ABSTRACT
Needs for public healthcare have recently increased. This paper proposes education topics for competency development in public healthcare in line with the needs of the times. In Korea, various lifelong education providers have already provided public health-related education. For example, the Research Institute for Health Policy (RIHP) under the Korean Medical Association provided an “executive course for physicians’ public health care competencies” in 2019 and 2020. At the end of the course, the RIHP published a comprehensive report, entitled “Curricular development and evaluation for doctors’ public healthcare competencies.” This article is based on a summary of that report. To develop a curriculum for public healthcare, the RIHP adopted the following methodologies for a needs analysis; reviewing already-existing education subjects, evaluating end-of-course reports, and conducting in-depth focused group interviews and questionnaire surveys with doctors at public healthcare-related institutions. The results from the needs analysis can be categorized into two domains of education topics for public healthcare. The first domain includes education subjects related to the theory and practice of public healthcare, as follows: a general overview, community or population health, organizational administration, planning and evaluation, budget and finance, responses to disasters such as infectious diseases, health policy, and the legal system. The second domain contained education topics related to general professional competencies: leadership, communication, cooperation, teamwork, and professionalism. In conclusion, the curricular content for public healthcare will be an appropriate combination of competencies specific to public healthcare and core competencies for health professionals.
ABSTRACT
Attention to medical professionalism has recently increased in S. Korea. The concept of the word ‘professionalism’ can be difficult to translate into Korean. Professionalism for individual doctors is not difficult to explain, but professionalism of organizations or collective dimension of professionalism are difficult to conceptualize in Korean. This might be due to the different trajectory of professional history of S. Korea from western countries. The collective dimension of medical professionalism is artificially divided into three main areas: professional ethics, clinical autonomy, and self-regulation. The concept of self-regulation is unfamiliar not only to Korea, but also to other Confucian countries such as China and Japan, where all regulatory matters are the responsibility of government entities. Medical professional societies do not have the authority to conduct self-regulation. Contemporarily, doctors organizations are classified according to regulatory or trading function. Medical associations usually are categorized as a trade association or trade union, while the medical council is the medical regulatory authority that guides doctors and their practice. However, patient care is a priority regardless of classification. An organization centered on diabetes mellitus could be classified as a doctors’ organization. Its role must be given to guide the best practice, also to prevent the bad practice for the management of diabetes mellitus based on the principle of self-regulation. To achieve this goal as a professional organization, members must be educated to understand the collective dimension of the medical professionalism.
ABSTRACT
Currently, accreditation in medical education is a priority for many countries worldwide. The World Federation for Medical Education’s (WFME) launch of its 1st trilogy of standards in 2003 was a seminal event promoting accreditation in basic medical education (BME) globally. In parallel, the WFME also actively spearheaded a project to recognize accrediting agencies within individual countries. The introduction of competency-based medical education (CBME), with the 2 key concepts of entrusted professional activity and milestones, has enabled researchers to identify the relationships between patient outcomes and medical education. The recent data-driven approach to CBME has been used for ongoing quality improvement of trainees and training programs. The accreditation goal has shifted from the single purpose of quality assurance to balancing quality assurance and quality improvement. Although there are many types of postgraduate medical education (PGME), it may be possible to accredit resident programs on a global scale by adopting the concept of CBME. It will also be possible to achieve accreditation alignment for BME and PGME, which center on competency. This approach may also make it possible to measure accreditation outcomes against patient outcomes. Therefore, evidence of the advantages of costly and labor-consuming accreditation processes will be available soon, and quality improvement will be the driving force of the accreditation process.
ABSTRACT
The Korean Medical Association (KMA) was established by legal mandate. It is a statutory body for the medical profession. However, the collective dimension of professionalism is a foreign concept for Korean doctors; the KMA is perceived as a fraternity of physicians. Korea’s history of medical professionalization is different from that of Western countries where two different kinds of professional organization have developed: one for the public as a regulator and the other for doctors as a union or trade association. The KMA represents doctors nationally assembled by type of practice, geographic location, and function. Consequently, the KMA became a trade association. However, it is not easy for the KMA to serve two conflicting functions of self-regulation and trading body under one umbrella. It is time for the KMA to build up the organizational strength for the sake of doctors as well as the public. Having a sound trade association is a part of medical professionalism; it can advocate the critical value of medicine against undue influences from employers or governments in the era of industrialization and commercialization of medicine. To achieve this goal, the KMA should revamp its troublesome communication structure regarding its governance. Improving integration among key acting bodies within the KMA can streamline management by better communication. Preventing political feudalism to build consensus within the KMA requires new competencies for the leaders as well as the members of the KMA.
ABSTRACT
It is regrettable that in recent years, the Korean Medical Association (KMA) has held special meetings of the house of delegates almost annually, purely for the removal of the president of the KMA from his/her office. There could be several reasons for this, but the failure of communication caused by the fragmentation of the KMA’s governance structure may be a major contributing factor. It may therefore be helpful to benchmark the governance of other professional organizations like the British Medical Association (BMA) to identify differences in the practice of consensus building, which leads to policy making. Due to the unexpected COVID-19 (coronavirus disease 2019) outbreak, this study was limited to internet resources. It was impossible for the author to conduct participant observation or direct face-toface interviews to get essential information about the governance of the BMA. Nevertheless, the findings provide valuable lessons for the KMA. There seem to be chasms among the house of delegates, the regional association and the board of directors in the KMA; better integration among major bodies within the KMA is required. Furthemore, the time spent by these bodies on generating policies and strategies is not sufficient. The BMA is a union with its professional activities secured by labor laws, whereas major players of the KMA do not have a protected time for their professional trade association. The KMA needs to remodel the current governance which is characterized by inadequate communication and subsequent fragmentation among the acting bodies of the Association. Continuous professional development for the leaders and members of the KMA might enable this change in governance.
ABSTRACT
Currently, accreditation in medical education is a priority for many countries worldwide. The World Federation for Medical Education’s (WFME) launch of its 1st trilogy of standards in 2003 was a seminal event promoting accreditation in basic medical education (BME) globally. In parallel, the WFME also actively spearheaded a project to recognize accrediting agencies within individual countries. The introduction of competency-based medical education (CBME), with the 2 key concepts of entrusted professional activity and milestones, has enabled researchers to identify the relationships between patient outcomes and medical education. The recent data-driven approach to CBME has been used for ongoing quality improvement of trainees and training programs. The accreditation goal has shifted from the single purpose of quality assurance to balancing quality assurance and quality improvement. Although there are many types of postgraduate medical education (PGME), it may be possible to accredit resident programs on a global scale by adopting the concept of CBME. It will also be possible to achieve accreditation alignment for BME and PGME, which center on competency. This approach may also make it possible to measure accreditation outcomes against patient outcomes. Therefore, evidence of the advantages of costly and labor-consuming accreditation processes will be available soon, and quality improvement will be the driving force of the accreditation process.
ABSTRACT
Currently, accreditation within medical education is a priority on the agenda for many countries worldwide. The World Federation for Medical Education’s (WFME) launch of its first trilogy of standards in 2003 was a seminal event in promoting accreditation within basic medical education (BME) globally. Parallel to that, WFME also actively spearheaded a project to recognize the accrediting agencies within individual countries. The introduction of competency-based medical education (CBME) with the two key concepts of “entrusted professional activity” and milestones has enabled researchers to identify the relationship between patient outcomes and medical education. Recent data driven by CBME has been used for the continuous quality improvement of trainees and training programmes as well. The goal of accreditation has shifted from the single purpose of quality assurance to balancing quality assurance and quality improvement. Even though there are a plethora of types of postgraduate medical education (PGME), it may be possible to accredit resident programmes on a global scale by adopting the concept of CBME. In addition, the alignment of the accreditation for BME and PGME, which center on competency, will be achievable. This argument may extend the possibility of measuring the outcomes of the accreditation itself against patient outcomes as well. Therefore, evidence of the advantages of costly and labor-consuming accreditation processes will be available in the near future and quality improvement will be the driving force of the accreditation process.
ABSTRACT
This study aimed to suggest the justification for a self-regulatory body for medical licenses in Korea by reviewing recent cases of physician arrests for medical accidents in Korea. A number of recent cases of medical mistakes have been criminalized by courts in Korea, leading to widespread concern and fear throughout the healthcare community. Without a profession-led self-regulation system ever having been introduced in Korea, there is no alternative method for disciplining doctors other than through criminal tort law. It is expected that the volume of malpractice lawsuits will increase rapidly in Korea as the government ambitiously expands its plans for universal health coverage. Instead of facing criminal charges, however, doctors must put forth an effort to introduce a contemporary form of medical regulation, with more advanced disciplinary measures against substandard practice. The Korean Medical Association has undertaken the challenging mandate of establishing a new professional regulatory body to provide a tribunal and disciplinary system for the medical profession. It has proven difficult to persuade doctors of its purpose and value, as the majority do not yet fully grasp the very foreign concept of self-regulation. Moving forward, however, it will eventually become the responsibility of doctors to persuade society, lawmakers, government, and patient interest groups of the necessity and viability of self-regulation, which may also prove challenging. Despite these predictable challenges, it is imperative that Korean doctors solve the issue of creating a new, modern regulatory body capable of effective self-regulation and acceptable disciplinary measures, within the near future.
Subject(s)
Humans , Criminals , Delivery of Health Care , Hand Strength , Jurisprudence , Korea , Liability, Legal , Licensure , Malpractice , Medical Errors , Methods , Public Opinion , Self-ControlABSTRACT
This study aimed to suggest the justification for a self-regulatory body for medical licenses in Korea by reviewing recent cases of physician arrests for medical accidents in Korea. A number of recent cases of medical mistakes have been criminalized by courts in Korea, leading to widespread concern and fear throughout the healthcare community. Without a profession-led self-regulation system ever having been introduced in Korea, there is no alternative method for disciplining doctors other than through criminal tort law. It is expected that the volume of malpractice lawsuits will increase rapidly in Korea as the government ambitiously expands its plans for universal health coverage. Instead of facing criminal charges, however, doctors must put forth an effort to introduce a contemporary form of medical regulation, with more advanced disciplinary measures against substandard practice. The Korean Medical Association has undertaken the challenging mandate of establishing a new professional regulatory body to provide a tribunal and disciplinary system for the medical profession. It has proven difficult to persuade doctors of its purpose and value, as the majority do not yet fully grasp the very foreign concept of self-regulation. Moving forward, however, it will eventually become the responsibility of doctors to persuade society, lawmakers, government, and patient interest groups of the necessity and viability of self-regulation, which may also prove challenging. Despite these predictable challenges, it is imperative that Korean doctors solve the issue of creating a new, modern regulatory body capable of effective self-regulation and acceptable disciplinary measures, within the near future.
ABSTRACT
The Sustainable Development Goals (SDGs), officially known as ‘Transforming our world: the 2030 agenda for sustainable development’ has 17 “Global Goals” with 169 targets. This is the resolution by member countries as an intergovernmental agreement that acts as the Post 2015 Development Agenda (successor to the Millennium Development Goals). In conjunction with the United Nations SDG, World Health Organization published “The global strategy on human resources for health: workforce 2030”. It is primarily aimed at planners and policy-makers of WHO Member States and, its contents are of value to all relevant stake holders including medical education providers in the health workforce area. This article tried to explore the future direction of medical education to achieve the SDG in relation to Korean context.
Subject(s)
Humans , Conservation of Natural Resources , Education, Medical , Health Workforce , Public Sector , Social Control, Formal , Social Skills , United Nations , World Health OrganizationABSTRACT
No abstract available.
Subject(s)
Humans , Accreditation/legislation & jurisprudence , Education, Medical/legislation & jurisprudence , Legislation, Medical , Physicians/legislation & jurisprudence , Republic of KoreaABSTRACT
PURPOSE: While it is known that effective clinical education requires active involvement of its participants, regular feedback, communication skills and interprofessional training, limited studies have been conducted in Korea that demonstrate how pre-residency trainees acquire their core clinical skills. This is a cross-sectional study of interns and students across a third-tier university hospital in Korea to examine where and when they acquire core clinical skills. METHODS: A total of 74 students and 91 interns were asked to participate in a closed-ended questionnaire, and 50 participants (20 students and 30 interns) were involved in semistructured individual interviews. The questionnaire was based on the Accreditation Council for Graduate Medical Education core competencies. RESULTS: The majority of core clinical skills were acquired during their rotations in emergency medicine, general surgery and cardiothoracic surgery. The semistructured interviews revealed that these departments required their trainees to be highly involved and analytical, and participate in clinical discourse. CONCLUSION: The common factor among the three departments is an environment in which trainees are highly involved in clinical duties, and are expected to make first-contact patient encounters, participate in clinical discourse, interpret investigative results and arrive at their own conclusions. Work-based learning appear to be key to the trends observed, and further study is warranted to determine whether these findings are indicative of true acquisition of clinical competence.
Subject(s)
Humans , Accreditation , Clinical Competence , Cross-Sectional Studies , Education , Education, Medical , Education, Medical, Graduate , Emergency Medicine , Korea , LearningABSTRACT
No abstract available.
ABSTRACT
Practicing medicine is a social activity. Because doctor-patient interaction requires respect, leadership, and interpersonal skills that extend beyond medical diagnosis and treatment, medical education must incorporate non-clinical competencies. While qualities such as lifelong learning skills, resource management, teamwork skills, and active involvement in leadership and bettering the healthcare system have received little attention in medical academia, these competencies have proven vital for a physician in contemporary society. These non-clinical competencies are, in fact, the traits or components of social competency. Social competency has been an area of interest, particularly with regard to the development of children and adolescents, in the fields of education, psychology, and less commonly, economics. However, traditional Korean residency programs have not paid much attention to social competency due to their closed culture originating from the colonial period. Resident education is still heavily dependent on a patriarchal system based on "family" values. Resident education is concentrated in medical knowledge and skills within specialty departments functioning as a family-like unit. Specialty training has a very narrow, constrained vision without incorporating much education on the social dimension of medical practice. Nevertheless, developing a social competency scheme for resident education was initiated in 2008, when the Korean Medical Association celebrated the centennial of producing licensed physicians. However, the scheme is still under development and not widely used. Korean medical educators must, therefore, recognize the value of social competencies and include them as graduation outcomes of residency training to prepare doctors to meet the challenges of the future.
Subject(s)
Adolescent , Child , Humans , Delivery of Health Care , Diagnosis , Education , Education, Medical , Internship and Residency , Leadership , Learning , PsychologyABSTRACT
Medicine is the practice that occurs in the context of the society. It requires interaction with individual patients, fellow doctors and other health care professionals, health care officials, public, institution, and the society as a whole. To date, medical practice in Korea has largely been concentrated on applying biomedical knowledge and skill to a patient. We defines 'social competency' as 'competency for medicine as a social institution.' This survey aims to grasp the current situation of Korean doctors' perception on social competency, in terms of necessity, satisfaction, learning experience, and possible intervention. Respondents generally recognized the necessity of social competencies but were not satisfied with their demonstration of those competencies. Competencies for 'understanding on law and institution' and 'communication' were perceived highly necessary. General satisfaction and each satisfaction rate on individual competencies were all below 'neutral,' showing their dissatisfaction. Especially, doctors assess their fellow doctors' competencies for 'understanding on law and institution' and 'understanding on human being and society' at the lowest level. The mismatch between perceived necessity and satisfaction shows the legitimate ground for educational intervention. The proportions of respondents who have learned on each domain of social competency were all below 70%. Learning experience on self-management and leadership was the least. Among possible remedy for low social competency, respondents perceived 'improvement on national health insurance' and 'improvement on resident training program' as the most urgently needed. The data from this preliminary survey can be utilized for educational and institutional intervention in the future.
Subject(s)
Humans , Delivery of Health Care , Hand Strength , Jurisprudence , Korea , Leadership , Learning , Self Care , Surveys and QuestionnairesABSTRACT
No abstract available.
ABSTRACT
PURPOSE: This study aimed to collect information that is needed to develop interprofessional education curricula by examining the current status of interprofessional conflicts and the demand for interprofessional education. METHODS: A total of 95 doctors and 92 nurses in three university hospitals in Seoul responded to a survey that comprised questions on past experience with interprofessional conflicts, the causes and solutions of such conflicts, past experience with interprofessional education, and the demand for interprofessional education. RESULTS: We found that 86% of doctors and 62.6% of nurses had no interprofessional education experience. Most of them learned about the work of other health professions naturally through work experience, and many had experienced at least one interprofessional conflict. For doctors, the most popular method of resolving interprofessional conflicts was to let the event pass; for nurses, it was to inform the department head. Further, 41.5% of doctors and 56.7% of nurses expressed no knowledge of an official system for resolving interprofessional conflicts within the hospital, and 62.8% of doctors and 78.3% of nurses stated that they would participate in interprofessional education if the opportunity arose. CONCLUSION: In Korean hospital organizations, many doctors and nurses have experienced conflicts with other health professionals. By developing an appropriate curriculum and educational training system, the opportunities for health professionals to receive interprofessional education should expand.
Subject(s)
Curriculum , Education , Head , Health Occupations , Hospitals, University , Interprofessional Relations , Linear Energy Transfer , SeoulABSTRACT
The abolishment of the internship training program in Korea has become a hot issue in Korea. The internship has traditionally been a general competency build-up process to becoming a practicing doctor. However, despite its relatively long history, there is still no oversight or guidelines for the educational program itself. It is operated individually department-by-department on a rotation basis with no central supervision or clear goals and objectives. Very often, interns are abused as sources of simple cheap labor, performing not only medical duties but also menial administrative tasks as required by each department, without proper educational activity or training. This significant lack of system and structure is a chronic grievance among those who experience it, yet perhaps due to its short duration, is something that is endured and then forgotten. Medical students, however, have largely opposed the abolition, citing the loss of the opportunity for anthropologic exploration of various clinical departments and the chance to build networks to pursue specialty training in the fields of their choice. The key issue at hand is then whether the current problematic student clerkship training can be improved enough to replace the internship program. To do so would require overcoming the fragmented nature of the clinical education culture, which is still quite clannish in nature and based on family values. Whether these cultural barriers can be broken to develop a clerkship training curriculum sufficient to achieve general competency before specialty training is the determining factor for the fate of the internship program.