ABSTRACT
Purpose@#This study aims to verify whether the Reflective Practice Questionnaire (RPQ) developed by Priddis and Rogers is valid in the Korean context to identify the level of reflection of medical students in clinical practice. @*Methods@#A total of 202 third- and fourth-year medical students from seven universities participated in the study. After receiving approval for use from the authors, a survey was conducted on the students through an adaptation process. The original scale consists of 10 factors with 40 items. The Self-efficacy in Clinical Performance Scale (SECP), Korean Self-reflection and Insight Scale (K-SRIS), and Reflection-in-Learning Scale (RinLS) were used to validate the scale. Exploratory factor, confirmatory factor, correlation, and reliability analyses were used for data analysis. @*Results@#As a result of exploratory factor analysis, 10 subfactors were extracted (Kaiser-Meyer-Olkin=0.856, Bartlett’s test: χ 2 =5,044.337, degrees of freedom=780, p<0.001). Among the 40 items, one that showed a high overlapping load for other factors was excluded. As a result of confirmatory factor analysis, the 10-factor structure model was found suitable (χ 2 =1.980, comparative fit index=0.859, Tucker-Lewis index=0.841, root mean square error of approximation=0.070). As a result of the criterion validity test, most of the subfactors of the Korean version of the RPQ (K-RPQ) showed a positive correlation with K-SRIS, RinLS, and SECP. The reliability of 10 subfactors was satisfactory, ranging from 0.666 to 0.919. @*Conclusion@#The K-RPQ was confirmed to be a reliable and valid tool to evaluate the level of reflection among Korean medical students in clinical clerkship. This scale can be used as a tool to provide feedback on each student’s level of reflection in clinical clerkship.
ABSTRACT
Purpose@#This study aimed to reach a consensus among experts on the global health competencies for medical students in Korea. @*Methods@#A global health competency model was developed to identify domains and competencies for medical education, and a three-round modified Delphi method was used to reach consensus among 21 experts on the essential global health competencies. The degree of convergence, degree of consensus, and content validity ratio of the model were used to reach a consensus. @*Results@#A list of 52 competencies in 12 domains were identified according to a literature review. In the first-round Delphi survey, the global health competencies were refined to 30 competencies in eight domains. In the second round, the competencies were reduced to 24. In the final round, consensus was reached among the expert panel members, and the competencies were finalized. The global health competency domains for medical students include global burden of disease (three items), globalization of health and healthcare (five items), determinants of health (two items), healthcare in low-resource settings (two items), global health governance (three items), health as a human right (four items), cultural diversity and health (three items), and participation in global health activities (two items). @*Conclusion@#The group of experts in global health achieved a consensus that 24 global health competencies in eight domains were essential for undergraduate medical education in Korea. The domains and competencies identified herein can be used to develop an undergraduate medical education curriculum in global health.
ABSTRACT
Background@#Patient-centered outcomes can be achieved when common core and specialist competencies are achieved in a balanced manner. This study was conducted to assess the need to fill the gap between the defined competencies and learners’ achievement, in order to improve the internal medicine (IM) training education curriculum for promoting patientcentered outcomes. @*Methods@#A cross-sectional online survey was conducted. The participants were 202 IM specialists who obtained board certification in 2020−2021. We developed a questionnaire to investigate the self-evaluation of common core competencies and achievement level of IM essential competencies. For analysis, frequency tests, paired t-test, Borich priority formula, and χ 2 were performed. @*Results@#In common core competencies, IM specialists recognized that their achievement levels in all competency categories were lower than their importance level (P < 0.001), and the highest educational demands were related to self-management. They assessed their five essential procedure skill levels as novice or advanced beginner status. The achievement level for the essential symptoms and signs that IM specialists should be able to manage was predominantly competent level. However, on average, 34.9% answered that they had never assessed during training for essential skills, and 29.7% answered the same for essential symptoms and signs. @*Conclusion@#We identified the priorities of core competencies, the level of achievement in essential procedures and patient care with essential symptoms and signs for IM training, and the related educational methods and assessment status. This study is expected to be used as basic data for developing and revising IM training educational curriculum.
ABSTRACT
Purpose@#The purpose of this study is to analyze the accreditation standards items related to the decision of accreditation of medical schools by the Korea Institute of Medical Education and Evaluation (KIMEE). @*Methods@#The subjects are medical schools in Korea that have received post-2nd cycle accreditation from the KIMEE between 2012 and 2016. Analyses were conducted for differences in accreditation decisions according to the characteristics of medical schools, sufficient ratios of basic standards items, and correlation between standards items related to accreditation decisions. @*Results@#After examining differences in accreditation decisions by the medical school’s characteristics, there were no significant correlations between accreditation standard items and accreditation decisions. Second, according to the number of schools that sufficiently or insufficiently met each standard item, from the total of 97 standard items, 20 (20.6%) were sufficiently fulfilled by all medical schools. Standard item 2-5-2 demonstrated the highest insufficiency ratio. Third, with respect to the standard item that had an effect on accreditation decisions, standard item 1-5-1 showed the highest correlation with the sufficiency rate. @*Conclusion@#The validity of accreditation standards items was assured as this study evaluated the post-2nd cycle accreditation standards items regardless of each medical school’s characteristics. The accreditation standards items were found to have a meaningful impact on the development of medical schools and qualitative improvement in medical education. The findings are expected to contribute to guaranteeing the validity and reliability of accreditation decisions and raising the quality of accreditation.
ABSTRACT
Purpose@#: The COVID-19 pandemic has had a far-reaching impact on society. Understanding the changes perceived by medical students is meaningful in that it can suggest the direction of future changes in medical education. The purpose of this study is to investigate the impact of COVID-19 social distancing on psychosocial changes in medical students. @*Methods@#: Anxiety and depression caused by COVID-19, changes in fatigue caused by social distancing, areas where significant changes occurred, and changes in social activity participation and media use behavior among medical students who have experienced the COVID-19 pandemic for more than two years by an online survey. Two hundred twenty-one who are 1st and 2nd-year medical students responded, and we analyzed the results by frequency analysis, independent t-test, paired-sample t-test, and ANOVA. Also, we analyzed Post hoc tests with Tamhane T2, which does not assume equal variance. @*Results@#: The second year of medical school showed higher anxiety and depression than the first. The students who experienced COVID-19 showed lower anxiety, and the more severe the degree of corona blue experience, the higher the anxiety and depression. And the fatigue felt by medical students is higher now than during COVID-19. Areas where the changes due to COVID-19 were seen a lot, were lifestyle attitudes, learning methods, and human relationships. And also, social activities and media medical students use increased after social distancing. @*Conclusion@#: Before and After COVID-19 Social Distancing, medical students have experienced many psychosocial changes.
ABSTRACT
The purpose of this study was to investigate the current status of interprofessional education (IPE) and the efforts required to promote, popularize, and implement it in Korea. The IPE status of 40 medical colleges was investigated using a survey with questions regarding the details of IPE, the future plans and necessary support required, and the reasons for not implementing IPE. Thirty-two medical colleges responded, of which 10 are implementing or have implemented IPE. Most of these colleges started IPE in 2018, and the duration of IPE was less than 9 hours. All medical colleges held classes with nursing students. As for the type of IPE, there were independent courses for IPE, one-time special lectures, or partial sessions in one course. Lectures, discussions and presentations, role playing, and high-fidelity simulations were mainly used as educational methods. The support and interest of the dean was the most important facilitating factor. No medical colleges were currently preparing to implement IPE, four colleges had planned IPE but failed to implement it, and 16 had no plans for IPE at all. All medical colleges cited scheduling or cooperation with other majors as the most significant barrier. All the colleges listed their requirements for educational materials, cases, guidelines, and teaching and learning methods for IPE from external institutions. To activate IPE, it is necessary to create an appropriate atmosphere and conditions for developing IPE competencies and a model suitable for the domestic situation. External medical education support organizations should distribute IPE development guidelines and educational materials, form a network between medical colleges with IPE experience, and make efforts to promote the importance of IPE.
ABSTRACT
Background@#This study aimed to investigate differences in knowledge, and attitudes toward deceased organ and tissue donation of emergency physicians. Additionally, we analyzed factors affecting the attitudes toward deceased organ and tissue donation. @*Methods@#We conducted a survey of specialists and residents registered with the Korean Society of Emergency Medicine in December 2020. The respondents’ sex, age, position, personal registration for organ donation, experience of soliciting organ donation, participation in related education, knowledge, and attitude about brain death organ donation, and attitude toward stopping life-sustaining treatments were investigated.According to the characteristics of the respondents (specialists or residents, experience and education on organ and tissue donation), their knowledge and attitude toward deceased organ donation were compared. Stepwise hierarchical multiple regression analysis was used to investigate the factors affecting the attitudes toward deceased organ and tissue donation. @*Results@#Of the total 428 respondents, there were 292 emergency medicine specialists and 136 medical residents. Specialists and those who registered or wished to donate organs had higher knowledge and attitude scores regarding deceased organ and tissue donation.Those who had experience recommending organ and tissue donation more than 6 times had higher knowledge scores on deceased organ and tissue donation and higher overall scores in attitude. Those who received education from the Korean Organ Donation Agency had higher knowledge scores. Specialists, and those who wished to donate or had registered as organ donors and had a higher life-sustaining treatment attitude score and knowledge about deceased organ and tissue donation, had more positive attitudes toward deceased organ and tissue donation. @*Conclusion@#For more potential deceased organ and tissue donors to be referred for donation, there should be continuous education for emergency physicians on brain-dead organ and tissue donation-related knowledge and procedures. In addition, institutional or systematic improvements that can lead to organ donation when deciding on the withdrawal of life-sustaining treatment should be considered.
ABSTRACT
Background@#: Emergency physicians are increasingly participating in brain-death organ tissue donation (OTD).It is difficult communication to inform family members about suspected brain-death and potential donor.This study sought to explore the experiences and communication of emergency physicians in brain-death OTD. @*Methods@#: This is a qualitative study that interviewed 10 experienced emergency physicians with brain-death OTD and analyzed the data by thematic analysis method. @*Results@#: The study revealed 20 subthemes and 5 themes; 1) Families who are invited to donate organs make decisions after long periods of consideration by the entire family, 2) It is uncomfortable to recommend organ donation, 3) Explaining and obtaining consent is ‘the hardest job’ for the attending physician, 4) The way the attending physician does ‘the hardest job’ is by explaining, 5) Passively solicit donation. @*Conclusion@#: The experienced emergency physicians with brain-death OTD were using methods of communication to understand and sympathized with the family members and had abundant experiences. The findings of this study will help inexperienced emergency physicians with brain-death OTD.
ABSTRACT
Background@#The purpose of this study is to conduct a teamwork program for pre-medical students using a table-top simulation game called Friday Night at the ER®, and to investigate the effect. @*Methods@#This is a one group pretest-posttest design study 34 students. The tools were understanding of interpersonal relationships (11 questions), problem-solving initiative (8 questions), and system thinking (20 questions) were used. Satisfaction with the program was investigated, and a self-reflection essay was written. For the analysis, paired t-test, frequency analysis, and content analysis were used. @*Results@#After participating in the program, interpersonal understanding, proactivity in problem-solving, and systems thinking all significantly improved (p<.001), and the effect size of the program was also above medium (Cohen’s d= 0.580∼1.019). As a result of analyzing the contents of the self-reflection journal, it was classified into 7 themes and 3 categories; Teamwork competency, systems thinking skills, interpersonal skills. Students were generally satisfied with the program. @*Conclusion@#The simulation game-based teamwork program was effective in improving students’ teamwork. These results can be used as basic data for medical schools designing such programs.
ABSTRACT
This study examined the relationships among personality traits, coping efficacy, and academic stress in medical and non-medical students in South Korea, and investigated the mediating effect of coping efficacy in the relationship between personality traits and academic stress. The study group comprised 210 medical students and 175 non-medical students. They were asked to rate their personality traits, coping efficacy, and academic stress. The data were analyzed using IBM SPSS ver. 26.0 (IBM Corp., Armonk, NY, USA) and AMOS ver. 26.0 (IBM Corp.). Medical students scored higher for examination stress and lower for extroversion than non-medical students. In both groups, extroversion and conscientiousness positively affected coping efficacy, while neuroticism influenced it negatively. Neuroticism directly influenced all types of academic stress in both groups, while extroversion and conscientiousness only had direct effects on examination stress among medical students. Coping efficacy mediated the associations between personality traits and academic stress, except for the relationship between neuroticism and grade stress among medical students. The study indicates that coping efficacy had a significant effect on relieving academic stress among students with higher scores for extroversion and conscientiousness. Efforts should be made to decrease neuroticism to lower academic stress, as the relationship between neuroticism and academic stress is not directly influenced by coping efficacy. The implications of these results are discussed regarding a consultation system for students, especially those in medical school.
ABSTRACT
This study examined the relationships among personality traits, coping efficacy, and academic stress in medical and non-medical students in South Korea, and investigated the mediating effect of coping efficacy in the relationship between personality traits and academic stress. The study group comprised 210 medical students and 175 non-medical students. They were asked to rate their personality traits, coping efficacy, and academic stress. The data were analyzed using IBM SPSS ver. 26.0 (IBM Corp., Armonk, NY, USA) and AMOS ver. 26.0 (IBM Corp.). Medical students scored higher for examination stress and lower for extroversion than non-medical students. In both groups, extroversion and conscientiousness positively affected coping efficacy, while neuroticism influenced it negatively. Neuroticism directly influenced all types of academic stress in both groups, while extroversion and conscientiousness only had direct effects on examination stress among medical students. Coping efficacy mediated the associations between personality traits and academic stress, except for the relationship between neuroticism and grade stress among medical students. The study indicates that coping efficacy had a significant effect on relieving academic stress among students with higher scores for extroversion and conscientiousness. Efforts should be made to decrease neuroticism to lower academic stress, as the relationship between neuroticism and academic stress is not directly influenced by coping efficacy. The implications of these results are discussed regarding a consultation system for students, especially those in medical school.
ABSTRACT
Concern for patient safety underlies the need for interprofessional education (IPE). One way to measure the effectiveness of IPE is by measuring attitude change toward other healthcare professionals; however, there are currently no valid Korean tools to measure such a change in attitudes. Therefore, this study aims to develop and test a Korean version of the Interprofessional Attitudes Scale (IPAS). The original IPAS was translated into Korean according to the World Health Organization’s guidelines after obtaining permission from the article’s corresponding author. A total of 414 questionnaires were collected from third- and fourth-year medical and nursing students at four Korean institutions in December 2018. To analyze the validity of the Korean IPAS, exploratory and confirmatory factor analyses were conducted. Cronbach’s α was used to evaluate reliability. Results from the exploratory factor analysis identified four functions: teamwork, community-centeredness, patient-centeredness, and respect for diversity. Significant cross-correlations were found among the four functions (r=0.438–0.631, p<0.001) along with overall reliability (Cronbach’s α=0.929) and reliability of each subfactor (Cronbach’s α=0.804–0.897). This study verified the validity and reliability of the Korean version of the IPAS, so this scale can be used in the future to measure the effectiveness of IPE in Korea.
ABSTRACT
Purpose@#Today's students have distinctive generational characteristics and increased psychopathology and generational tension. The authors investigated the negative experiences of Late Millennial students in medical school to draw implications for student support. @*Methods@#The authors explored medical students’ negative experiences using the critical incident technique. The authors conducted semi-structured in-depth interviews with 13 medical students, between February and May 2016. The authors focused on occurrences that significantly influenced medical students’ school lives negatively from the students’ perspective. All interviews were recorded and transcribed. The authors classified incidents into frames of reference for the use of faculty development for student support. @*Results@#The authors extracted 22 themes from a total 334 codes and classified them into eight subcategories. Finally, four categories emerged from frames of reference. Students manipulate relationships and colluding for better specialty choice. They experience uncontrolled rifts in interpersonal relationships between peers including lawsuits, sexual assaults, and social network service conflicts. Today’s students feel resentment towards dependent hierarchical relationships with seniors. They struggle with gender discrimination but perpetuate outdated gender role toward the opposite gender. @*Conclusion@#Faculty members should understand today’s students’ level of career stress and desire for work life balance. They should motivate students’ professional identity, promote assertiveness against unfair authorities, and focus on mental health, teamwork, and relationship building. All generations need to understand other generations and develop appropriate leadership and gender sensitivity.
ABSTRACT
Purpose@#This study will compare differences in perception of interprofessional education (IPE) in the faculty of medicine, nursing, and pharmacy. It will also analyze differences in the level of importance of IPE competences and the present competence levels of their students perceived by the faculty. @*Methods@#The study included 115 participants from the faculty of medicine, 31 from nursing, and 23 from pharmacy. The surveys contained 21 questions on their perceptions of IPE, and perception on the nine competences of IPE. The results were analyzed using analysis of variance and χ2 analysis, and the Borich coefficient was calculated to identify the educational order of priority from the competence levels of their student of IPE. @*Results@#Participants of 14.8% responded that they were aware of IPE, 95.8% responded that they did not have experience in IPE, and 95.8% responded that IPE was necessary. Among the subfactors of perception of IPE, the faculty of medicine had significantly lower perceptions of the importance, effectiveness, and support of IPE (p<0.001). The present competence levels of their students were significantly lower (p<0.001) than the level of importance of IPE competences perceived by the faculty, and its perception was at its lowest in the faculty of medicine. The needs assessment of the IPE program was in the order of communication skills (10.210), conflict-solving skills (10.114), problem-solving skills (9.319), empathy skills (9.110), and collaborative leadership (8.624) among the nine competences. @*Conclusion@#This study will contribute to providing basic data needed to develop faculty development programs on IPE and IPE programs for their students.
ABSTRACT
Purpose@#This study is to develop an interprofessional education (IPE) program for medical, nursing, and pharmacy students and to analyze the effectiveness. @*Methods@#Subjects consisted of 116 students (41 medical, 46 nursing, and 29 pharmacy students) enrolled in their final year. Subjects were randomly assigned to either the intervention group or the control group, with 58 in each group. A pretest-posttest control group design was used. The program was operated for a single day, and consisted of small-group activities and role-play. We utilized the following tools: Perceptions towards Interprofessional Education (PIPE), Self-Efficacy for Interprofessional Experiential Learning (SEIEL), and Perception towards Interprofessional Competency (PIC). We used t-test and analysis of covariance for analysis. @*Results@#The PIPE tool revealed that the scores of the intervention group were significantly higher than those of the control group (p=0.000). The result was the same when the scores were categorized into the groups medical students (p=0.001), nursing students (p=0.000), and pharmacy students (p=0.005). The SEIEL study also indicated the intervention group scored significantly higher than the control group (p=0.000). However, pharmacy students did not reveal significant (p=0.983). The intervention group scored significantly higher than the control group in the PIC. A concluding survey of the intervention group indicated that most students were satisfied with the IPE program. @*Conclusion@#We hope this study will provide useful information for designing and improving IPE programs in other universities.
ABSTRACT
PURPOSE@#This study investigated the attitudes of Korean medical students about patient safety to determine which perspectives required increased focus in terms of educational development.@*METHODS@#Attitudes were assessed using the Patient Safety Questionnaire, a tool designed to measure attitudes toward patient safety among medical students. Questionnaires were distributed to 580 clinical year students across four medical schools in December 2018.@*RESULTS@#A total of 300 returned questionnaires were used in the final analysis. More than half of all respondents agreed (i.e., gave more than 4 out of 7 points) with most items and thoroughly considered the concept of patient safety. However, many students misperceived several items (e.g., professional incompetence as a cause of errors, disclosure responsibility, the importance of patient safety in the curriculum, and situational awareness).@*CONCLUSION@#Attitudes toward patient safety are highly important due to their substantial impacts on behavioral decisions in the clinical setting. As such, patient safety education should be designed to place greater emphasis on proper attitude. This study's findings should be useful for medical instructors who wish to determine the appropriate areas of curricular focus.
ABSTRACT
Team communication, teamwork, and interprofessional collaboration are critical and the basis for patient safety in a more diverse and complex clinical environment. This study explored the current status of teamwork, team communication, and interprofessionalism in the context of patient safety within undergraduate medical education. A scoping review of the literature published since 2010 was undertaken. Fifteen papers were included for final review. The most commonly used educational methods were off-line lectures and simulations. Standard team communication tools suggested in TeamSTEPPS (team strategies and tools to enhance performance patient safety) were covered in some of the research. Knowledge, skills, and teamwork attitudes, interprofessional collaboration, and/or patient safety were improved in most of the papers. In the previous studies of team communication, the content and method of education, and the change in knowledge and attitudes of the individuals have been widely reported, but more research is needed regarding the method of evaluating the teamwork itself. In addition, education on team communication as well as patient safety and interprofessionalism is lacking. As the importance of team communication in patient safety increases, more attention is needed on this topic in undergraduate medical education.
Subject(s)
Humans , Cooperative Behavior , Education , Education, Medical, Undergraduate , Lecture , Methods , Patient SafetyABSTRACT
PURPOSE: This study investigated the attitudes of Korean medical students about patient safety to determine which perspectives required increased focus in terms of educational development. METHODS: Attitudes were assessed using the Patient Safety Questionnaire, a tool designed to measure attitudes toward patient safety among medical students. Questionnaires were distributed to 580 clinical year students across four medical schools in December 2018. RESULTS: A total of 300 returned questionnaires were used in the final analysis. More than half of all respondents agreed (i.e., gave more than 4 out of 7 points) with most items and thoroughly considered the concept of patient safety. However, many students misperceived several items (e.g., professional incompetence as a cause of errors, disclosure responsibility, the importance of patient safety in the curriculum, and situational awareness). CONCLUSION: Attitudes toward patient safety are highly important due to their substantial impacts on behavioral decisions in the clinical setting. As such, patient safety education should be designed to place greater emphasis on proper attitude. This study's findings should be useful for medical instructors who wish to determine the appropriate areas of curricular focus.
Subject(s)
Humans , Curriculum , Disclosure , Education , Education, Medical , Patient Safety , Schools, Medical , Students, Medical , Surveys and QuestionnairesABSTRACT
Interprofessional education (IPE) can promote high-quality patient care and good medical outcomes through teamwork among health professionals. However, there are no valid measurements to prove the effectiveness of IPE in Korea. This study aimed to develop and test a Korean version of the Self-efficacy for Interprofessional Experimental Learning Scale (SEIEL). The original SEIEL was translated into Korean by two experienced medical professors, and 368 questionnaires were collected from medical and nursing students (third and fourth year). To analyze the validity of the Korean version of the SEIEL, an exploratory and confirmatory factor analysis was conducted. Cronbach's α was used to evaluate reliability. Results from the exploratory factor analysis identified two functions: “interprofessional collaboration†and “interprofessional team evaluation.†A significant cross-correlation was found between the two functions (r=0.690, p<0.001), with a Cronbach's α value of 0.932. The reliability and validity of the Korean version of the SEIEL was identified in this study. This tool can be helpful in measuring the effectiveness of IPE in Korea.
ABSTRACT
PURPOSE: The purpose of this study was to explore the experience of medical teachers in the process of adapting flipped learning method through a phenomenological approach. METHODS: Semi-structured interviews with five medical teachers from two medical colleges and one medical school were conducted in December, 2017. Data analysis was done according to Colaizzi's descriptive phenomenological methodology. RESULTS: A total of 160 unique significant statements were extracted. These statements generated 17 formulated meanings that were categorized into seven theme clusters and four theme categories. Main themes were: (1) teacher with high levels of passion and motivation; (2) hurdles of flipped learning: students were still passive, struggling in preparing for flipped learning; (3) positive changes from flipped learning: changes to classroom environment and teachers' reflection through experience; and (4) challenges of flipped learning: remaining tasks for teachers, expansion of flipped learning. CONCLUSION: Through phenomenological approach, researchers were able to elucidate categories about the experience of medical teachers when attempting flipped learning. Although medical teachers did not have the exact same idea on how flipped learning was conducted and implemented, the perception of flipped learning, or difficulties in class activities, they were still wondering how they could teach students well. This study might draw more attention to flipped learning and stimulate educational and institutional supports to improve teaching and learning in medical schools.