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노혜린,김양희 한국의학교육학회 2007 Korean journal of medical education Vol.19 No.3
Purpose: The aim of this study is to evaluate the students' clinical competency from the patient safety perspective. Methods: We conducted this evaluation in 2006 at College of Medicine, Kangwon National University. We surveyed 50 fourth-year medical students after finishing all clinical clerkships. 49 Students evaluated their achievement with 5-Likert score scale. The questionnaires were composed 6 domains: communication skills, prevention & management of adverse events, using evidence and information techniques, teamwork & leadership, medical ethical behaviors, and procedural skills. The each domains were constituted several items. Total 53 items was evaluated. Results: The students' preparedness was relatively low in 28 items of the total 53(difficult communication, detecting and managing medical errors, using evidence and information technique, understanding of complex systems, autonomy, and procedural skills). Conclusion: The items with low achievement were closely related with medical errors and patient safety. These findings suggest that the clinical education is insufficient for preventing medical errors by students. For patient safety, we should understand the importance of achievement of competency related with patient safety and establish a systematic clinical curriculum with explicit learning outcomes.
노혜린,Roh, HyeRin 연세대학교 의과대학 2016 의학교육논단 Vol.18 No.3
The aim of this study is to provide the background of developing guides to clinical performance and basic clinical skills and to introduce how to teach and learn using the guide. The students' performance problems presented in an objective clinical skills examination were disease-centered tertiary hospital clinical care, incomplete performance, doing by rote, and an exam-oriented learning attitude. The problems were caused by a tertiary hospital-based educational environment as well as schools and faculty who are unfamiliar with the concept of patient-centered care. The purpose of the guide to clinical performance and basic clinical skills is to overcome these problems and address the causes. The guides show a clinical presentation approach to primary care; clinical care integrated with knowledge, skills, and attitude; a schematic approach; and a patient-centered attitude. To achieve these goals, a strategy to change the educational culture is important. Curricular reform, faculty development, and improving educational facilities and environments are suggested.
의료윤리 능력 평가로서의 객관구조화 구술시험 개발 경험
노혜린,황종윤,박승배,이상욱,김자경 한국의학교육학회 2009 Korean journal of medical education Vol.21 No.1
Purpose: We developed an objective structured oral examination (OSOE) case to assess the medical ethics of students. The aim of this study was to assess the reliability of OSOE with generalizability theory. Methods: One 10-minute OSOE that contained key questions was developed. The evaluation sheet consisted of 4 domains: moral sensitivity, moral reasoning, decision making, and attitude. The total number of items was 13. The numbers of checklist items and global rating items were 11 and 2, respectively. Items and key questions were validated by 6 professionals. Standardization of the raters and the pilot study was performed before the OSOE. Fifty-four third-year medical students participated in the OSOE. The OSOE was duplicated, and 2 professors assessed 1 student independently. Each station lasted 8 minutes and was followed by a 2-minute interval,during which raters completed the checklist forms. We analyzed the reliability of the OSOE with the GENOVA program. Results: The reliability (generalizability coefficient) was 0.945, and the interrater agreement was 0.867. The type of item, checklist or global rating, was the largest variance component. The reliability of the checklist alone was 0.668 and that of the global rating alone was 0.363. Conclusion: The OSOE is reliable and can be used to assess ethics. More research should focus on achieving validity.
노혜린,박경혜,박송이 한국의학교육학회 2017 Korean journal of medical education Vol.29 No.4
Purpose: Standardized patients (SPs) tend to rate medical students’ communication skills subjectively and comprehensively, in contrast to such objective skill set defined in the clinical performance examination (CPX). Meanwhile, medical school instructors have a different approach in their evaluation of students’ communication skills. We aim to analyze medical students’ verbal communication skills using objective methods, and to determine the contributing factors of a patient–physician interaction (PPI) score. Methods: Students with high- and low-ranking scores for PPI in CPX were selected. The Roter interaction analysis system was used to compare verbal communication behaviors of the students and SPs. Patient-centeredness scores (PCSs), physician’s verbal dominance, and number of utterances were compared between the two groups. Results: PCSs and physician’s verbal dominance had no difference between the groups. The number of utterances during the limited time of 5 minutes of CPX was higher for the high-ranking students. They tended to employ more paraphrase/check for understanding, and closed questions for psychosocial state and open questions for medical condition. The SPs interviewed by high-ranking students gave more medical information and requested for more services. Conclusion: In the case of the routine checkup, smooth conversations with more frequent utterances were detected in the high-ranking students. More medical information exchange and requests for services by SPs were higher for the high-ranking students. Medical communication instructors should keep in mind that our results could be indicators of a high PPI score.