Instructor factors associated with medical students’ lecture evaluation: a longitudinal analysis / 한국의학교육

Purpose@#This study identified factors that affect lecture evaluation by analyzing sophomores from Dankook University, examining each cluster’s characteristics, and comparing differences among trajectories. @*Methods@#This study identified factors that affect lecture evaluation by analyzing sophomores from Dankook University, examining each cluster’s characteristics, and comparing differences among trajectories. @*Results@#The lecture evaluation score decreased as the teaching hours per instructor in a year increased by an hour, and the number of instructors per lecture increased by one individual. During trajectory analysis, the first trajectory had lower lecture evaluation scores overall but relatively high appropriateness of the textbook and punctuality of class, whereas the second trajectory had higher lecture evaluation scores overall for all four items. @*Conclusion@#The two trajectories showed differences in teaching methods (understanding of lecture content and usefulness of the lecture) rather than in external factors (appropriateness of the textbook and punctuality of class). Therefore, to improve lecture satisfaction, enhancing instructors’ instructional competencies through lectures and adjusting the teaching hours by assigning an adequate number of instructors per lecture are recommended.

Analysis and suggestions on medical educators’ roles / 한국의학교육

Purpose@#This study aimed to investigate the differences in the perception between professors and students regarding medical educators’ roles and discuss their desirable roles. @*Methods@#A survey was administered to 116 professors and 379 students of the medical colleges from Dankook University and Hallym University. The subjects were given a self-created questionnaire designed to measure their perception of medical educators’ roles. @*Results@#First, “student performance management” for professors and “teaching skill development” for students were recognized as the most essential medical educators’ role. Second, females students perceived the roles to be more important than males in eight of 10 roles. @*Conclusion@#First, “student performance management” for professors and “teaching skill development” for students were recognized as the most essential medical educators’ role. Second, females students perceived the roles to be more important than males in eight of 10 roles.

The relationship between classical item characteristics and item response time on computer-based testing / 한국의학교육

PURPOSE: This study investigated the relationship between the item response time (iRT) and classic item analysis indicators obtained from computer-based test (CBT) results and deduce students' problem-solving behavior using the relationship. METHODS: We retrospectively analyzed the results of the Comprehensive Basic Medical Sciences Examination conducted for 5 years by a CBT system in Dankook University College of Medicine. iRT is defined as the time spent to answer the question. The discrimination index and the difficulty level were used to analyze the items using classical test theory (CTT). The relationship of iRT and the CTT were investigated using a correlation analysis. An analysis of variance was performed to identify the difference between iRT and difficulty level. A regression analysis was conducted to examine the effect of the difficulty index and discrimination index on iRT. RESULTS: iRT increases with increasing difficulty index, and iRT tends to decrease with increasing discrimination index. The students' effort is increased when they solve difficult items but reduced when they are confronted with items with a high discrimination. The students' test effort represented by iRT was properly maintained when the items have a 'desirable' difficulty and a 'good' discrimination. CONCLUSION: The results of our study show that an adequate degree of item difficulty and discrimination is required to increase students' motivation. It might be inferred that with the combination of CTT and iRT, we can gain insights about the quality of the examination and test behaviors of the students, which can provide us with more powerful tools to improve them.

Evaluation for effectiveness of oriental medicine-based infertility treatment and spontaneous pregnancy rate of infertile patients using systematic review

This study is to evaluate the effectiveness of oriental medicine-based infertility treatment and to examine the validity of the oriental medicine-based infertility treatment program through a systematic review. The literature search database included not only PubMed, DBpia, and RISS (Research Information Sharing Service) but also OASIS (Oriental Medicine Advanced Searching Integrated System) and Korean Traditional Knowledge Portal. Among 575 articles that searched, only three papers were randomized controlled trials and could be included for the evaluation of the effects of oriental medicine-based infertility treatment. There was no study showing the effectiveness of oriental medicine-based infertility treatment alone. Among 5,165 articles that searched, only 15 studies could be included for the evaluation of the natural pregnancy rate of infertile patients. These studies reported the natural pregnancy rates from 20.3% to 41.9%. As pregnancy rates ranged from 23.8% to 27.6% after the oriental medicine-based infertility treatment supporting programs, we cannot conclude that pregnancy rates for infertile patients might increase by this project. Therefore, there is a need to reconsider whether the oriental medicine-based infertility treatment program should continue in the future.

Evaluation for effectiveness of oriental medicine-based infertility treatment and spontaneous pregnancy rate of infertile patients using systematic review

This study is to evaluate the effectiveness of oriental medicine-based infertility treatment and to examine the validity of the oriental medicine-based infertility treatment program through a systematic review. The literature search database included not only PubMed, DBpia, and RISS (Research Information Sharing Service) but also OASIS (Oriental Medicine Advanced Searching Integrated System) and Korean Traditional Knowledge Portal. Among 575 articles that searched, only three papers were randomized controlled trials and could be included for the evaluation of the effects of oriental medicine-based infertility treatment. There was no study showing the effectiveness of oriental medicine-based infertility treatment alone. Among 5,165 articles that searched, only 15 studies could be included for the evaluation of the natural pregnancy rate of infertile patients. These studies reported the natural pregnancy rates from 20.3% to 41.9%. As pregnancy rates ranged from 23.8% to 27.6% after the oriental medicine-based infertility treatment supporting programs, we cannot conclude that pregnancy rates for infertile patients might increase by this project. Therefore, there is a need to reconsider whether the oriental medicine-based infertility treatment program should continue in the future.

The relationship between classical item characteristics and item response time on computer-based testing / 한국의학교육

PURPOSE@#This study investigated the relationship between the item response time (iRT) and classic item analysis indicators obtained from computer-based test (CBT) results and deduce students' problem-solving behavior using the relationship.@*METHODS@#We retrospectively analyzed the results of the Comprehensive Basic Medical Sciences Examination conducted for 5 years by a CBT system in Dankook University College of Medicine. iRT is defined as the time spent to answer the question. The discrimination index and the difficulty level were used to analyze the items using classical test theory (CTT). The relationship of iRT and the CTT were investigated using a correlation analysis. An analysis of variance was performed to identify the difference between iRT and difficulty level. A regression analysis was conducted to examine the effect of the difficulty index and discrimination index on iRT.@*RESULTS@#iRT increases with increasing difficulty index, and iRT tends to decrease with increasing discrimination index. The students' effort is increased when they solve difficult items but reduced when they are confronted with items with a high discrimination. The students' test effort represented by iRT was properly maintained when the items have a 'desirable' difficulty and a 'good' discrimination.@*CONCLUSION@#The results of our study show that an adequate degree of item difficulty and discrimination is required to increase students' motivation. It might be inferred that with the combination of CTT and iRT, we can gain insights about the quality of the examination and test behaviors of the students, which can provide us with more powerful tools to improve them.

Nonspecific Building Related Illnesses / 대한산업의학회지

Nonspecific building related illnesses (NBRI) are an array of diverse symptoms related to working in particular buildings. There are numerous contributing factors, including basic factors (temperature, humidity and ventilation) as well as chemicals, dust, microorganisms, and psychosocial factors. At the individual level, taking a careful history is the essential first step. After ruling out other diseases, clinicians can start the symptomatic treatment for NBRI. If a relationship to the building is suspected, a walk through evaluation is very helpful. At the group level, standardized questionnaires and investigations of the building environment can be applied simultaneously. If the prevalence of symptoms are greater than that of general population, appropriate interventions have to be provided for prevention and group health care. In both approaches, it is essential to periodically follow up with symptomatic patients and work environments after an intervention. For the management of NBRI, taking care of the patient's symptoms and maintaining a good indoor environment are important. To achieve this goal, cooperation among workers, building managers, employers and occupational health staff is crucial.

Effect of Sociodemographic Factors, Cancer, Psychiatric Disorder on Suicide: Gender and Age-specific Patterns / 예방의학회지

OBJECTIVES: We examined the effect of sociodemographic factors, cancer, and psychiatric disorders on suicide by gender and age-specific patterns in South Korea. METHODS: The study is a case-control study. Claim data was obtained from the national health insurance database and national death registration database. The number of people who committed suicide was 11,523, which was matched with a control group consisting of ten times as many people at 115,230 selected from the national health insurance and medical aids beneficiaries. The medical utilization of the case group was one year before death and that of the control group was from July 1,2003 to June 30, 2004. Four variables-address, economic status, presence of a psychiatric disease, and cancer-were used in multiple logistic regression analyses. RESULTS: Living in cities or in rural areas showed a greater risk for suicide than living in a metropolitan city. Low economic status, the presence of a psychiatric disorder, and cancer were also statistically meaningful risk factors for suicide. The three major psychiatric diseases, schizophrenia, alcohol abuse, and bipolar disorder, were meaningful in all age groups, but the scale of the odds ratio differed by the age group. Only the psychiatric disorder variable was meaningful in the adolescent group, whereas a psychiatric disorder and economic status were meaningful for the young adult group, and all variables were meaningful for the middle-aged group. A psychiatric disorder and cancer were meaningful in the elderly group, economic status was meaningful for male subjects, and address was meaningful for female subjects. CONCLSIONS: Factors such as living in city or rural areas, low economic status, the presence of a psychiatric disorder, and cancer were statistically meaningful risk factors in suicide. These factors also differed by age group. Therefore, policymakers should establish policies for suicide prevention that are relevant for each age group.

Comparison of the Accuracy of Mammography, Ultrasonography and MRI for Evaluating Residual Tumor after Neoadjuvant Chemotherapy for Breast Cancer

PURPOSE: The purpose of our study was to determine the relative accuracy of mammography, ultrasonography and MRI for evaluating residual tumor after neoadjuvant chemotherapy for breast cancer, as compared with the pathological results. MATERIALS AND METHODS: From December 2004 through August 2005, 13 patients who had mammography, ultrasonography and MRI performed for evaluating tumor response were enrolled in our study from a total of 47 patients who received neoadjuvant chemotherapy for breast cancer. The therapy response was defined by ultrasonography that was able to compare the images taken before and after therapy, and each imaging was retrospectively analyzed by two board-certified radiologists who specialized in breast imaging. The presence or absence of residual tumor was investigated and the tumor measurement according to the imaging was divided into underestimating, being equal to or overestimating the size of the residual tumor, compared with that of the pathological results. The relative accuracy of these modalities was then assessed. RESULTS: Eight of 13 patients showed a partial response and 5 patients showed stable lesion. Agreement rates about the residual tumor, as measured by mammography, ultrasonography and MRI and then compared with the pathological results, were 39%, 54% and 77%, respectively. Of the three methods, MRI agreed with the pathological results significantly more often, but it may overestimate (8%) or underestimate (15%) (p = 0.102). When there was disagreement with the pathological results, mammography exhibited a tendency to underestimate (38%) and ultrasonography exhibited a tendency to overestimate (31%). CONCLUSION: MRI had a higher relative accuracy than did mammography and ultrasonography for evaluating the residual tumor in patients receiving neoadjuvant chemotherapy for breast cancer. However, MRI may overestimate (8%) or underestimate (15%) the residual tumor.

Factors Associated with the Degree of Quality Improvement Implementation / 예방의학회지

OBJECTIVES: To assess the degree of quality improvement (QI) implementation and to identify its associated factors. METHODS: A mailed questionnaire survey of the QI staffs at hospitals with 400 beds or more was conducted between September 15 and October 30, 2000. Of the 108 hospitals eligible for inclusion in our study, 79 participated, yielding a response rate of 73.1%. After excluding 12 hospitals that did not perform any QI activities, 117 responses from 67 hospitals were used in our analysis. The degree of QI implementation was measured using the Malcolm Baldrige National Quality Award Criteria (MBNQAC). Factors evaluated for association with the degree of QI implementation were cultural, technical, strategic, and structural factors of the hospitals. RESULTS: The average QI implementation score across the 7 dimensions of MBNQAC was 3.34 on a 5-point scale, with the highest score for the area of customer satisfaction (3.88) followed by information and analysis (3.59) and quality management (3.35). The results of regression analysis showed that hospitals with a etter information system (p<0.05) and using scientific and systematic problem solving approach (p<0.01) tended to perform a higher degree of QI implementation. While statistically insignificant, positive associations were observed for the factors of group or developmental culture, the degree of employee empowerment, and the use of prospective strategy. CONCLUSIONS: It appears that the most important factors contributing to active implementation of QI in Korean hospitals were the use of scientific skills in decision making, and having a quality information system to produce precise and valid information.