우리나라 예방의학교육의 미래: 희망과 도전

맹광호,Meng, Kwang-Ho 대한예방의학회 2006 예방의학회지 Vol.39 No.1

Throughout the century, based on the precedent set by Flexner in the United States, almost every subsequent report on the reform of medical education has pointed out the need for more prevention-oriented teaching in the curriculum. This has been particularly so in countries like Korea where the basic public health services have been so important for the improvement of health of the people. And, in fact, preventive medicine and public health have contributed a great deal to the prevention of communicable diseases and prolongation of life expectancy. Recently, however, along with the educational reform that emphasizing the interdisciplinary teaching, integration of basic science and clinical education, and centralization of responsibility for the medical education curriculum, concerns are being voiced by preventive medicine educators. These concerns are primarily centered around the fear that the implementation of interdisciplinary, centrally administered courses would result in a weakening of content and teaching expertise as well as a loss of departmental power and control. This paper foresees that preventive medicine and public health will be more important in Korea in the future and proposes that preventive medicine educators will have to step forward and turn the challenges of curricula restructuring into opportunities to expand the role of preventive medicine in the curricula of their institutions.

공중보건 활동에서의 '사전 동의' 문제 - 유네스코 <생명윤리 및 인권에 관한 선언>을 중심으로 -

맹광호,Meng, Kwang-Ho 대한예방의학회 2008 예방의학회지 Vol.41 No.5

Objectives : The objective of this paper is to discuss the importance of obtaining informed consent for conducting epidemiological studies and public health activities, based on the Report of the UNESCO's Working Group on Informed Consent. Methods : The Report of the UNESCO's Working Group on Informed Consent was reviewed and discussed in connection with the ethical considerations of public health activities and epidemiological research. Results : It was at the Nuremberg Trial for the German war criminals of the Second World War that the principle of 'consent' was first stated as a consequence of the medical abuses carried out during the War. As a result of the Trial, the Nuremberg Code came out in 1947. Since then, various international declarations or ethical principles on 'informed consent' have been developed and published. These ethical principles on 'informed consent' have mostly to do with the clinical research that involves human subjects, and not with epidemiological studies and public health activities. However, UNESCO recently issued a comprehensive Report on Informed Consent based on the Universal Declaration on Bioethics and Human Rights adopted in 2005, and this included detailed guidelines on informed consent in epidemiological studies and public health activities. Conclusions : Universal Declaration on Bioethics and Human Rights emphasizes the principle of autonomy to protect the human rights of the human subjects involved in any public health activities and epidemiological research. As a practical guideline, obtaining informed consent is strongly recommended.

저체중아(低體重兒) 출산 관련요인에 관한 사례-비교군 연구

맹광호,이상윤,이해천,Meng, Kwang-Ho,Lee, Sang-Yoon,Lee, Hae-Chun 대한예방의학회 1984 Journal of Preventive Medicine and Public Health Vol.17 No.1

Low birth weight baby, defined as the baby born with less than or equal to 2,500g of body weight by WHO has been a great concern in the fold of maternal and child health since the low birth weight is a major cause of high perinatal mortality. Any measure to prevent the low birth weight baby is most desirable not only for saving the life of a baby but also for levelling up the health of the whole society. The authors attempted to figure out how some known maternal risk factors are related to the low birth weight and to measure their strengh of associations in terms of relative risk using hospital birth records. For this study, hospital birth records of 66 low birth weight cases and sex-parity matched 198 normal controls were chosen from Kangnam St. Mary's Hospital, Catholic Medical Center, and the data were analyzed in regards to several maternal factors. The risk factors studied were mother's age, mother's ABO blood type, previous histories of abortion, low birth weight baby, fetal wastage, and maternal diseases represented by anemia, hypertension, proteinuria, and glucosuria. The results obtained in this study were as follows: 1. The mean body weight of the cases and controls were 1,955g and 3,251g, respectively, and the heights were 41cm for cases and 50cm for controls. Mean gestation periods of cases and controls were 34 weeks and 39 weeks, respectively. 2. Young mother(less than or equal to 20 years of age) or old mother(more than or equal to 30 years of age) experienced more frequently the delivery of low birth weight babies than mothers in between 21 and 29 years of age. But the difference was not statistically significant. 3. Mothers whose blood type was O tended to have slighty higher frequency of low birth weight babies while B mothers have lower frequency. But the difference was not statistically significant too. 4. Those mothers who had experienced low birth weight baby in the past tended to give more births of low birth weight babies. This factor is even statistically significant and the relative risk of the prior experience of low birth weight was 6.7. 5. Mothers with experience of fetal losses and mothers of more than two pregnancies had higher frequency of low birth weight than the mothers with no fatal losses and of first pregnancy, but the difference was not statistically significant. 6. Statistically significant higher frequency of low birth weight were found in mothers with hypertension(odds ratio=4.07), anemia(odds ratio=22,33), and proteinuria(odds ratio=2.79). In summary, these study results strongly suggest that in order to prevent the low birth weight, special care should be made when the mother is too young or too old, and when the mother has experienced deliveries of low birth weight and fetal deaths. Medical control for the maternal diseases such as anemia and hypertension is also needed before or during the pregnency.

하기(夏期) 무의촌진료(無醫村診療)에서 나타난 우리 나라 일부(一部) 농촌주민(農村住民) 의 질병양상(疾病樣相)

맹광호,이세훈,Meng, Kwang-Ho,Lee, Se-Hoon 한국농촌의학지역보건학회 1977 농촌의학·지역보건 Vol.15 No.1

This study was made with 1394 clinical records obtained by a mobile charity health team in a rural Korea for 10 days from July 23 to Aug. 1, 1977 to see the disease pattern of the rural population in Korea. The health team consisted of 7 physicians in different clinical departments of the St. Mary's Hospital tried to cover as many as patients in that area by giving full informations and instructions before starting health services. which supposed to minimize the omissions of patients visits in that area. The proportion of each disease as well as its order in terms of the number of patients was reviewed by matching with age and sex distribution of patients, and with the duration of illness (complaints). Major findings obtained in this analysis were as follows; 1. Among 1394 patients, 536 (38.5%) was male and 858(61.5%) was female. As to the age distribution of the patients. those who are in the age group of 10-19 showed the highest proportion of 15.6% and those who are in the age group of 5-9 and 40-49 was the next with the proportion of 15.4% and 15.2% respectively. 2. The most prevalent cause of general morbidity were diseases of digestive system, diseases of nervous system and sensory organs, diseases of respiratory system, and diseases of skin and subcutaneous tissue in order. And their proportions among all patients were 21.8%, 20.7%, 14.5%, and 12.4% in respectively. The order of the diseases ranked by the number of patiens was slightly different in female population from that of total population, i. e. diseases of nervous system and sensory organs was the first. diseases of digestive system was the second, and the diseases of circulatory system was the third. 3. 23.2% of all patients were found to have had symptoms relating to their illness for more or less 5 years, and 18.3%, for more or less 6 months. Looking at the duration of illness by diseases, 28.6% of digestive tract disease patients and had the relating symptoms for about 1 week while 24.3% had had the symptoms for about 5 years, and in diseases of nervous system and and sensory organs, many(33.7%) had had symptoms for relatively long period (more than one year). On the other hand, in diseases of respiratory system, those who had had the relating symptoms for about 1 month was 24.3 % among all patients in this category and those who had had the symptoms for less than 1 week was 32.2%. 4. The duration of illness (complaints) was longer in females than in males and shorter in younger age groups than in older age groups.

의과대학에서의 윤리교육 -왜, 그리고 무엇을 어떻게-

맹광호 ( Kwang Ho Meng ) 한국의료윤리학회 1998 한국의료윤리학회지 Vol.1 No.1

21세기 한국 의학교육계획-희망과 도전

맹광호(Kwang-ho Meng) 한국의학교육학회 2004 Korean journal of medical education Vol.16 No.1

보건대학원의 교육 및 학습목표

맹광호(Kwang-Ho Meng) 한국의학교육학회 2000 Korean journal of medical education Vol.12 No.2

Schools of public health are graduate level higher educational institutions training students who will be engaging in educational, research and service activities in the field of public health after completing the educational programs. To meet this institutional goal, the schools of public health should provide diverse academic and professional courses and programs to the students based on their educational objectives. Educational objectives of schools of public health, of course, should well reflect the working definition of public health : public health is the science and art of preventing disease, prolonging life, and promoting physical health and efficiency through organized community efforts. There are 13 schools of public health in Korea an of 1999 including occupational and environmental schools. However, most of them were opened in 1980s and 90s, and therefore, do not have properly described educational and learning objectives. This paper proposes that Korean schools of public health should review their institutional goals and have clearly stated educational objectives. This also proposes development of standardized learning objectives of core subjects such as epidemiology, statistics, environmental health, health education and public health administration. Important units of these core subjects are also provided.

주기법(週期法) 사용부인(使用婦人)들의 개인(個人) 및 출산관련(出産關聯) 특성(特性)에 대한 비교연구(比較硏究)

맹광호 ( Kwang Ho Meng ),김숙자 ( Soak Ja Kim ),공세권 ( Sae Kwon Kong ) 한국보건사회연구원 1985 保健社會硏究 Vol.5 No.1

Rhythm method which is also referred as `periodic abstinence is voluntary avoidance of inter-course by a couple during the fertile phase of the menstrual cycle in order to avoid pregnancy. In a 1982 national survey, 10.3 percent out of 57.7 percent family planning practicing couples were rhythm users. This is almost 35 percent of all the women practicing temporary family planning methods for spacing. However, this method has neither been properly taught nor been recommended to use in over 20 years` of Korean national family pinning programs. No study, of course, has been focused on either this particular method or the couples using it. This study firstly attempted to see if the rhythm users were different from the other method users in their selected personal and reproductive characteristics. For this study, 1982 National Family Health Survey data were reused. Education and income levels of rhythm users were significantly higher than other method users and the urban couples were using rhythm more frequently than the rural couples. Wives of professional or office working men were using rhythm more than those women of other job working men. Age of women and their religion did not significantly affect the women`s decision of using or not using rhythm. Number of children and particularly the number of sons the couple currently have significantly associated with couples` using rhythm. Experience of induced abortion and the numbers of abortion the women had experienced did not show any significant difference between rhythm and other methods users. In multiple regression analysis. only the number of current children the women have was turned out to be significant factor among 7 personal and reproductive factors studied. This study results show that special attention on the natural methods of family planning should be given in the future not simply because currently a significant number of couples are using it, but because the increase of educational and income levels as well as urbanization which are associated with using of rhythm method are soon expected. This study results show that special attention on the natural methods of family planning should be given in the future not simply because currently a significant number of couples are using it, but because the increase of educational and income levels as well as urbanization which are associated with using of rhythm method are soon expected.

가톨릭과 생명의료윤리교육

맹광호 ( Kwang Ho Meng ) 한국의료윤리학회 1999 한국의료윤리학회지 Vol.2 No.1

최근 2년간 우리나라 의사국가시험 문제의 지식수준, 문항유형 및 내용분석

맹광호(Kwang Ho Meng),강봉규(Bong Kyu Kang),이세훈(Se Hoon Lee) 한국의학교육학회 1994 Korean journal of medical education Vol.5 No.2

Multiple Choice Question(MCQ) method of examination has long been used as the national medical licensing examination in Korea. If properly used, the MCQ method of examination has considerable value fo r evaluation, and in fact, it has become popular due to its economy of scale, ease of marking and consistency. Moreover, with this method of examination, a large number of candidates can be tested at once and the marking can even be read by automatic readers. However, MCQ does not lend itself so well to problem-solving, which is a far more real-life situation than having to choose between a number of pre-formed alternatives. This, again, however, can be much improved by increasing the proportion of question items associated with interpretation and problem solving level of cognitive domain, and adopting various types of MCQ. This study was planned to examine the proportions of question items by their levels of cognitive domains and the types MCQ together with the contents of medical knowledge of the Korean National Medical Licensing Examinations (NMLE) conducted in 1992 and 1993. All 880 question items (440 question items in each year) were reviewed one by one by three medical education specialists and the levels of cognitive domains, types of MCQ and contents of questions were judged by test subjects. Major findings obtained from the study are as follows: 1) In both years of 1992 and 1993, recall level question items formed 68.0% of all MCQ question items of NMLE. Problem-solving level question items were only 77.% in 1992 and 11.1% in 1993. 2) Major types of MCQ were best answer type one correct answer type . They were 40.7% and 30.9% of all respectively in 1992, and 35.0% and 32.0% respectively in 1993. Some subjects such as urology and internal medicine were adopting more combined response type MCQ than other subjects. 3) Knowledge contents asked in the NMLE varied very much from subject to subject. However, the names of diseases were the most prevalent answers asked and they were 21.6% in 1992 and 18.2% in 1993. This study suggests that the Korean NMLE should increase the proportion of question items measuring the interpretation and/or problem-solving level of knowledge, and adopt several different types of MCQ.