Patient-Centered Doctor’s Competency Framework in Korea / 의학교육논단

With increasing demands for medical care by society, the medical system, and general citizens and rapid changes in doctor’s awareness, the competencies required of doctors are also changing. The goal of this study was to develop a doctor’s competency framework from the patient’s perspective, and to make it the basis for the development of milestones and entrustable professional activities for each period of medical student education and resident training. To this end, a big data analysis using topic modeling was performed on domestic and international research papers (2011–2020), domestic newspaper articles (2016–2020), and domestic social networking service data (2016–2020) related to doctor’s competencies. Delphi surveys were conducted twice with 28 medical education experts. In addition, a survey was conducted on doctor’s competencies among 1,000 citizens, 407 nurses, 237 medical students, 361 majors, and 200 specialists.Through the above process, six core competencies, 16 sub-competencies, and 47 competencies were derived as subject-oriented doctor’s competencies. The core competencies were: (1) competency related to disease and health as an expert; (2) competency related to patients as a communicator; (3) competency related to colleagues as a collaborator; (4) competency related to society as a health care leader (5) competency related to oneself as a professional, and (6) competency related to academics as a scholar who contributes to the development of medicine.

Is the Accreditation in Medical Education an Opportunity or a Burden? / 의학교육논단

The accreditation process (AccP) is both an opportunity and a burden for medical schools—which one it becomes depends on how medical schools recognize and utilize the AccP. In other words, if a medical school recognizes the AccP only as a formal procedure or as a means for continuing medical education, it will be a burden for the medical school. However, if a medical school recognizes the real and positive value of the AccP, it can be both an opportunity and a tool for developing medical education. The educational value of the AccP is to improve the quality, equity, and efficiency of medical education, along with increasing the options of choice. In order for the AccP to contribute to the development of medical education, accrediting agencies and medical schools must first be recognized as part of an “educational alliance” working together towards common goals. Secondly, clear guidelines on the accreditation standards should be periodically reviewed and shared. Finally, a formative evaluation using self-evaluation as a system that can utilize the AccP as an opportunity to develop medical education must be introduced. This type of evaluation system could be developed through collaboration among medical schools, academic societies for medical education, and the accrediting authority.

Is accreditation in medical education in Korea an opportunity or a burden? / 보건의료교육평가

The accreditation process is both an opportunity and a burden for medical schools in Korea. The line that separates the two is based on how medical schools recognize and utilize the accreditation process. In other words, accreditation is a burden for medical schools if they view the accreditation process as merely a formal procedure or a means to maintain accreditation status for medical education. However, if medical schools acknowledge the positive value of the accreditation process, accreditation can be both an opportunity and a tool for developing medical education. The accreditation process has educational value by catalyzing improvements in the quality, equity, and efficiency of medical education and by increasing the available options. For the accreditation process to contribute to medical education development, accrediting agencies and medical schools must first be recognized as partners of an educational alliance working together towards common goals. Secondly, clear guidelines on accreditation standards should be periodically reviewed and shared. Finally, a formative self-evaluation process must be introduced for institutions to utilize the accreditation process as an opportunity to develop medical education. This evaluation system could be developed through collaboration among medical schools, academic societies for medical education, and the accrediting authority.

Is accreditation in medical education in Korea an opportunity or a burden? / 보건의료교육평가

The accreditation process is both an opportunity and a burden for medical schools in Korea. The line that separates the two is based on how medical schools recognize and utilize the accreditation process. In other words, accreditation is a burden for medical schools if they view the accreditation process as merely a formal procedure or a means to maintain accreditation status for medical education. However, if medical schools acknowledge the positive value of the accreditation process, accreditation can be both an opportunity and a tool for developing medical education. The accreditation process has educational value by catalyzing improvements in the quality, equity, and efficiency of medical education and by increasing the available options. For the accreditation process to contribute to medical education development, accrediting agencies and medical schools must first be recognized as partners of an educational alliance working together towards common goals. Secondly, clear guidelines on accreditation standards should be periodically reviewed and shared. Finally, a formative self-evaluation process must be introduced for institutions to utilize the accreditation process as an opportunity to develop medical education. This evaluation system could be developed through collaboration among medical schools, academic societies for medical education, and the accrediting authority.

Social Accountability of Medical Schools: Concept and Implementation Strategies / 의학교육논단

Medical schools have been working to produce competent doctors and improve the quality of care by introducing and implementing new curricula and innovative teaching and learning methods. Despite these efforts, health disparities within and between countries still exist. To close these gaps, medical schools must identify the priorities of the community, region, and/or nation and conduct education, research, and service that reflect them-the core foundation of the social accountability of medical schools. Many medical schools and networks around the world have tried to achieve social accountability, but this needs more attention in Korea. This study will review the literature in aims to improve understanding and promote the implementation of the social accountability of medical schools. Most medical schools that practice the principles of social accountability focus primarily on the medically underserved in their communities or those who have limited access to health services, and have built collaborative partnerships with stakeholders to meet the needs of society. In addition, in order to implement social accountability effectively and efficiently, medical schools have developed strategies and various evaluation frameworks appropriate to the context of each school. To have more socially accountable medical schools, it is necessary to clarify the concept of social accountability and to establish a system that can evaluate the impacts. Medical schools exist to alleviate suffering and promote health, and this can be accomplished through social accountability.

For the formation of a health community on the Korean Peninsula, inter-Korean cooperation should begin in the field of healthcare

On April 27, 2018, a historic inter-Korean summit took place. Accordingly, the hostile confrontation that lasted for the past 70 years is over, and many exchanges of human resources and material between the two Koreas are expected. In this situation, I propose that the reasons for and methods of cooperation in healthcare between North and South Korea should be among the first issues to be considered. The reasons are as follows. First, as exchanges increase, the South and the North will rapidly develop into a single health community on the Korean peninsula. Second, cooperation in the field of healthcare can play a leading role in fostering a positive attitude among South and North Koreans toward the improvement of inter-Korean relations and the possibility of future unification. Third, the two Koreas have conditions that make them ideal partners for improving healthcare quality and systems in each country. Some suggestions for specific ways to do this are presented. First, an inter-Korean healthcare agreement should be concluded. Second, specific organizations for inter-Korean cooperation should be established and operated. Third, it is necessary to form and operate a ‘control tower’ for this process in South Korea. It is expected that cooperation between the two Koreas in the field of healthcare will eventually extend to cooperation in all areas.

Health Systems Science / 의학교육논단

No abstract available.

For the formation of a health community on the Korean Peninsula, inter-Korean cooperation should begin in the field of healthcare

On April 27, 2018, a historic inter-Korean summit took place. Accordingly, the hostile confrontation that lasted for the past 70 years is over, and many exchanges of human resources and material between the two Koreas are expected. In this situation, I propose that the reasons for and methods of cooperation in healthcare between North and South Korea should be among the first issues to be considered. The reasons are as follows. First, as exchanges increase, the South and the North will rapidly develop into a single health community on the Korean peninsula. Second, cooperation in the field of healthcare can play a leading role in fostering a positive attitude among South and North Koreans toward the improvement of inter-Korean relations and the possibility of future unification. Third, the two Koreas have conditions that make them ideal partners for improving healthcare quality and systems in each country. Some suggestions for specific ways to do this are presented. First, an inter-Korean healthcare agreement should be concluded. Second, specific organizations for inter-Korean cooperation should be established and operated. Third, it is necessary to form and operate a ‘control tower’ for this process in South Korea. It is expected that cooperation between the two Koreas in the field of healthcare will eventually extend to cooperation in all areas.

Copycat Suicide Induced by Entertainment Celebrity Suicides in South Korea

OBJECTIVE: Throughout the past several years, there have been a number of entertainment celebrity suicides in South Korea. The aim of this study was to investigate the clustering of suicides following celebrities' suicides in South Korea from 2005 to 2008, particularly according to certain characteristics. METHODS: Seven celebrity suicides were examined and defined using the Korean Integrated Newspaper Database System (KINDS) and from these, we considered four affected periods occurring 28 days after each celebrity's suicide. A Poisson time-series autoregression model was used to estimate the relative risk of the total suicide number for each affected period from 2005 to 2008. Logistic regression analysis was performed to investigate whether there were specific increases in the numbers of suicides in subgroups matching each celebrity. RESULTS: There were significant increases in the risk of suicide during the affected periods. Remarkable increases were found in the subgroups matching each celebrity, especially in the group in which all factors (sex, age, and method) were similar. CONCLUSION: This study provides confirmation that a significant copycat effect was induced by these celebrities' suicides, especially among people who identified more with the celebrities. This implies that countermeasures for upright media coverage of celebrity suicides should be discussed and practiced properly in South Korea.

Unification Is Healing : Psychiatric Contemplation of Korean Peninsula Division and Unification / 신경정신의학

Koreans have repeatedly experienced societal traumas, of which Korean Peninsula division and 6.25 are the greatest sources of trauma. Such division and the Korean War have destroyed the concept of "nation community," "town community," and "rational community" in the Korean people. Thus, Korean people have come to 1) live in a society with no recognition of community, 2) obsession with extreme ideologism, 3) lower ability to resolve conflict making societal dissension more serious. For the healing of this trauma, the following projects are needed : 1) foreign case analysis of societal trauma healing, 2) analysis of each subject and healing, 3) rebuilding of nation, town, and ration community in Korean society, 4) creation of artwork that gives introspection to division and its sublimation, 5) take the challenge to sublimate suffering in order to create a higher mental state of individual and society. Thus, the professional role of a psychiatrist is important. First, administer professional treatment to those in need of medical psychiatric help who are suffering from societal trauma resulting from division. Second, grasp the mental and societal difficulties and special help needed for the various traumas. Third, help in creation of artwork dealing with the pain of division. Fourth, create a more culturally sensitive and appropriate psychiatric support method for North Korean Refugees in South Korea. Fifth, help in sublimating pain and finding meaning and maturation through it. It is important to acknowledge that "Unification is Healing."

The relationship between academic self-efficacy and academic burnout in medical students / 한국의학교육

PURPOSE: The purpose of this study was to examine the correlation between academic burnout and academic self-efficacy in medical students. METHODS: The study group comprised 446 students in years 1 to 4 of medical school. They were asked to rate their academic burnout and academic self-efficacy on a scale. The data were analyzed by multivariate analysis of variance and regression analysis. RESULTS: Academic self-efficacy was correlated negatively with academic burnout explaining 37% of academic burnout. CONCLUSION: Academic self-efficacy (especially self-confidence) had the greatest effect on academic burnout. The implications of these results are discussed in terms of an evaluation and support system for students.

The Factors Affecting the Development of National Identity as South Korean in North Korean Refugees Living in South Korea

OBJECTIVE: This study aims to observe the factors that influence the development of national identity of North Korean refugees who have resettled in South Korea. METHODS: The study population was comprised of 500 North Korean refugees who immigrated to South Korea in 2007. The variables measured national identity as South Korean, a scale for discrimination perceived during daily life, a social for supporting social network, a for childhood trauma experience, traumatic experiences in North Korea, and traumatic experiences during the escape process. Factor analysis was conducted on the result from the scale for national identity as South Korean which produced 4 factors including national consciousness, positive emotions, positive values, and negative values. Multiple regression was done to identify how variables such as demographic data, discrimination, social network, and past trauma had influenced each of 4 factors. RESULTS: National identity was negatively related by traumatic experience during childhood, perceived discrimination, and positively influenced by social networks. Positive emotion was related negatively to education level in North Korea and perceived discrimination, but positively related to traumatic experiences in North Korea. Negative value was related positively age and perceived discrimination but negatively related to supporting social network. CONCLUSION: The results of this study suggests that promoting social networks, decreasing discrimination and healing past traumas were important factors for North Korean refugees in South Korea to facilitate a new national identity as a South Korean.

Analysis of the Characteristics of Discussion Materials that Promote Group Discussion in the Medical Humanities / 한국의학교육

PURPOSE: This study aims to analyze the characteristics of discussion materials that promote student participation in discussions, satisfaction with student instruction, and tutor intervention in the medical humanities. METHODS: We surveyed 117 premedical students and 7 tutors who attended 4-week group discussions in the medical humanities in 2010. We described the discussion materials using the following 4 characteristics as independent variables: material type, level of understanding, interest, and quantity. Dependent variables were: student participation in the discussion, student instruction satisfaction, and tutor intervention. Correlation analysis, multiple regression analysis, and crosstab were performed using SPSS 15.0. RESULTS: The correlation between the characteristics of the discussion materials differed by grade. When the books were chosen as the discussion material in the instruction of first-year premedical students, the correlation between level of understanding, interest, and quantity was negative. Higher levels of understanding of the material and interest in the material led to an increase in discussion participation among both first- and second-year premedical students. Higher levels of understanding and interest of the discussion material also increased student satisfaction with the instruction, regardless of grade. Finally, levels of understanding of the material affected the degree of tutor intervention. Tutors intervened more often in discussions with first-year premedical students than with second-year premedical students. CONCLUSION: Differences in grades and the understanding of the discussion material should be considered when choosing discussion materials. Further study is required to continue the development of the discussion model and improve methods of facilitate discussion among students in the medical humanities.

"I'm Not Happy, But I Don't Care": Help-Seeking Behavior, Academic Difficulties, and Happiness / 한국의학교육

PURPOSE: Medical education is perceived as being very stressful, which leads to declines in subjective well-being in medical students. Therefore, student counseling is becoming an exigent issue. The goal of this study was to investigate the academic difficulties and subjective well-being of medical students to identify their needs with regard to counseling. In addition, we analyzed help-seeking behaviors of students to develop an effective counseling program. METHODS: We performed a survey (n=205) to determine the extent to which medical students encounter academic difficulties in their lives in medical school and how they attempt to resolve their problems. In addition, we used the Oxford Happiness Scale to examine the relationships between academic performance, previous help-seeking behavior, and happiness in medical students. RESULTS: Of various types of problems, 62% of medical students perceived learning difficulties to be the most serious issue in medical school. Despite encountering difficulties, more than 67% of students failed to seek help from faculty or their fellow students. There was a significant relationship between happiness score and previous help-seeking behavior. A lack of perceived seriousness was identified as the most significant barrier to seeking help. CONCLUSION: Access to counseling programs must be improved for students with apparent academic difficulties who do not seek counseling. Through such programs, students can learn and practice methods of coping with their difficulties and develop medical and professional competence.

A Seven-Year Panel Study on North Korean Defectors Perception and Satisfaction on Life in South Korea / 신경정신의학

OBJECTIVES: North Korean defectors' comprehension of South Korean society and satisfaction with their lives in South Korea both symbolize their adaptation to their new society. The current report is an analysis of three serial panel studies of 200 North Korean defectors who entered South Korea in 2000. METHODS: From February 2009 to March 2009, we interviewed 121 defectors face-to-face. RESULTS: The results showed that the participant's satisfaction level had been relatively well-maintained, and their understanding of the South Korean culture and language had increased. However, their attitudes toward fellow North Korean defectors had worsened. Their satisfaction level with government support for medical care was very low. Gender, age, level of education in North Korea, Communist Party membership, completion of military service, and current employment status had significant influences on their interpretation and understanding of South Korea. CONCLUSION: The results suggest creating North Korean defector self-help groups, strengthening the medical support system, developing programs tailored according to defectors' different backgrounds, gender, age, and educational levels, as well as increasing South Koreans' awareness of these North Koreans through a appropriate campaign, will be necessary for the peaceful unification of the Korean Peninsula.

Quality of Life of North Korean Defectors in South Korea : Three Years Follow-Up Study / 신경정신의학

OBJECTIVES: This study evaluated the quality of life (QoL) of North Korean defectors in South Korean society in the year 2007 for purposes of comparing it to their QoL in 2004 and identifying demographic variables that influence QoL. METHODS: We used the Korean version of WHOQoL-BREF to evaluate the QoL of 106 North Korean defectors. Other instruments included a questionnaire for discerning demographic data, life experiences, and physical health. RESULTS: For last 3 years, more defectors had higher education, married, and higher income. However, their unemployment numbers did not decrease, while their number of believers in a religion did decrease. QoL scores remained low in the areas of negative feelings, financial resources, dependence on treatment and drugs, recreation and leisure activities, and opportunities for new information and skills, but were high in areas of cognitive mental functions, personal beliefs, work capacity, self-esteem, and transportation. Path analysis suggested that the psychological domain influenced overall QoL while other domains influenced overall QoL indirectly, through the psychological domain. Since 2004, defectors' QoL in the physical domain and in opportunities for education and transportation had improved, while QoL with regard to pain and discomfort, mobility, and negative feelings had worsened. Variables that were negatively correlated with QoL included male sex, higher age, being married, experiencing army service in North Korea, and shorter stays in third countries. In South Korea, QoL was negatively correlated with current physical illness but positively correlated to having a family, a stable job, higher income, and someone to talk with. CONCLUSION: These results suggest that defectors' QoL would be improved by tailored services according to their sex and age, focusing on educational programs to provide new information and skills, support for building families, health services, and community support.

Teaching Medical Students in Primary and Secondary Care: a Resource Book (Sarah Hartley, Deborah Gill, Frances Cater) / 한국의학교육

No abstract available.

The Failure Experiences of Medical School Students: A Qualitative Study / 한국의학교육

PURPOSE: In medical school, where high-scoring students are respected, a student who fails is regarded as a feckless individual who cannot survive in a competitive atmosphere. This study aims to analyze the experiences of failure inmedical school students using a qualitative approach. METHODS: In-depth, semi-structured interviews were conducted with nine medical students who had failed the program and became a repeater or failed to pass the Korean Medical Licensure Exam, and three former and present vice deans of Yonsei University between April 2007 and May 2007. Students were classified into two groups: those who attend medical school and those who had graduated but failed the Korean Medical Association (KMA) examination. RESULTS: The structural factors of experiences with failure were competitive culture, restrictive professor-student relationships, and indifference toward students' quality of life. Students perceived the factors of their failure to be maladjusted learning patterns emotional problems, such as loss of confidence, feelings of inferiority, and depression physical and economic difficulties and poor time management. The results revealed that students felt their status decline and changed their self-concept and that their social network became restricted. CONCLUSION: Medical schools and faculty consider students who have failed as community members. In addition, to prevent student failure, medical schools must reestablish a rigid professor-student relationship, develop a learner-centered curriculum and teaching method, implement a better learning support system, and improve the students' quality of life.

Reliability and Validity of the Korean Version of Obsessive-Compulsive Inventory-Revised in a Non-clinical Sample

PURPOSE: The reliability and validity of a Korean version of the Obsessive-Compulsive-Inventory-Revised (OCI-R) was examined in non-clinical student samples. MATERIALS AND METHODS: The Korean version of OCI-R was administered to a total of 228 Korean college students. The Maudsley Obsessive Compulsive Inventory (MOCI), Beck's Depression Inventory (BDI), and Beck's Anxiety Inventory (BAI) were administered to 228 students. RESULTS: The total and each of subscale of the Korean OCI-R demonstrated excellent internal consistency, good test-retest reliability, moderate convergent validity and good divergent validity. CONCLUSION: It was concluded that the Korean version of the OCI-R has strong psychometric properties as the original version.

3-Year Follow up Study of the Way of Thinking and Satisfaction Level of North Korean Defectors in South Korea / 신경정신의학

OBJECTIVES: The aim of this study was to examine the change in attitudes and satisfaction level of North Korean defectors in South Korea over a 3 year period (2001-2004). METHODS: In our first study in 2001, a total of 200 defectors were interviewed. In the follow up study after 3 years, 151 defectors were re-interviewed by an in-person interview. RESULTS: The level of satisfaction to the governmental support policy to defectors decreased significantly. However, the general level of satisfaction increased slightly (from 3.52 to 3.56 ; 5-score scale). This shows that North Korean defectors are stably adapting to South Korean society. The level of satisfaction significantly correlated with the defectors' confusion of the different value systems, the defectors' understanding of the South Korean people, satisfaction with their physical and mental health, and the prejudice of South Korean people to defectors. In terms of the attitudes, the type of schooling, the military service and the communist party membership in North Korea were not related to the change in attitude. However, there was a significant correlation with gender and age. Women showed a greater change in attitude compared to men. Older people had difficulty in understanding the South Korean people, but they showed little psychological affiliation to North Korea. Moreover, they showed a high level of satisfaction with the economic situation in South Korea and had an optimistic viewpoint for their future than younger people. Even though many defectors attended churches, religion was not associated with the level of satisfaction or their change in attitude. CONCLUSION: The factors that influence the level of satisfaction and attitudes of North Korean defectors have changed over 3 years. Therefore, the government, nongovernmental organizations (NGOs) associated with defectors and the churches need to be more sensitive to these changes and make plans to support the adaptation of defectors to South Korean society.