activities was conducted in 'S' National University Hospital. Total nursing activities were selected 72 items which included direct care and indirect care. This study was conducted to evaluating the degree of importance and difficulties according to nursing activities through questionnaire to 204 RN. and so relative difficulties (acuity) were computered because the nursing cost level of each nursing service was differently established by the equivalent coefficient according to degree of relative difficulty and time required. 2. Calculation of cost according to nursing activities; After 47 nursing activities were selected in General surgery nursing units, calculation of nursing cost was as follows Cost of Nursing activity = (relative difficulty X Average hourly wage and benefits of nurse) + material cost of nursing -t- Average nursing administration cost So, Calculated cost by nursing activities was compared to current non-insured and insurance rate. 3. Calculation of nursing cost by K - DRG ; Total of 578 patients who were hospitalized in General Surgery units from January to March 1988 ware classified by K - DRG After estimation of total nursing cost based on the K-DRG, verified the appropriateness of basic nursing fee in medical insurance rate (Results) 1. Analysis of degree of importance and difficulties were 4.16 and 3.67 based on 5 point scale. This score were judged that it is worthy specifying the nursing fee 2. The nursing cost of 47 nursing service items in general surgery patients showed that the average cost of nursing activity was \1374.5 and The lowest cost was \217 of 'oral administration nursing' item, The highest cost was \11,025 of 'saline enematill clear' item 3. The result of comparison between the calculated cost by nursing activities against the current non-insured and insurance rate showed that 13 items(27.7%) involved to payment of insurance rate, 9 items(19.1%) involved to non-insured rate, remainder 25 items (53.2%) were not charged anywhere of total 47 nursing activities 4. When calculated cost by nursing activities was 100. current insurance rate was 62.3, non-insured rate was 176.6. Therefore this showed that most of non-insured rate were higher than calculated nursing cost. The insurance rate, however, were lower than it. Reim-bursement was imputed to non-insured patients. So the current rate system became estrainged from cost system. When Remainder 25 items of nursing activities compared' to \1390 of daily basic nursing fee per patient belonged to payment as a insurance fee schedule, basic nursing fee schedule was 1-2% of calculated cost of nursing activities. Therefore it showed that nursing fee was not counted adequately in it. 5. Nursing cost by K-DRG estimated in chart review based on counting number of nursing activities and length of stay The result showed that average amount of total nursing cost was \183828.1 Comparison of nursing cost calculated by K- DRG and basic nursing fee schedule showed that only 12.3% of nursing cost was charged (Conclusion) From the above research result, It is fact that nursing prime cost should be estimated more accurately and included adequately in current medical payment system. The payment system of nursing activities should be introduced not only nursing activities of drug administration and injection fee belonged to insurance fee schedule but also most nursing activities belonged not to mekical fee schedule. Even if introducing payment system of nursing activities, It should be estimated scientific method of Accounting nursing cost So nurses could offer nursing care of good quality, thereby they could make a great contribution not merely to the convalescence of the patient but to the promotion of the people's health.

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한국표준질병사인분류중 한방내과영역의 분류체계 개선 및 진단명 구성에 관한 연구 (The Research about the Classification System Improvement and Cord Development of Korean Classification of Disease on Oriental Internal Medicine)

  • 이원철
    • 대한한방내과학회지
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    • 제31권1호
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    • pp.1-10
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    • 2010
  • Objectives : It is necessary that the international classification of diseases (ICD) be examined in order to comprise the third revision of the Korean Classification of Disease on Oriental Medicine (KCD-OM) and disease classification in the oriental internal medicine field. It is essential that the selection, classification and definition of disease and pattern names of oriental concepts in internal medicine be clear. Since 2008, the fifth revision of the Korean Classification of Disease (KCD-5) has been used in Korea. It was required to use the reference classification from the Oriental medicine area based on the ICD-10. Methods : In this review, the necessity for, meaning of and content of the third revision are briefly described. The ICD system was reviewed and KCD-OM was reconstructed. How diagnosis in the oriental internal medicine area had changed is discussed. Review and Results : In 1973, the disease classification of oriental medicine was established the basis on the contents of Dongeuibogam. It was irrespective of the ICD. As to the classification system in the Oriental internal medicine field, systemic disease was comprised of wind, cold, warm, wet, dryness, heat, spirit, ki, blood, phlegm and retained fluid, consumptive disease, etc. Diseases of internal medicine comprised a system according to the five viscera and the six internal organs and followed the classification system of Dongeuibogam. The first and second revisions were of the classification system based on the curriculum in 1979 and 1995. In 1979, in the first revision, geriatric disease and idiopathic types of disease were deleted, and skin disease was included among surgery diseases. This classification was expanded to 792 small classification items and 1,535 detailed classification items to the dozen disease classes. In 1995, in the second revision, it was adjusted to 644 small classes and 1,784 detailed classification items in the dozen disease classes. KCD-OM3 did KCD from this basis. It added and comprised the oriental medical doctor's concept names of diseases considering the special conditions in Korea. KCD-OM3 examined the KCD-OMsecond revised edition (1994). It improved the duplex classification, improper classifications, etc. It is difficult for us to separate the disease names and pattern names in oriental medicine. We added to the U code and made one classification system. By considering the special conditions in Korea, 169 codes (83 disease name codes, 86 pattern name codes) became the pre-existence classification and links among 306 U codes of KCD-OM3. 137 codes were newly added in the third revision. U code added 3 domains. These are composed of the disease name (U20-U33, 97 codes), the disease pattern name (U50-U79, 191 codes) and the constitution pattern name of each disease (U95-U98, 18 codes). Conclusion : The introduction of KCD-OM3 conforms to the diagnostic system by which oriental medical doctors examine classes used with the basic structure of the reference classification of WHO and raises the clinical study and academic activity of the Korean oriental medicine and makes the production of all kinds of nation statistical indices possible. The introduction of KCD-OM3 promotes the diagnostic system by which doctors of Oriental medicine examine classes using the association with KCD-5. It will raise the smoothness and efficiency of oriental medical treatment payments in the health insurance, automobile insurance, industrial accident compensation insurance, etc. In addition, internationally, the eleventh revision work of the ICD has been initiated. It needs to consider incorporating into the International Classification of Diseases some of every country's traditional medicine.

환자분류에 의한 일개 2차 의료기관의 간호업무량 조사;전산화를 위한 기초작업으로서 (Measurement of the Nursing Workload by Patient Classification System in a Secondary Hospital;As a Preliminary Step for Computerization of Nursing Staffing and Scheduling)

  • 박정호;조현;박현애;한혜라
    • 간호행정학회지
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    • 제1권1호
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    • pp.132-146
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    • 1995
  • Even though Korean medical law stipulates that number of patients attended by a nurse is 2.5 for hospitalization and 30 for ambulatory care, the number of patients cared by a nurse per day is much greater than the standard prescribed by the medical law. Current productivity of nurses is not desirable unless the quality of care is considered. And nursing manpower staffing based on neither current nurses' productivity nor standard of medical law cannot respond properly to dynamic situation of the medical services. Under this background, the necessity of more efficient management of nursing manpower occupying 1/3 of total hospital workers has been recognized by many nursing administrators. Many nursing researchers have studied to foretell the nursing manpower objectively on the basis of measured nursing workload according to patient classification as well. Most of These researches, however, have been conducted in the tertiary hospitals, so it is imperative to conduct other researches to predict necessary nursing manpower in the secondary and the primary hospitals. The study was performed to measure nursing workload and predict pertinent nursing manpower to a secondary hospital with 400beds. Nursing workload was surveyed using measuring tool for direct and indirect care hours in a surgical unit and a medical unit. Survey was conducted from Sep.10 to Sep.16 and from Oct.5 to Oct.11, 1994 respectively by two skilled nurses, Subjects were patients, patients' family members and nursing personnels. Results are follows : 1. Patient classification distributed as 22% of class I (mildly ill patient), 57% of class II (moderately ill patient), and 21% of class III (acutely ill patient) in the medical nursing unit, while 23% of class I, 29% of class II, 12% of class III, and 36% of classIV (critically ill patient) in the surgical nursing unit. There was no difference of inpatient number between weekday and weekend. Bed circulation rate was 89% in both units and average patients number per day was 37.4 (total 42beds) in the medical nursing unit, 32.9 (total 37beds) in the medical nursing unit. 2. Direct care hours per day measured as 2.8hrs for class I, 3.3hrs for class II, and 3.5hrs for class III in the medical nursing unit, while 3.1hrs for class I, 3hrs for class II, 2.7hrs for class III, and 2.2hrs for classIV in the surgical nursing unit. Meanwhile, hours for nursing assistant activities per patient by patients' family members were 11mins and 200mins respectively. Direct care hour rate by shift was day 36%, evening 25%, and night 39% in the medical nursing unit, while 40%, 29%, and and 31% respectively in the surgical nursing unit. 3. Measurement and observation activity held 44.2% of direct care activities of nurses and medication 36.7%, communication 11.7%, exercise 1.8%, treatment 1.3%, hygiene 1.3%, elimination and irrigation 1.1%, suction 1%, nutrition 0.5%, thermotherapy 0.3%, oxygen therapy 0.1% in order. 4. Indirect care hours per day were 294.2mins in the medical nursing unit, and 273.9mins in the surgical nursing unit. By shift, evening was the highest in both units. Indirect care hours for each patient were 44.5mins in the medical nursing unit and 46mins in the surgical nursing unit. 5. checking activities including doctor's order, medication, and delivering patients to the next shift occupied 39.7% of indirect care activities, and preparation 26%, recording 23.8%, communication and conference 6.7%, managing equipments 2.1%, messenger activity 1.7% in order. 6. On the ground of these results, nursing manpower needed in a secondary hospital was estimated ; 27 nursing personnels for the medical nursing unit of 37beds, and 20 nursing personnels for the surgical nursing unit of 33beds.

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의료시장 개방에 따른 국내병원 대응에 대한 치위생과 학생들의 견해에 관한 연구 (A Study on the Outlook of Dental Hygiene Students on the Possible Countermeasure of Domestic Hospitals for the Opening of the Medical Market)

  • 윤현서;김동열
    • 치위생과학회지
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    • 제9권4호
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    • pp.443-451
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    • 2009
  • 부산지역에 소재한 2개 대학 치위생과 1, 2, 3학년에 재학 중인 학생 269명을 대상으로 의료시장 개방에 따른 국내 병원의 대응 방안에 대한 조사 분석의 결과는 다음과 같다. 1. 찬반의견과 대응방안에서 고객만족 병원마케팅의 수립(p=0.023), 해외의료시장 분석 및 진출 모색(p<0.000), 의료서비스의 질 개선 및 다양화(p=0.025)에서 통계적으로 유의한 차이를 보였다. 2. 치과 병 의원 실습 및 아르바이트 경험 유무와 대응 방안은 경험이 있는 경우 병원이미지 차별화(p=0.01), 국민건강보험 수가 현실화(p=0.004), 보험 급여대상 확대(p=0.012)평점이 높고 통계적으로 유의하였다. 3. 학년과 대응방안은 학년이 높을수록 병원이미지 차별화(p=0.009), 국민건강보험 수가 현 실화(p=0.004), 보험 급여대상 확대(p=0.045) 평점이 높고, 통계적의로 유의한 차이를 보 였다. 4. 보건/의료관련 기사에 대한 관심 유무와 대응방안은 관심이 있는 경우 경영의 합리화 (p<0.000), 중소병원과 대형 병원간 협력관계 구축(p=0.027), 고객만족 병원마케팅의 수립 (p<0.000), 의료시장 변천에 따른 정책 개발(p=0.001), 해외의료시장 분석 및 진출모색(p=0.001), 의료서비스의 질 개선 및 다양화 (p<0.01), 직원 친절서비스교육 및 훈련 (p=0.01), 병원의 이미지 차별화(p=0.012), 진료예약제의 개선(p=0.025), 병원 부대시설 의 개선(p=0.029), 의사들의 의식 개혁(p=0.007)에서 평점이 높았으며 통계적으로 유의한 차이를 보였다. 5. 외국 병원 이용의사에서는 진료비와 상관없이 이용 (p<0.000), 국내병원 진단 후 외국병 원에서 재 진단 유무(p<0.000), 거주지와 거리부분(p=0.05), 의료서비스가 진료비와 진료 비(p=0.005), 통역사의 도움부분(p=0.023)에서 통계적으로 유의하였다. 외국 병원 선호 국 가에서 1위 미국(41.9), 2위 호주(19.9), 3위 캐나다(14.2)순으로 나타났다.

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구급대원의 전문심장소생술 시뮬레이션훈련이 직무수행융합능력에 미치는 영향 (The effects of out of hospital ACLS simulation training on the paramedic's duty ability)

  • 박유나;조병준;김경용
    • 한국융합학회논문지
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    • 제10권4호
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    • pp.99-106
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    • 2019
  • 본 연구는 시뮬레이션을 기반으로 한 전문심장소생술 교육이 병원 전 단계에 구급대원이 환자에게 시행하는 전문심장소생술 직무수행에 미치는 영향을 분석하고 효과적인 전문심장소생술을 시행하기 위한 기초자료를 제공하는데 그 목적이 있다. 비동등성 대조군 전후 설계를 기초하였으며 연구대상은 K소방학교의 신규 임용된 구급대원 16명이 참여하였다. 평가 도구로 사용된 시뮬레이션 교육 프로그램과 평가지는 ACLS 시뮬레이션 전문가 6인(응급의학 전문의 2명, 전공교수 2명, 전문강사 2명)에게 사전 검토 및 의견을 받아 본 연구에 적합한 도구로 개발하였다. 교육은 이론 30분, 실습 150분으로 구성하여 4인 1조 1개팀으로 구성하였다. 강사가 5분간 시연을 한 후 개인별 실습 후 디브리핑(debriefing)을 통한 교정을 거친 후 개별, 팀별 교육을 실시하였다. 평가척도는 5점 리커트(Likert) 척도로 수행능력 평가 점수를 부여하였다. 자료분석은 Windows용 SPSS 22.0 프로그램을 사용하였으며, 대상자의 일반적 특성은 빈도분석을 하였으며, 실험군과 대조군의 동질성 검증은 t검정을 하였고 두 그룹의 집단의 차이 분석은 대응표본 t 검정(paired t-test)으로 분석하였다. 동질성 검사에 실험군과 대조군의 동질성을 확인 할 수 있었다. 전문심장소생술(ACLS) 수행기술 6가지에 대한 평가에서 시뮬레이션 교육을 받은 실험군이 교육을 받지않은 전통적 교육 방식의 대조군보다 모든 면에서 수행능력이 우수하였음을 증명하였다. 수행기술은 1. 심전도 2. 전문기기 3. 수액처치 4. 리더십과 팀워크 5. 의료지도 6. 이송중 평가 이상 6가지 이다. 일반적인 강의와 실습을 한 구급대원보다 시뮬레이션 교육을 받은 구급대원이 직무수행 능력이 향상된 것이 검증되었다 따라서 종합술기 과정에 있는 학생이나 임상에 종사하는 응급구조사에게 시뮬레이션 훈련과 교육이 확대 적용된다면 더 능숙하게 직무를 수행해 나갈 수 있을 것이며, 심정지 환자에게 제공되는 구급서비스가 향상될 것으로 기대한다.

산림법제도의 변천과 산림전문가 양성의 체계에 관한 연구 (A Study on the Changes in Forest Laws and System of Forest Specialists)

  • 윤종면;김동필;김영하
    • 한국조경학회지
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    • 제49권6호
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    • pp.1-15
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    • 2021
  • 본 연구는 산림청 소관 법령분석을 통해 법제도에 의해 양성되는 산림전문가를 고찰했다. 특히, 산림관련 법률의 변천과정과 산림전문가를 양성하는 법률을 파악하고, 산림정책 분야에 따른 산림전문 인재 양성에 관한 변화 및 특성을 규명했다. 그 결과, 산림산업 정책에 관한 산림전문가는 임야를 가지고 임업진흥을 위한 임업후계자와 산림산업 발전을 위한 기술능력을 갖춘 산림기술자가 있으며, 목재의 지속가능한 이용을 위한 법률 개정에 따라 목구조기술자, 목재등급평가사, 목재교육전문가를 별도로 양성하는 것으로 나타났다. 산림복지 정책에 관한 산림전문가는 산림에 설치하는 산림문화 휴양시설, 치유의 숲, 산림레포츠시설의 다양한 서비스를 제공하기 위해 전문 교육과정을 이수하는 산림전문가를 양성하는 것으로 밝혀졌으며, 산림복지전문가와 산림레포츠지도사가 있다. 산림복지전문가는 산림교육전문가와 산림치유지도사로 구분되며, 산림교육전문가는 숲해설가, 유아숲지도사, 숲길등산지도사로 구분하고 있다. 산림보호 정책에 관한 산림전문가는 수목원과 정원의 효율적 관리 및 전시를 위한 수목원·정원 전문가와 수목진료를 위한 나무의사와 수목치료기술자를 양성하는 것으로 나타났다. 나무의사와 수목치료기술자는 수목피해 진단 및 치료를 위한 나무병원업을 운영하기 위해 필요한 자격조건으로 밝혀졌다. 따라서 산림청은 임업 진흥 및 산림산업 발전과 수목진료를 위한 기술능력을 갖춘 산림전문가와 산림 내 문화·휴양·치료·보전 등의 시설에서 교육 및 복지 서비스를 제공하는 산림전문가를 양성하는 것으로 사료된다.