The status quo and influencing factors of the overall clinical performance in nursing students / 中国实用护理杂志

Objective:To investigate the overall clinical performance of nursing students and analyze its influencing factors to provide evidence for the improvement.Methods:A questionnaire survey was carried out among 288 nursing students from Qilu Hospital of Shandong University in March to May 2020. The survey included a general data questionnaire, Holistic Clinical Assessment Tool, Clinical Learning Environment, Supervision and Nurse Teacher evaluation scale, Medical Student Safety Attitudes and Professionalism Survey of nursing students. The factors associated with overall clinical performance of nursing students were analyzed by t test, analysis of variance, Pearson correlation analysis and multiple linear regression. Results:The total score of Holistic Clinical Assessment Tool was 114.95 ± 22.91. The total score of Clinical Learning Environment, Supervision and Nurse Teacher evaluation scale was 156.70 ± 26.98. The total score of Medical Student Safety Attitudes and Professionalism Survey was 123.65 ± 31.00. The influencing factors included social practice experience and clinical learning environment, which accounted for 28.0% of the total variation of overall clinical performance of nursing students.Conclusions:Educators and managers of nursing students' schools and internship hospitals should actively explore the educational reform practice to promote the improvement of clinical ability, so as to promote the improvement of the overall clinical ability of nursing students.

One-year clinical evaluation of IPS Empress CAD versus polished Celtra Duo ceramic Laminate veneers (randomized controlled clinical trial) / Avaliação clínica de um ano de IPS Empress CAD versus laminados de cerâmica Celtra Duo polidos (ensaio clínico randomizado controlado)

Objective: To evaluate fracture resistance and survival rate of IPS Empress CAD versus Polished Celtra Duo ceramic laminate veneers. Material and Methods:Thirty-six ceramic laminate veneers were fabricated for maxillary anterior teeth. The patients were divided into two groups according to the material Group 1(control group) fabricated from IPS Empress CAD laminate veneers and group 2 (intervention group) fabricated from Polished Celtra Duo laminate veneers. Standardized the same preparation with butt joint design and chamfer finish line located supra gingival were performed for all the teeth. The fabrication of the veneers was performed using Cad\Cam (Ceramill motion) machine, with software (Exocad). The veneers surfaces were treated and silanated according to the manufacture instruction of each ceramic and enamel surfaces were etched where total etch adhesive protocol was obeyed using BISCO. Follow up sessions were done every two months up to one year for each patient using dental probe and operator vision to evaluate the fracture, survival rate, marginal adaptation, sensitivity and caries. according to USPHS criteria (United States Public Health Service). This was performed by an experienced, blinded investigator. Results: Fracture resistance, marginal adaptation, retention, caries and sensitivity were evaluated according to the criteria of USPHS and we found there is no significant difference as both groups scaled zero score. Conclusion: Both IPS Empress Cad and Polished Celtra Duo laminate veneers revealed successful clinical performance in terms of fracture resistance, marginal adaptation, retention, and sensitivity after one year follow up period (AU)

Objetivo: Avaliar a resistência à fratura e a taxa de sobrevivência de laminados de cerâmica IPS Empress CAD versus Celtra Duo polidos. Material e Métodos: Trinta e seis facetas cerâmicas laminadas foram confeccionadas para dentes anteriores superiores. Os pacientes foram divididos em dois grupos de acordo com o material Grupo 1 (grupo controle) confeccionado com laminados IPS Empress CAD e grupo 2 (grupo intervenção) confeccionado com laminados Celtra Duo polidos. A mesma forma de preparo e acabamento de chanfro localizado supra-gengival padronizados foram realizados para todos os dentes. A confecção das facetas foi realizada em máquina Cad \ Cam (Ceramill motion), com software (Exocad). As superfícies laminadas foram tratadas e silanizadas de acordo com as instruções do fabricante de cada cerâmica e as superfícies de esmalte foram condicionadas seguindo o protocolo adesivo de condicionamento ácido total com BISCO. Sessões de acompanhamento foram realizadas a cada dois meses durante um ano para cada paciente usando sonda exploradora e visão do operador para avaliar a fratura, taxa de sobrevivência, adaptação marginal, sensibilidade e cárie; de acordo com os critérios USPHS (Serviço de Saúde Pública dos Estados Unidos). Isso foi realizado por um investigador experiente e cego. Resultados: a resistência à fratura, adaptação marginal, retenção, cárie e sensibilidade foram avaliadas de acordo com os critérios da USPHS e não encontramos diferença significativa, pois ambos os grupos escalonaram pontuação zero. Conclusão: As facetas laminadas IPS Empress Cad e Celtra Duo polido revelaram desempenho clínico bem-sucedido em termos de resistência à fratura, adaptação marginal, retenção e sensibilidade após um período de acompanhamento de um ano. (AU)

Establishment and clinical performance evaluation of 2019 novel coronavirus antibody colloidal gold detection method / 中华传染病杂志

Objective@#To establish a colloidal gold technique assay for the rapid detection of immunoglobulin(Ig) M and IgG antibodies against 2019 novel coronavirus (2019-nCoV) and to evaluate its clinical performance.@*Methods@#A total of 278 patients who were treated at Wuhan Hankou Hospital and the People's Hospital of Honghu from February 12, 2020 to February 20, 2020 were collected. According to the diagnostic criteria, 89 patients were confirmed with 2019-nCoV nucleic acid positive diagnosis, and 189 were 2019-nCoV nucleic acid-negative suspected patients. A total of 273 medical examiners from Nanfang Hospital, Southern Medical University from 2015 to 2018 were selected as controls. The serum samples of patients were collected. 2019-nCoV nucleic proteins were obtained from prokaryotic expression vectors. Indirect IgM and IgG colloidal gold techniques were established by using recombinant N protein. 2019-nCoV nucleic acid detection by reverse transcription-polymerase chain reaction (RT-PCR) was used as control. Serum specimens were tested for 2019-nCoV IgM and IgG. The specificity and sensitivity of colloidal gold assay were analyzed.@*Results@#The sensitivity and specificity of IgM detection reagents were 78.7% and 98.2%, respectively, those of IgG detection reagents were 73.0% and 99.3%, respectively, and those of IgM combined with IgG detection were 87.6% and 98.2%, respectively. For suspected patients with negative 2019-nCoV nucleic acid, the positive rates of IgM and IgG were 59.8% (113/189) and 52.9% (100/189), respectively, and the positive rate of IgM combined with IgG detection was 66.1% (125/189).@*Conclusion@#This reagent of 2019-nCoV antibodies detection (colloidal gold technique) fulfills the requirement for clinical application with high specificity and sensitivity, which can be served as a supplementary detection method for 2019-nCoV nucleic acid detection by RT-PCR.

Clinical Performance of Direct Anterior Composite Restorations Using Esthetic Dual-Shade versus Polychromatic Natural Layering Technique: a split mouth randomized controlled clinical tria / Avaliação clínica do comportamento de desgaste do esmalte humano e lascamento da zircônia de cobrimento contra a zircônia monolítica (ensaio clínico randomizado controlado)

Objective: to evaluate the clinical performance of the dual shade layering and polychromatic resin composite layering techniques using a randomized controlled trail. Material and Methods: 42 participants (84 restorations) of class IV or class III through and through within a pair of anterior contra-lateral teeth were randomly allocated into two groups according to technique of composite restoration placement: control "polychromatic layering" and intervention "dual-shade layering". Follow-up was done at 1 month (baseline) and 1 year. Restorations were evaluated using Visual Analog Scale (VAS), restoration color shade match using Vita Easyshade V ®, and blinded assessor using FDI criteria for assessment of dental restorations measuring (aesthetic properties). Chi-square test was used to compare between restorations of both techniques. Results: There was no statistically significant difference between restorations of both techniques for patient satisfaction outcome, restorations color match outcome, and for all tested FDI outcomes except surface luster with 100% success. Conclusion: Bothdual-shade layering and polychromatic natural layering techniques, exhibited acceptable clinical and esthetic performance (AU)

Objetivo: Avaliar o comportamento de desgaste do esmalte humano e lascamento de zircônia de cobrimento e monolítica para restaurações posteriores de cobertura total. Material e métodos: Trinta e quatro restaurações de zircônia de cobertura total (dezessete em cada grupo) foram fabricadas. Os pacientes foram divididos em dois grupos de acordo com o tipo de zircônia utilizada; grupo 1 (grupo comparador) coroas com zircônia de cobrimento e grupo 2 (grupo de intervenção) coroas únicas de zircônia monolítica. Todas as coroas foram fabricadas e polidas em laboratório. Para medidas de desgaste de dentes opostos, foi utilizado um perfilômetro 3D sem contato, onde réplicas de resina epóxi foram construídas para o arco oposto imediatamente após a cimentação das coroas, três, seis e doze meses. O lascamento da restauração foi medido usando critérios modificados dos Serviços de Saúde Pública dos Estados Unidos (USPHS). Resultados: Todas as restaurações foram relatadas como alfa sem lascamento. Não houve diferença estatisticamente significativa entre (Grupo 1) e (Grupo 2) para o teste de desgaste. Conclusão: As restaurações monolíticas e de cobrimento revelaram propriedades mecânicas satisfatórias sem lascamento após um ano de uso clínico. O desgaste do esmalte oposto foi clinicamente aceitável para ambos os materiais (AU)

Interpersonal and Intrapersonal Intelligence Skills of Nursing Students: Its Relevance in the Goal of Patient Care

Background: The researchers believe in the power of intelligence to improve the clinical performance of nursing students at Fakeeh College for Medical Sciences. The clinical competency shown of every nursing student is not exactly like the other. The impact of these differences may deliver unharmonious and differentiated outcomes in the clinical performance of the students in achieving the goals of care. Objective: The study aims to identify the relevance of the level of intelligence manifested by the Arab student nurses with respect to interpersonal and intrapersonal and their level of clinical performance in achieving the goal of care. Methods: This study used a quantitative descriptive. The design was utilized to describe the interpersonal and intrapersonal intelligence of nursing students. Results:The findings of the study revealed that the majority of Arab nursing student respondents demonstrated a high level of intrapersonal intelligence (x̅=1.76, SD ± 0.41). Meanwhile, Arab nursing students demonstrated a very high level of intelligence in only 3 of the intrapersonal intelligence skills, namely: self-therapeutic (x̅=2.00, SD ± 0.00), ethico-moral-legal responsibilities (x̅=1.85, SD ± 0.35), and evidenced-based nursing care (x̅=1.81, SD ± 0.40). Conclusion:The study concludes that Arab nursing student respondents have a high and very high level of intrapersonal and interpersonal intelligence, respectively. Also, the study concludes that there is a statistically significant relationship between interpersonal skills and clinical performance but there was no statistically significant relationship between intrapersonal skills and clinical performance among Arab nursing students.

The Effectiveness of Direct Feedback of Faculty and Standardized Patient after Medical Students’ Clinical Performance Examination / 의료커뮤니케이션

BACKGROUND: Clear and proper feedback is necessary to decrease the gap between knowledge and practice. Feedback can improve clinical competence of medical students up to expertise level.METHODS: A total of 180 4th-year students of Daegu-Kyungbuk consortium area participated in the scheduled feedback program of clinical performance examination on August 26th in 2017. Among them, 167 students filled out the questionnaire on helpfulness of the direct observation and feedback of faculty and standardized patient (SP), helpfulness for history taking (Hx), physical examination (PE), and patient-physician interaction (PPI), and any change of clinical competence and clinical reasoning of the students preand post-feedback. All the responses were measured on 5-point Likert scale.RESULTS: Among the total students, 88.6% responded that direct feedback at the practice is helpful, particularly 95.2% of faculty and 76.6% of SP. A 37.3% answered that it was helpful for all the categories of feedback, but only 25.3% for PE and 24.7% for Hx. A 56.3% responded that feedback is helpful for both disease questions and counseling practice. Mean score of self-assessment by the students increased from 2.52 to 3.36 for Hx, 2.30 to 3.24 for PE, 2.46 to 3.33 for clinical reasoning, 2.84 to 3.59 for PPI, and 2.44 to 3.28 for overall competence. And all these differences were found to be statistically significant (P <0.001)CONCLUSION: A majority of students responded that the direct feedback from faculty and SP was helpful at the clinical practice of Hx, PE, and PPI, and increased the level of clinical competence.

Medical students' clinical performance of dealing with patients in the context of domestic violence / 한국의학교육

PURPOSE: The aim of this study was to inquire about the clinical performance and determine the performance pattern of medical students in standardized patient (SP) based examinations of domestic violence (DV). METHODS: The clinical performance sores in DV station with SP of third-year (n=111, in 2014) and 4th-year (n=143, in 2016) medical students of five universities in the Busan-Gyeongnam Clinical Skills Examination Consortium were subjected in this study. The scenarios and checklists of DV cases were developed by the case development committee of the consortium. The students’ performance was compared with other stations encountered in SP. The items of the checklists were categorized to determine the performance pattern of students investigating DV into six domains: disclosure strategy (D), DV related history taking (H), checking the perpetrator’s psychosocial state (P), checking the victim’s condition (V), negotiating and persuading the interviewee (N), and providing information about DV (I). RESULTS: Medical students showed poorer performance in DV stations than in the other stations with SP in the same examination. Most students did confirm the perpetrator and commented on confidentiality but ignored the perpetrator’s state and patient’s physical and psychological condition. The students performed well in the domains of D, H, and I but performed poorly in domains P, V, and N. CONCLUSION: Medical students showed poor clinical performance in the DV station. They performed an ‘event oriented interview’ rather than ‘patient centered’ communication. An integrated educational program of DV should be set to improve students’ clinical performance.

Responses of Medical Students to Using Smartphone Video at Clinical Performance Examination / 의료커뮤니케이션

BACKGROUND: There are practical difficulties to show exact clinical symptoms such as seizure to medical students at Clinical Performance Examination (CPX). We developed a new CPX case of child's seizure on video using smartphone.METHODS: A total of 356 4th-year students of five universities in Daegue-Gyeongbuk and Gyeongnam area took the clinical skill examination from June 13th to 17th in 2016. Among them, 72 students took the new CPX case in June 15th and 71 students filled out the questionnaire on whether the new CPX with smartphone video is helpful, authentic, difficult, and necessary for other CPX. All the questions were measured on 5-Likert scale.RESULTS: Mean score of the new CPX was 57.1, lower than the mean scores of the other 11 CPX cases, 62.8. For the question “Smartphone videos helped to solve the problem”, 45 students (63.4%) answered ‘Very much’. For the question “Is it realistic compared to other questions?” 30 students (42.3%) and 25 students (35.2%) answered ‘Very much’ and ‘Much’. For the question “Is it difficult compared with other questions?” 18 students (25.4%) and 26 students (36.6%) answered ‘Very much’ and ‘Much’. As for the question “I would like to have more tests using smartphone video”, 26 students (36.6%) answered ‘So and so’.CONCLUSION: A majority of students responded that video presentation was helpful and authentic to figure out the CPX, whereas they assessed smartphone video was more difficult compared with other CPXs. Further, students were negative toward using smartphone video for the other CPXs.

Habilidades profesionales de intervención clínica según modos de actuación de estudiantes de tercer año de estomatología / Professional skills in clinical intervention by the performance ways of third-year dental surgery students

Introducción: el proceso de formación de habilidades profesionales de intervención clínica relacionadas con los modos de actuación profesional en los estudiantes de tercer año de la carrera de Estomatología, en la Universidad de Ciencias Médicas de Pinar del Río se ha caracterizado por su falta de sistematicidad, al no garantizar la relación entre los objetivos y propósitos del año con los problemas a enfrentar, limitando su contribución al modo de actuación del Estomatólogo General Básico. Objetivo: definir, a partir de la aplicación de un grupo de fundamentos pedagógicos y didácticos basados en reconocidas teorías, el sistema de habilidades profesionales de intervención clínica en función de los modos de actuación de este profesional. Métodos: se aplicaron métodos de investigación teóricos y empíricos, donde destaca el dialéctico que guía el proceso de perfeccionamiento de la formación del estudiante de Estomatología, a partir de las demandas que impone el sistema nacional de salud en Cuba, garantizando la relación básica entre habilidad-objetivo de salida del año y modo de actuación del profesional. Resultados: se obtuvo el sistema de habilidades profesionales de intervención clínica a partir del objetivo integrador del año, compuesto por 165 habilidades en cinco grupos: de intervención comunitaria, de intervención clínica, diagnósticas-comunicativas, docente-investigativas y administrativas. Conclusiones: el enfoque sistémico del proceso de formación de habilidades de intervención clínica en el tercer año de la carrera de Estomatología se sustenta en la correlación de sus componentes tomando como eje articulador el objetivo de salida, para la habilidad rectora en aras de alcanzar el tributo al modo de actuación que caracteriza el año(AU)

Introduction: The process of building professional skills in clinical intervention associated with the performance ways of third-year students of the Dental Surgery major at Pinar del Rio University of Medical Sciences has not been systematic, since it does not guarantee the relation between the objectives and purposes of the year with the problems to be faced, limiting their contribution to the performance ways of the basic comprehensive doctor in dental surgery. Objective: To define, from the application of a group of pedagogical and didactic foundations based on recognized theories, the system of professional skills in clinical intervention in view of the professional's performance ways. Methods: Theoretical and empirical research methods were applied, highlighting the dialectic approach that guides the process of perfecting the student's training in dentistry, based on the demands imposed by the national health system in Cuba, guaranteeing the basic relationship between skill-objective of year outcome and the professional's performance ways. Results: We obtained the system of professional skills in clinical intervention from the integrating objective of the year, consisting of 165 skills in five groups: community intervention, clinical intervention, diagnostic-communicative, teaching-research and administrative. Conclusions: The systemic approach to the process of training skills in clinical intervention in the third year of the Dental Surgery major is based on the correlation of its components, taking the outcome objective as an articulating axis, for the guiding ability to achieve the tribute to the performance ways characterizing this year(AU)

Selection of Tasks for Assessment of Pharmacy Clinical Performance in Korean Pharmacist Licensure Examination: Results of an Expert Survey

OBJECTIVE: As the demands of pharmacist's role and quality performance have increased, the verification of pharmacist's ability has been required. In this study, we aimed to select appropriate items for assessment of pharmacist's knowledge, attitude and performance. METHODS: Based on the pharmacist job analysis, we selected duties and tasks in consideration of applying pharmacy practical examination through brainstorming of internal researchers and group discussion with experts. Survey was conducted to evaluate the tasks according to the criteria detailed below: Realistic, Understandable, Measurable, Behavioral and Achievable (RUMBA). The subjects included professors at colleges of pharmacy and instructors of institutional or community pharmacy settings. RESULTS: Nine duties including 41 tasks were drawn for the survey through primary internal researchers. Of the 90 respondents, 95.6% were professors or preceptors who was engaged in practical training, and 62.2% had more than five years of practical experience. As a result of survey and discussion with expert panel, selected seven duties were selected as followings: ‘Patient (customer) reception’, ‘Drug preparation and distribution’, ‘Patient care’, ‘Administration’, ‘Patient counseling’, ‘Non-prescription medication counseling’, and ‘Provision of drug information’. The final 20 tasks from seven duties were chosen to assess skills that a pharmacist should be able to perform. CONCLUSION: This is the first study to select the items that can be included in pharmacist practical examination in the future, based on the RUMBA criteria. As a next step, it is necessary to study how to implement these items.

Interpretation of guidance for establishing the performance characteristics of in vitro diagnostic devices for the detection or detection and differentiation of high-risk human papillomaviruses issued by Food and Drug Administration of United States and China / 中华肿瘤杂志

To establish the standardization of clinical verification designs for in vitro diagnostic devices(IVDs) of human papillomavirus, China Food and Drug Administration (CFDA) and United States Food and Drug Administration (FDA) issued guidelines of detailed study designs and effectiveness evaluation for accuracy validation and clinical performance of nucleic acid detection, respectively, including triage of a typical squamous cells of undetermined significance(ASC-US) patients and validation of combined screening and preliminary screening. The design, study population, sample size estimation and statistical analysis of guidelines were moderately different from America to China, however, the evaluation indication was similar. According to the guideline issued by CFDA, prospective design suggested by FDA could be replaced by cross sectional study design to validate the triage of ASC-US patients. Alternatively, prospective design could be used to conduct the HPV product declaration and cellular parallel detection for the same natural population, and the clinical effectiveness of declared products could be validated by at least 3 years follow-up of cytology.

Perception survey on the introduction of clinical performance examination as part of the national nursing licensing examination in Korea / 보건의료교육평가

PURPOSE: The purpose of this study was to analyze opinions about the action plan for implementation of clinical performance exam as part of the national nursing licensing examination and presents the expected effects of the performance exam and aspects to consider regarding its implementation. METHODS: This study used a mixed-methods design. Quantitative data were collected by a questionnaire survey, while qualitative data were collected by focus group interviews with experts. The survey targeted 200 nursing professors and clinical nurses with more than 5 years of work experience, and the focus group interviews were conducted with 28 of professors, clinical instructors, and nurses at hospitals. RESULTS: First, nursing professors and clinical specialists agreed that the current written tests have limitations in evaluating examinees' ability, and that the introduction of a clinical performance exam will yield positive results. Clinical performance exam is necessary to evaluate and improve nurses' work ability, which means that the implementation of a performance exam is advisable if its credibility and validity can be verified. Second, most respondents chose direct performance exams using simulators or standardized patients as the most suitable format of the test. CONCLUSION: In conclusion, the current national nursing licensing exam is somewhat limited in its ability to identify competent nurses. Thus, the time has come for us to seriously consider the introduction of a performance exam. The prerequisites for successfully implementing clinical performance exam as part of the national nursing licensing exam are a professional training process and forming a consortium to standardize practical training.

Microhybrid versus nanofill composite in combination with a three step etch and rinse adhesive in occlusal cavities: five year results

OBJECTIVES: The aim of the study was to evaluate the 5-year clinical performance of occlusal carious restorations using nanofill and microhybrid composites, in combination with 3-step etch-and-rinse adhesives, in patients who were going to commence orthodontic treatment. MATERIALS AND METHODS: A total of 118 restorations for occlusal caries were conducted prior to orthodontic treatment. Occlusal restorations were performed both with Filtek Supreme XT (3M ESPE) and Filtek Z250 (3M ESPE) before beginning orthodontic treatment with fixed orthodontic bands. Restorations were clinically evaluated at baseline and at 1, 2, 3, 4, and 5-year recalls. RESULTS: None of the microhybrid (Filtek Z250) and nanofill (Filtek Supreme XT) composite restorations was clinically unacceptable with respect to color match, marginal discoloration, wear or loss of anatomical form, recurrent caries, marginal adaptation, or surface texture. A 100% success rate was recorded for both composite materials. There were no statistically significant differences in any of the clinical evaluation criteria between Filtek Z250 and Filtek Supreme XT restorations for each evaluation period. CONCLUSIONS: The composite restorations showed promising clinical results relating to color matching, marginal discoloration, wear or loss of anatomical form, recurrent caries, marginal adaptation, and surface texture at the end of the 5-year evaluation period.

Can disclosure of scoring rubric for basic clinical skills improve objective structured clinical examination? / 한국의학교육

PURPOSE: To determine whether disclosure of scoring rubric for objective basic clinical skills can improve the scores on the objective structured clinical examination (OSCE) in medical students. METHODS: Clinical performance score results of one university medical students (study group, n=345) were compared to those of another university (control group, n=1,847). Both groups took identical OSCE exam. OSCE rubric was not revealed to the study group until they were in the last 2 years of medical school. RESULTS: There was no significant difference between before and after disclosure of rubric. However, history taking and physical examination scores of the study group were lower than those of the control group before the disclosure of rubric. After disclosure of rubric, the scores were either unchanged or slightly increased in the control group. Trend analysis of scores demonstrated that history taking and physical examination scores after the disclosure were significantly increased in the study group for 2 years. CONCLUSION: This study revealed that disclosure of basic clinical skills rubric to medical students could enhance their clinical performance, particularly in history taking and physical examination scores.

The Mediating Effect of Self-Efficacy in the Relationship between Emotional Intelligence and Clinical Performance among Nursing Students / 한국간호교육학회지

PURPOSE: The purpose of this study was to identify the mediating effect of self-efficacy in the relationship between emotional intelligence and clinical performance in nursing students. METHODS: Data were collected through structured questionnaires between March 1 and March 25, 2016. Study participants were 223 fourth year nursing students in B and K metropolitan city. Data were analyzed using t-test, ANOVA, Scheffe' test, Pearson's correlation coefficients, and hierarchical multiple regression with SPSS WIN v 18.0. RESULTS: The mean scores of emotional intelligence was 3.85±0.43, self-efficacy was 3.25±0.40, and clinical performance was 3.63±0.51. There were significant positive correlations between emotional intelligence, self-efficacy and clinical performance. There were partial mediating effect of self-efficacy in the relationship between emotional intelligence and clinical performance. CONCLUSION: In order to enhance nursing students' clinical performance, strategies for intervention development such as stimulating emotional intelligence and motivation by self-efficacy are necessary.

The differences in self-efficacy in clinical performance between medical students and residents / 한국의학교육

PURPOSE: The purpose of this study was to compare the differences in self-efficacy in clinical performance (SECP) between medical students and residents. METHODS: A total of 267 medical students and 110 residents participated in a survey on SECP with regard to seven factors: knowledge acquisition and application, clinical reasoning, clinical skills, communication with patients, relationships with other health professionals, medical ethics, and self-development. The data were examined by multivariate analysis of variance. RESULTS: Residents had higher scores for clinical skills than students (F[1, 372]=8.919, p<0.01), whereas students scored significantly higher for communication with patients (F[1, 372]=26.779, p<0.001), relationships with other health professionals (F[1, 372]=12.807, p<0.001), medical ethics (F[1, 372]=40.136, p<0.001), and self-development (F[1, 372]=32.380, p<0.001). There were no differences between genders or specialties of residents. CONCLUSION: There are differences in SECP between students and residents. These results can guide the design of self-efficacy improvement programs.

Analysis of clinical features of brucellosis complicated with nervous system damage / 中华地方病学杂志

Objective To evaluate the clinical features of central nervous system involvement in brucellosis,and to provide references for clinical treatment and diagnosis.Methods A retrospective review was carried out in 14 hospitalized patients who were diagnosed as neurobrucellosis from October 2008 to September 2011 at the First Hospital of Jilin University.Patients' clinical manifestation,pathogen characteristics,cerebrospinal fluid analysis and imaging data were recorded.Results Among the 14 cases of patients with neurobrucellosis,10 cases had the clinical manifestations of headache and vomiting,11 cases meningeal irritation,2 cases dysphoria and seizures,3 cases apathia,3 cases coma,3 cases positive pathological sign,and 2 cases lower extremities weakness.From the perspective of clinical diagnosis of 14 patients with neurobrucellosis,4 cases were meningitis,of which,meningitis with both lower extremities paralysis were 2 cases; encephalitis in 2 cases; meningoencephalitis in 6 cases; abducent paralysis,decreased vision,myelitis and ataxic gait in 1 case,respectively.All patients were in acute phase and had irregular fever.After combination therapy with antibiotics for 2 to 9 days,body temperature of all patients returned to normal,and they were discharged from the hospital after 1 to 2 weeks.All cases were followed up for 12 months,finding no sequelae.Conclusions Due to the diversity of central nervous system involvement in brucellosis,in case of a patient with long-term fever and neurological symptoms,medical and epidemiological history should be inquired and diagnosis would be made easy based on combination of cerebrospinal fluid with laboratory tests.Early treatment of acute neurological brucellosis has showed a good prognosis.

A school-level longitudinal study of clinical performance examination scores / 한국의학교육

PURPOSE: This school-level longitudinal study examined 7 years of clinical performance data to determine differences (effects) in students and annual changes within a school and between schools; examine how much their predictors (characteristics) influenced the variation in student performance; and calculate estimates of the schools' initial status and growth. METHODS: A school-level longitudinal model was tested: level 1 (between students), level 2 (annual change within a school), and level 3 (between schools). The study sample comprised students who belonged to the CPX Consortium (n=5,283 for 2005~2008 and n=4,337 for 2009~2011). RESULTS: Despite a difference between evaluation domains, the performance outcomes were related to individual large-effect differences and small-effect school-level differences. Physical examination, clinical courtesy, and patient education were strongly influenced by the school effect, whereas patient-physician interaction was not affected much. CONCLUSION: Student scores are influenced by the school effect (differences), and the predictors explain the variation in differences, depending on the evaluation domain.

The Effects of Preclinical Clinical Performance Examination on Nursing Students' Confidence in Nursing Skills and Critical Thinking Competence / 한국간호교육학회지

PURPOSE: The purpose of this study was to investigate the effects of preclinical clinical performance examination (CPX) on nursing students' confidence in their nursing skills and critical thinking competence. METHODS: The design of this research was one-group pretest-posttest, and the participants were 112 nursing students. The preclinical CPX consisted of a clinical examination, patient-nurse relationship, oral test of related knowledge, written test of the nursing process, and debriefing using comprehensive scenarios based on real patient cases. The confidence of nursing skills consisted of an 8-item NRS and the critical thinking competence consisted of a 12-item 4-point scale developed by researchers and measured in both the pretest and posttest. The collected data were analyzed using paired t-tests, ANOVA, and Pearson correlation coefficients. RESULTS: The score for confidence in nursing skills (t=10.60, p<.001) and that for critical thinking competence (t=7.03, p<.001) increased significantly after preclinical CPX. CONCLUSION: This study showed that preclinical CPX was effective in improving nursing students' confidence in their nursing skills and critical thinking competence. Therefore, preclinical CPX is expected to be utilized in nursing practice education. Additional studies including those on control groups are recommended to compare differences between the preclinical CPX group and control group.

Changes in medical students' patient-centeredness attitudes by implementation of clinical performance examination / 한국의학교육

PURPOSE: From 2009, the Korean Medical Licensure Exam implemented a clinical performance examination (CPX) that highlighted the importance of good patient-physician relationships in medical education. This study aimed to examine changes in medical students' attitudes before and after implementation of the CPX in their medical education curriculum. METHODS: In 2006 and 2009, 236 fourth-year medial students of C College of Medicine took the Patient Practitioner Orientation Scale (PPOS) by Krupet et al. (2000), which measures patient-centered attitudes in patient-physician relationships. The data were analyzed by independent t-test and two-way analysis of variance using SPSS 21.0. RESULTS: The PPOS scores of year 2006 students were 3.88+/-0.25 for males and 3.98+/-0.38 for females. For year 2009 students, males scored 3.81+/-0.42 and females scored 4.01+/-0.48. All students had higher Care scores than Share scores (2006: Share, 3.67+/-0.47 vs. Care, 4.19+/-0.51; 2009: Share, 3.56+/-0.34 vs. Care, 4.18+/-0.53). There were significant differences in PPOS and Share scores by gender before and after the CPX. With regard to Care scores, female students' scores tended to rise and males' scores declined over time. CONCLUSION: An educational program is needed for students to foster patient-centered attitudes, but gender differences should be taken into account.