표준화 환자를 이용한 가천의대 임상수행평가의 운영 경험

박귀화(Gwi Hwa Park),오재환(Jae Hwan Oh),박연호(Yeon Ho Park),임영희(Young Hee Lim),이선녀(Sun Neo Lee),박찬용(Chan Yong Park),김선숙(Sun Suk Kim),임용수(Yong Su Lim),이영돈(Young Don Lee),김용일(Yong Il Kim) 한국의학교육학회 2005 Korean journal of medical education Vol.17 No.2

Purpose: This study aims to abstract the differences of scores between the clinical instructors and standardized patients (SPs) in a clinical performance examination (CPX) using SPs and to correlate the concordance between the evaluation scores and the school records. Methods: The CPX was administered in 2003 to a total of thirty-six fifth year medical students at Gachon Medical School. The examination consisted of four cases, and four stations were duplicated, each requiring a total of 7.5 minutes per station. Evaluation of the student s performances was conducted by both clinical instructors and SPs using a formatted checklist. Results were analysed by t-test, agreement rates, and Pearson correlation. Result: The mean scores given out by the clinical instructors and the SPs for the newly developed case were significantly different, while those scores for pre-existing cases were not in the old cases. The correlation coefficients between these two evaluation groups were relatively high. And agreements between the two evaluation groups were 0.37~0.72. The mean scores among clinical instructors were not significantly different, but the correlation coefficients and agreement rates were relatively high. The correlation between the evaluation scores and school records did not correlate significantly. Conclusion: It is concluded that the CPX is a useful tool to measure the students essential competences in areas of knowledge, skills and attitude during the subinternship stage. In conducting a successful CPX, it is crucial to reconsider the recycling of cases and the selection and training of SPs aside from the development of an objective checklist.

임상수기훈련센터의 개발과 운영

박귀화(Gwi-Hwa Park),고희정(Hi-Jung Koh),최인석(In-Suck Choi),이영돈(Young-Don Lee),임윤명(Yoon-Myung Yim),김용일(Yong-Il Kim) 한국의학교육학회 2002 Korean journal of medical education Vol.14 No.2

Purpose: The purpose of this study is to introduce the operational design of clinical skills training program and to evaluate the outcome of one-year experience in Gachon Medical School. Methods: The School set up a clinical skills training center(laboratories) helping preclinical year-students being able to improve their clinical competences by using simulators and models prior to start their clerkship so that they can apply accurate and stable clinical technical skills to the patients. The program was divided into two parts; one for the communication and interviewing skills(M3) and the other for development of basic clinical skills(M4). For the latter, a total of 32 skill units with model items were selected from the minimum essential clinical skills requirements. The training course was conducted 3 weeks for 37 students of the fourth year medical school(M4) students in the second semester of 2001. Pass/Fail system with 2 credits was applied as a student evaluation. Both advantages and disadvantages of the program were analysed by questionnaires. Results: Every students met the school requirement and passed the requirements mostly by the second trial within the two weeks duration following self-directed hard practice for every items. Of 37 students, 80% became confident on their final performance, and 72% agreed themselves being much enthusiastic compared to other courses. The visiting frequency to the center was over 2~3 times/day during the course, and their average staying hours/week were 20~30 hours. Students(78%) were satisfactory to the appropriativeness of faculty‘s instructional skills and their evaluation results. Conclusion: We conclude that the clinical skills training program is a useful tool not only to improve the essential technical skills prior to take their responsibilities of subinternship but also to motivate students learning during the preclinical studies.

의과대학생의 학년과 성별에 따른 환자안전에 대한 태도와 전문직 간 협력 준비도 차이

박귀화(Park, Gwi-Hwa),김수경(Kim, Soo-Kyung),이현록(Lee, Hyun-Rok),조준건(Cho, Joon-Geon),진세윤(Jin, Se-yun),윤소정(Yune, So-Jung) 부산대학교 교육발전연구소 2019 교육혁신연구 Vol.29 No.4

연구목적: 의료계에서 환자안전이 강조되고 있고 전문직 간 협력에 관한 우려와 필요성도 점차 증가하고 있다. 그러나 대다수 의과대학생의 환자안전과 전문직 간 협력에 대한 인식이 부족한 상태이다. 따라서 본 연구에서는 설문조사를 통해 의대생들의 이에 대한 인식이 학년별, 성별로 어떤 차이를 보이는 살펴보고, 환자안전에 대한 태도와 전문직 간 협력 준비도 간의 관계를 알아보고자 한다. 연구방법: 의과대학생의 학년과 성별에 따른 환자안전에 대한 태도와 전문직 간 협력 준비도 차이 조사는 2개 의과대학의 500여명을 대상으로 설문조사를 통해 진행하였다. 환자안전에 대한 인식 조사는 APSQ-III을 활용하였고, 전문직 간 협력 준비도 조사는 RIPLS을 활용하였다. 환자안전과 전문직 간 협력 준비도 간의 관계를 알아보기 위해 단순회귀분석을 실시하였다. 연구결과: 학년과 성별에 따른 환자안전에 대한 태도 차이는 하위요인인 환자안전 훈련 경험, 오류보고 의무감, 오류의 불가피성, 팀의 기능, 과실을 줄여주는 환자의 관여, 교육과정에서의 환자의 안전에 대한 중요성에서 유의미한 차이가 있었다. 학년과 성별에 따른 전문직 간 협력 준비도에 대한 차이는 팀워크와 협력, 전문가 정체성에서 유의미한 차이가 있었다. 학년과 성별 모두에서 전문직 간 협력의 하위요인인 팀워크와 협력이 환자안전에 유의미하게 영향을 미치는 변인으로, 예측력은 15.0%에서 35.0%의 범위로 나타났다. 논의 및 결론: 본 연구는 의학교육과정에서 환자안전과 전문직 간 협력에 대한 교육의 필요성을 제고한다. 의학교육에서 전문직 간 협력을 포함한 환자안전 교육이 학년에 따라 어떻게 이루어져야 할지에 대한 방향성을 설정하는데 도움을 줄 수 있을 것이다. Purpose: Necessity about interprofessional cooperation keeps on increasing and patient safety is also highlighted in the medical community. However, there is a lack of awareness of patient safety and interprofessional cooperation among medical students. Therefore, this study aims to find out the grade and gender-based difference among medical students through questionnaire, and then examines the relationship between attitude toward patient safety and readiness for interprofessional cooperation. Method: The survey on grade and gender-based differences in attitudes toward patient safety and readiness for interprofessional cooperation was conducted through a questionnaire survey of 500 medical students from two medical school. For perception of patient safety, APSQ-III was used, and RIPLS was used for readiness for interprofessional cooperation. For the study analysis, we used a two-way ANOVA and simple regression analysis Results: There were significant differences in attitudes to patient safety by grade and gender are sub-factors: Patient safety training received to date, Error reporting, Error inevitability, Team functioning, Patient’s role in error, Importance of patient safety in the curriculum. Team-work and collaboration, and professional identity, which are sub-factors of Readiness of healthcare students for interprofessional learning, differed significantly by grade and gender. Teamwork and collaboration have been shown to influence on attitudes to patient safety. Conclusion: This study is expected to raise awareness of patient safety and interprofessional cooperation in the medical education curriculum. It may also help to establish the direction of how patient safety awareness education, including interprofessional collaboration in medical education, should be conducted by grade.

「시민생활과 예절」교과목의 개발 및 운영 경험: 의예과 교양교육으로서의 의미와 기대

김정아(Chung-Ah Kim),권복규(Bok-Kyu Kwon),박귀화(Gwi-Hwa Park),임윤명(Yoon-Myung Yim),김용일(Yong-Il Kim) 한국의학교육학회 2002 Korean journal of medical education Vol.14 No.2

Purpose: This study aims to introduce a one semester ‘Global Citizenship program, being offered as a part of the premedical course at Gachon Medical School. The program was designed to meet the community needs in terms of etiquette and manner education for the future physicians and also to review the outcome of short-term experience. Methods: The program was offered to M1 (premedical students year-1) students from the first semester after entrance to the school with following objectives: to understand the anthropological aspect of culture, to motivate students in relation to medical scientific foundation, and to develop the appropriate human relations, including international etiquette and manners, prior to the subinternship in M5 (medical student year-3). Results: The program consisted of 12 sessions of lectures and/or practice-based learning such as etiquette for dormitory life, Korean traditional culture, gender role in the 21st century, dining etiquette in various cultural programs, netiquette(for computer usage), Korean housing and its architectural beauty, etiquette for alcoholic beverage drinking, dressing, and the respect and understanding of other cultures, services and manners. They were all instructed with presentations combined with site-visits or hands-on experience followed by a reflection paper and group discussion. Although the program was costly and time-consuming compared to the traditional theory-based natural science and humanity subjects, students expressed their strong motivation and concerns on their future responsibilities. Conclusion: We conclude that “Global Citizenship” course is a useful program to provide a meaningful motivation to the newly enrolled students, Further, it encourages students to understand human relations as a global citizen equipped with the appropriate etiquette and manners.

멀티캠퍼스 의학교육의 현황분석과 대응방안 - 41개 의과대학의 복합형 교육병원형 교육체계 분석을 중심으로 -

김용일(Yong Il Kim),김지영(Ji Young Kim),박귀화(Gwi Hwa Park) 한국의학교육학회 2005 Korean journal of medical education Vol.17 No.2

Purpose: This study was designed to analyze the current status of multicampus medical education in Korea, to identify its educational significance, and to develop strategies for overcoming such disadvantages. Methods: The logistic data were collected from 41 medical schools, and the educational impacts based on the location of campuses and clinical teaching hospitals, types of education, major functions, and collaboration system between campuses were analyzed. Results: 35 from 41 medical schools ran various forms of multicampus education, and only 8 claimed a system that bridged the school campus and teaching hospital(s). However, none were equipped with any form of meaningful liaison accommodating a distant learning system between learning centers. Regardless, the advantages of multicampus school system aimed to provide a wide range of learning experiences, serious disadvantages remained without the system developing an effective method for overcoming difficulties of communication or establishing an achievement to reach a common educational consensus. Conclusion: Various advantages of multicampus system in terms of producing pleuripotential physicians have been rationalized, but any measures for their effective collaboration remains limited. This paper stresses the development of a responsible unit for better support between school campus and clinical teaching centers in multicampus curriculum planning. It is also crucial to design an educational communication channel between them.

학생 인턴제의 임상실습 공통평가 모듈 개발

김용일(Yong Il Kim),이영돈(Young Don Lee),오재환(Je-Hwan Oh),최인석(In Suck Choi),차 한(Hann Chah),이의돈(Eui Don Lee),함봉진(Bong Jin Han),이 근(Keun Lee),이병국(Byung Kook Lee),임윤명(Yoon-Myung Im),박귀화(Gwi Hwa Park) 한국의학교육학회 2003 Korean journal of medical education Vol.15 No.2

Purpose: The aims of this paper are to develop a student evaluation format as a part of core clinical clerkship (student internship) program at Gachon Medical School, and to identify its impeding factors in implementation. Methods: Both rating scale of Likert type and check list for student s clerkship assessment were designed; the rating scale format was developed into two parts, namely attendance and the clinical competence demonstrated during the clerkship in which 3 domains of knowledge, skills and attitude were included in balance; the professional competence was made of 9 items, each being designed to accommodate 3 degrees by learner s performance. The clinical instructors in charge were requested to sit a short feedback session on the evaluation results with students who were signed at the end. Nursing staff was also asked to participate in evaluation of the student attitude in a limited area. Results: Despite the full acceptance of the evaluation approach theoretically, its practical implementation was not successful because of difficulties related to adjustment of their department-based scoring system to the comprehensive assessment, or unfamiliarity with face-to-face feedback system. Conclusion: The authors assume that this Likert type of the rating scale is a simple, more comprehensive and strong tool to meet the learning objectives, and easy to enhance the feedback effect. It is, however, advised that the formative reporting system is crucial to transform the traditional evaluation approach into the pass/fail format so that unnecessary conversion risk is eliminated.