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Purpose@#This study aims to establish if medical students think it is fair to be assessed by nursing professors in interprofessional education (IPE) and why. @*Methods@#Eighty-seven third-year medical students who participated in the IPE in 2022 submitted self-reflection essays. They were asked how they perceived the assessors, and 86 medical students responded to content analyses. @*Results@#Sixty-seven students (77.9%) agreed to be assessed by nursing professors. They believed that interprofessional assessment is possible because it is an IPE. They also believed that this was an opportunity to be assessed from various perspectives. Nineteen students (22.1%) objected because the assessment criteria may be different and nursing professors would not understand the learning experiences of medical students. @*Conclusion@#Regarding the reasons medical students oppose it, IPE developers should supplement the development of assessment criteria and understand learners’ experiences during planning assessment.
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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.
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Objective@#Emergency medicine residents are expected to exhibit a poor health status due to excessive working hours and high stress. Because much of patient care depends on them, their health conditions will have a significant impact on patient outcomes. Our study was designed to analyze the health status of emergency medicine residents and the affecting factors using the 2019 Korean Emergency Medicine Residents Survey (KEMRS) results. @*Methods@#The study evaluated the self-rated health-defined percentage of responders who thought they were in good health. Based on this response, the influencing factors were categorized statistically. These factors included personal characteristics, lifestyle (drinking, smoking, eating, sleeping, and exercise), and emotional stress. @*Results@#Of a total of 384 respondents, 176 (46%) thought they were in good health. Participants who perceived themselves to be unhealthy included residents who were married, female, and those in the 3rd grade. Drinking and smoking were not perceived to affect health status, but regular exercise and proper eating patterns were seen to be positive influencing factors. Daytime sleepiness, depressive moods, and personal well-being were correlated with health status. @*Conclusion@#While personal characteristics and emotional problems cannot be changed easily, lifestyle changes can be made for better health. The health conditions of emergency residents have not been considered a matter of importance thus far. To overcome their health problems, responsible improvements in schedules and a program of long-term follow-ups need to be implemented, followed by training programs.
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Purpose@#This study aimsed to gather opinions from medical educators on the possibility of introducing an interview to the Korean Medical Licensing Examination (KMLE) to assess professional attributes. Specifically following topics were dealt with: the appropriate timing and tool to assess unprofessional conduct; ; the possiblity of prevention of unprofessional conduct by introducing an interview to the KMLE; and the possibility of implementation of an interview to the KMLE. @*Methods@#A cross-sectional study approach based on a survey questionnaire was adopted. We analyzed 104 pieces of news about doctors’ unprofessional conduct to determine the deficient professional attributes. We derived 24 items of unprofessional conduct and developed the questionnaire and surveyed 250 members of the Korean Society of Medical Education 2 times. Descriptive statistics, cross-tabulation analysis, and Fisher’s exact test were applied to the responses. The answers to the open-ended questions were analyzed using conventional content analysis. @*Results@#In the survey, 49 members (19.6%) responded. Out of 49, 24 (49.5%) responded in the 2nd survey. To assess unprofessional conduct, there was no dominant timing among basic medical education (BME), KMLE, and continuing professional development (CPD). There was no overwhelming assessment tool among written examination, objective structured clinical examination, practice observation, and interview. Response rates of “impossible” (49.0%) and “possible” (42.9%) suggested an interview of the KMLE prevented unprofessional conduct. In terms of implementation, “impossible” (50.0%) was selected more often than “possible” (33.3%). @*Conclusion@#Professional attributes should be assessed by various tools over the period from BME to CPD. Hence, it may be impossible to introduce an interview to assess professional attributes to the KMLE, and a system is needed such as self-regulation by the professional body rather than licensing examination.
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Purpose@#This study aimed to investigate burnout and resilience among emergency physicians (EPs) at university teaching hospitals during the coronavirus disease (COVID-19) pandemic. @*Materials and Methods@#In April to May 2021, a survey was administered to 331 and 309 emergency medicine specialists and residents, respectively, from 31 university teaching hospitals in Korea. Data on the respondents’ age, sex, designation, working area, experience with treating COVID-19 patients, and personal experience with COVID-19 were collected. Based on the participants’ characteristics, quality of life (compassion satisfaction, burnout, and secondary traumatic stress), resilience, emotional content, and self-image were analyzed. @*Results@#A total of 247 responses were analyzed. Compared to specialists, compassion satisfaction and resilience in residents were not good, burnout was severe, and emotional content and self-image were less positive. Experiences with treating COVID-19 patients did not cause any difference in quality of life, resilience, emotional content, and self-image among participant subgroups. Personal COVID-19 experiences were associated with poor compassion satisfaction, resilience, less positive emotional content and self-image, and severe burnout. Compassion satisfaction, secondary traumatic stress, and resilience can definitively affect burnout. @*Conclusion@#The quality of life and resilience of EPs in university teaching hospitals in Korea during the COVID-19 pandemic have been low. Supportive measures to improve resilience can prevent burnout among emergency staff, particularly residents and EPs, with personal experiences related to COVID-19.
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This study aimed to analyze the subjects, situations, and reflection levels related to role modeling experienced by medical students during their clinical clerkship and their own reflections. This study intends to suggest ways of improving how residents and clinical faculty should treat and teach medical students. Written interviews were conducted regarding senior medical students’ role modeling experiences during their clinical clerkships in 2018 and 2019. Content analysis was conducted for a total of 224 cases from 196 students. Content analysis revealed three types of role modeling content: subjects (faculty, residents, nurses, peer students), situations (clinical competence, personal qualities, teaching skills), and the level of reflection (critical reflection, reflection, thoughtful action, and habitual action) in each case. As role model subjects, faculty were found to be the paramount role model (n=142, 62.83%). Role modeling was the most frequently performed for clinical competence (n=103, 45.98%). Clinical competence was frequently shown in communication and empathic listening during rounds and outpatient relationships between the patient and doctor. Regarding the level of reflection for role modeling, the number of critical reflections was 86 (38.39%) and that of reflections was 80 (35.71%). In particular, negative role modeling showed a high level of critical reflection in relation to faculty (64.44%) and nurses (8.89%). In conclusion, role modeling of medical students participating in clinical clerkships occurs in situations that the role models are not aware of, with positive or negative effects on the formation of professional identity among medical students.
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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.
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Background@#: We analyze the contents of conversations of emergency medicine (EM) residents in a simulation using standardized patients in error disclosure education, and examine the characteristics of them. @*Methods@#: Error disclosure education program was conducted for 15 EM residents at a training hospital. One case of near miss and one case of adverse event were developed, and all 15 residents participated in each case. The contents of 30 error disclosure conversation were analyzed. @*Results@#: Residents talked more in ‘Acknowledge what happened’ and ‘Response/Plan for care’, and it was rare to have conversations of ‘Tell me about it’ or ‘Answer questions’ in both cases. The cause of the incident was explained frankly, but when the patient blamed there were some residents who told honestly or not. There was a tendency to vaguely reveal the subject who made the mistake or attribute it to another cause. Most of residents apologized to the patient. Most of residents explained systematic recurrence prevention measures and compensation plans, but there were cases where the contents were not specific or inaccurate. Throughout the entire phase, the expression “we” was often used. @*Conclusion@#: Residents had doctor-led conversations while error disclosure, so that they need more patient-centered conversations. When apology, empathy and regret should be conveyed in various expressions. Residents need to be properly trained and able to explain to patients about follow-up measures such as systematic recurrence prevention measures and compensation plans. These results can be a basic material for teaching error disclosure or guidelines.
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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.
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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.
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This study investigated medical students’ perceptions of good jobs. We classified medical students’ perceptions of good jobs and analyzed the characteristics of each type. The Q methodology was used to extract medical students’ subjective thoughts. After extracting statements based on previous studies, 46 Q samples were selected. The P sample consisted of 40 medical students divided evenly by gender and grade. They performed a Q sort of the 46 Q sample questionnaire and the results were analyzed using the QUANL ver. 1.2 program.Very few consensus statements were found in the replies. We divided answers into four types, each of which was clearly distinguished: (1) quality of life-oriented jobs, (2) reward-oriented jobs, (3) service-oriented jobs, and (4) self-realization-oriented jobs. Medical students in type 1 prioritized quality of life equally at work and at home. Medical students in type 2 preferred high-paying jobs. Medical students in type 3 placed importance on serving others. Finally, medical students in type 4 viewed good jobs as involving learning and development. The types of jobs sought were classified according to individual students’ values and subjectivity. Medical schools may use the results of this study as a basis for career guidance.
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Purpose@#This study aimed to examine the differences in scores of the Attitude to Patient Safety Questionnaire (APSQ) by medical students before and after the outbreak of COVID-19. @*Methods@#In total, 97 and 118 medical students completed patient safety courses at Yonsei University Wonju College of Medicine in 2019 and 2020, respectively. In 2019, the course was conducted using traditional learning in the classroom, whereas, in 2020, most of the classes were conducted using non-face-to-face learning methods. @*Results@#In 2019 and 2020, 49 and 53 students responded to the APSQ. Only one item “Patients are not really aware of how safe their care is” had a lower score in 2020 than in 2019. @*Conclusion@#Although the total APSQ score did not differ between 2019 and 2020, the students in 2020 might have a poor understanding of the role of patients in medical errors.
ABSTRACT
This study investigated medical students’ perceptions of good jobs. We classified medical students’ perceptions of good jobs and analyzed the characteristics of each type. The Q methodology was used to extract medical students’ subjective thoughts. After extracting statements based on previous studies, 46 Q samples were selected. The P sample consisted of 40 medical students divided evenly by gender and grade. They performed a Q sort of the 46 Q sample questionnaire and the results were analyzed using the QUANL ver. 1.2 program.Very few consensus statements were found in the replies. We divided answers into four types, each of which was clearly distinguished: (1) quality of life-oriented jobs, (2) reward-oriented jobs, (3) service-oriented jobs, and (4) self-realization-oriented jobs. Medical students in type 1 prioritized quality of life equally at work and at home. Medical students in type 2 preferred high-paying jobs. Medical students in type 3 placed importance on serving others. Finally, medical students in type 4 viewed good jobs as involving learning and development. The types of jobs sought were classified according to individual students’ values and subjectivity. Medical schools may use the results of this study as a basis for career guidance.
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Purpose@#This study aimed to examine the differences in scores of the Attitude to Patient Safety Questionnaire (APSQ) by medical students before and after the outbreak of COVID-19. @*Methods@#In total, 97 and 118 medical students completed patient safety courses at Yonsei University Wonju College of Medicine in 2019 and 2020, respectively. In 2019, the course was conducted using traditional learning in the classroom, whereas, in 2020, most of the classes were conducted using non-face-to-face learning methods. @*Results@#In 2019 and 2020, 49 and 53 students responded to the APSQ. Only one item “Patients are not really aware of how safe their care is” had a lower score in 2020 than in 2019. @*Conclusion@#Although the total APSQ score did not differ between 2019 and 2020, the students in 2020 might have a poor understanding of the role of patients in medical errors.
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Purpose@#This study determined the effects of interprofessional education (IPE) on self-efficacy and attitude by comparing an interprofessional (IP) group of medical students (MSs) and nursing students (NSs) and a uniprofessional (UP) group of MSs. @*Methods@#An experimental IP group consisting of 49 MSs and 62 NSs was selected, alongside a UP control group of 48 other MSs. The groups participated in a class titled “Team Communication and Interprofessional Collaboration.” A sub-analysis of the two groups’ professions was also conducted. The groups participated in the same lesson separately, with a week’s interval. The Interprofessional Attitudes Scale (IPAS) and the Self-Efficacy Perception for Interprofessional Experiential Learning (SEIEL) scale were used before and after the class to compare changes in reports of self-efficacy and attitudes in both groups. Students’ responses to learning experiences and satisfaction were also evaluated. @*Results@#IPAS and SEIEL values increased after the class for MSs in both groups; there were no differences between the groups. IPAS and SEIEL values increased after the class in MSs and NSs in the IP group, and the effect size for IPAS was larger for IP-group NSs than for IP-group MSs. Satisfaction scores exceeded 3.70 in both groups. @*Conclusion@#The UP group showed similar IPE effects as the IP group, as measured by SEIEL and IPAS, in a single IPE program that used role-play and case-based discussion. However, it would be desirable for the UP group to interact with other professions to improve understanding and experience.
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Objective@#This study was conducted to identify the needs assessment for education and training of emergency medicine (EM) residents. @*Methods@#The results of a national survey of EM residents of the Korean Society of Emergency Medicine in 2019 were used. Education was one of the five categories in the survey. The preferred learning methods and their perceived importance and ability to perform in nine competencies were assessed. The Borich’s needs assessment model was used to analyze their needs. @*Results@#Among 591 EM residents, 382 responded, and 371 responses were finally analyzed. Regarding the learning methods, junior residents preferred in-hospital conferences, staff lectures, internet resources, and textbooks. Overall, medical knowledge and procedural skills were the most important, and research was less important to recognize. Medical knowledge showed the highest rank in the needs assessment in all years, and ethics and professionalism showed the lowest ranks. The needs for procedural skills were higher in junior years but lower in senior years. @*Conclusion@#These results will form the basis for the design of training programs to meet the educational needs of EM residents for each grade. Furthermore, an analysis of the educational needs should be done periodically according to the changes and demands of the times.
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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.
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Objective@#This study was evaluated the behavior intention of emergency medicine residents before and after education using a vignette case about professionalism, particularly in physician impairment. The residents’ reaction to this type of education was evaluated. @*Methods@#Thirty-four residents from five teaching hospitals participated in this education program consisting of lecture and discussion using cases. They wrote their behavioral intention and their opinions before and after education. Their satisfaction and reaction to the education experience were also collected. @*Results@#The frequencies of the common reasons for the action or the basis of the judgment, concerns during decision making, and desired help were similar, but their action decisions changed into more systemic and reasonable ones after the education. They had fewer learning experiences of non-clinical skills and were satisfied with this type of professionalism education. Furthermore, they felt the importance and educational needs of professionalism beyond this topic and would cope with similar problem situations the way they learned in this education. @*Conclusion@#In the professionalism education using the case discussion of impairment and self-monitoring, little had changed in the participants’ reasons for the action, concerns when decision making, and desired help, but their behavior intentions changed as they learned. This study provided the opportunity to recognize the importance of professionalism, patient safety, and peer relationship. Small group discussions using the vignette case can be suggested to provide professionalism education for the emergency medicine residents.
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Objective@#The 2019 Korean Emergency Medicine Residents Survey (KEMRS) is the first survey by the Korean Society of Emergency Medicine (KSEM) on the comprehensive satisfaction of their residents. Satisfaction is important not only for the personal well-being of the residents but also for patient safety. @*Methods@#A total of 622 emergency medicine residents were surveyed, using both a paper and email questionnaire from May to August of 2019. Factors related to satisfaction were analyzed. @*Results@#Of the responders, 66% said they would reapply for the emergency specialty and 51% said that they would reselect the same training hospital. The group of residents who said they would choose emergency medicine again felt that their expectations had been met and that they were comfortable with the choice of the specialty. They felt that the factors of satisfaction with their shift schedule and personal health played a more important role in their reselection of the training hospital than the workload. @*Conclusion@#The satisfaction levels of the Korean emergency residents were low. Thus, training hospitals should provide a reasonable working environment to increase their satisfaction. Also, it is important to create an environment where residents can feel rewarded and proud of the work they do.
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Objective@#This study was evaluated the behavior intention of emergency medicine residents before and after education using a vignette case about professionalism, particularly in physician impairment. The residents’ reaction to this type of education was evaluated. @*Methods@#Thirty-four residents from five teaching hospitals participated in this education program consisting of lecture and discussion using cases. They wrote their behavioral intention and their opinions before and after education. Their satisfaction and reaction to the education experience were also collected. @*Results@#The frequencies of the common reasons for the action or the basis of the judgment, concerns during decision making, and desired help were similar, but their action decisions changed into more systemic and reasonable ones after the education. They had fewer learning experiences of non-clinical skills and were satisfied with this type of professionalism education. Furthermore, they felt the importance and educational needs of professionalism beyond this topic and would cope with similar problem situations the way they learned in this education. @*Conclusion@#In the professionalism education using the case discussion of impairment and self-monitoring, little had changed in the participants’ reasons for the action, concerns when decision making, and desired help, but their behavior intentions changed as they learned. This study provided the opportunity to recognize the importance of professionalism, patient safety, and peer relationship. Small group discussions using the vignette case can be suggested to provide professionalism education for the emergency medicine residents.