The Development of Evaluation Methods for Outcomes in Medical Humanities Curriculum of a Medical School / 계명의대학술지

This study was performed to select the proper assessing methods for learning outcomes in undergraduate education of medical humanities (MH), and to evaluate whether student assessments in MH curricula are related to the graduate outcomes (GO)and/or periodic phase outcomes (PO). We searched the reasonable assessing methods for GO and PO of MH curricula of Keimyung University School of Medicine (KUSM). The outcomes are composed of six competencies including patient care, communication, patient support, professionalism, problem solving and research, and self-development. Then, we analyzed whether student assessments carried out during formal MH curricula properly achieved their PO, furthermore their GO. Four competencies including communication, patient support, professionalism, self-development were lightened to be closely related to outcomes for MH. Only the component of problem solving was settled to be related to MH in the competency of problem solving and research. The competency of patient care was excluded from the relationship with MH. The assessing methods for the GO and three PO recommended from educational experts, and there were various available assessing methods based on medical situations and clinical contexts including direct observation of clinical skills, 360 degree feedback, peer review, self-assessment, project-based assessment, portfolio-based assessment, discussion & presentation-based assessment, log-based assessment. For the outcome-achieving from formal MH curricula, the MH programs of phase-1 (1st and 2nd grades) almost accomplished the PO of communication, patient supporting and professionalism, and considerably accomplished the PO of problem solving and self-development. The MH programs of phase-2 (3rd and 4th grades) accomplished considerably their PO as the competencies of professionalism and problem solving, and partially as communication, patient supporting and self-development. However, as only one program, public health law, was provided for MH program in phase-3 (5th and 6th grades), the extra methods to evaluate their MH outcomes are needed. Many assessing methods can be available for the most MH competencies consisting of the GO of KUSM, and the proper assessing methods for each MH competency should be selected based on programs and learning contexts in MH education. While formal MH curricula of the school variously accomplished the MH competencies of GO according to periodic phases of curricula, it is recommended to enhance the feasibility and effectiveness of evaluation for GO in MH curricula of the school.

Analysis of the Satisfaction with Computer Based Test Program and Test Environment in Medical School / 의학교육논단

This study aimed to identify needed improvements to current evaluation methods in medical school computer-based test (CBT) programs and test environments. To that end, an analysis of the importance and satisfaction was conducted through a survey of 3rd and 4th year medical students who had sufficient experience with CBT programs. Importance performance analysis methodology using the correlation coefficient was applied to assess average satisfaction and importance. The first quadrant (keep up the good work) was a factor of review and time management and test facilities among the conveniences of the CBT program.The second quadrant (concentrate here) was a factor of the convenience of the CBT program and computer monitor and chair factor within the test facilities. The third quadrant (low priority) was a factor of cheating and computer failure. The fourth quadrant (possible overkill) was the location, spacing, and temperature factors of the test facilities. Improvements are needed to reduce ‘eye fatigue’ and help students focus and understand the questions in the CBT programs. It is necessary to improve computer monitors, desks and chairs, and consider the subject’s body type and manager in order to cope with computer breakdown and peripheral failures. Spare computers are needed. These findings are meaningful in that they have been able to identify factors that require improvement in the CBT program and test environment resulting from changes in assessment tools.

Malignant Transformation of Pulmonary Benign Metastasizing Leiomyoma

Pulmonary benign metastasizing leiomyoma (PBML) is defined as metastasis of a leiomyoma to lung tissue. It was first reported in 1937. P BML is known as a benign disease, but can undergo malignant transformation. Only 1 case of the malignant transformation of PBML to leiomyosarcoma has been reported previously. In this report, we present a case of malignant transformation of PBML.

Sleep Status and Quality of Life in Patients with Frozen Shoulder / 대한정형외과학회잡지

PURPOSE: The aims of this study were to assess sleep status and quality of life (QOL) in patients with frozen shoulder and to evaluate correlations between pain, disability, sleep disturbance and QOL. MATERIALS AND METHODS: Thirty patients with idiopathic frozen shoulder and 60 healthy controls were enrolled into this study. Participants were evaluated using the following: visual analogue scale (VAS), American Shoulder and Elbow Surgeon's Score (ASES), Korean Shoulder Score (KSS), Pittsburg Sleep Quality Index (PSQI), and World Health Organization Quality of Life Scale Abbreviated Version (WHOQOL-BREF). RESULTS: The mean VAS, ASES, and KSS scores in patient groups were 6.5, 40.3, and 45.1, respectively. The mean PSQI score was 8.6 in the patient group and 4.1 in the control group. Patient groups had significantly higher scores than the control group for the PSQI score (p0.05). The ASES score had a positive correlation with physical health domain and KSS score had a positive correlation with overall QOL and physical health domain of the WHOQOL-BLEF (p<0.05). CONCLUSION: Patients with frozen shoulder had noticeable pain and functional disability. Furthermore, they had significant incidence of sleep disturbance and had a significantly lower QOL.

TEE-guided Excision of Intravenous Leiomyomatosis with Right Atrium Extension through an Abdominal Approach: A Case Report

Intravenous leiomyomatosis (IVL) is a rare, benign tumor that originates from the uterus. IVL is usually confined to the pelvic venous system, but it travels into the inferior vena cava (IVC) in 10% of cases and even into the heart in 3% of cases. We present a case of successful resection of recurrent IVL with right atrium extension. We used only an abdominal incision and transesophageal echocardiography (TEE) guidance. A 40-year-old female patient visited our hospital with recurrent IVL. She had a history of total abdominal hysterectomy and right salpingo-oophorectomy due to IVL performed one year prior. On computed tomography (CT) and ultrasonography, IVL was found to involve both ovarian veins, the left renal vein, and the IVC extending to the right atrial junction. Using intraoperative TEE monitoring, we could see that IVL was not attached to the vascular wall. After creating a midline abdominal incision, we removed the tumor through the enlarged ovarian vein and ovary. The patient had an uneventful recovery and was discharged home on the ninth postoperative day.