의학 전문직업성의 기초자질 함양을 위한 교육과정 평가 및 구성

방재범,이광윤,이충기,이동협,이영환,김재룡,강복수 한국의학교육학회 2008 Korean journal of medical education Vol.20 No.2

Purpose: Today, the social requirement of medicine emphasizes the importance of medical professionalism. This forces medical educators to introduce new contents and methods into the curriculum. This study aims to offer ideas for developing the curriculum through clarifying priorities on the basic qualities of medical professionalism and evaluating the current curriculums in medical schools in South Korea. Methods: In April 2005, 46 respondents majoring in basic medical sciences, clinical medicine, and medical humanities/social sciences completed a structured questionnaire. The questionnaire consisted of 3 categories related to: 1) the basic qualities of medical professionalism/general education courses, 2) the process of developing the qualities of humanities and social sciences in medical education, and 3) the appropriate allocation of credits for each subject to premedical and medical courses. The analysis consisted of frequency, chi-square, and multiple responses using Korean Ed, SPSS 14.0 for Windows. Results: The most important basic quality is basic medical knowledge. The credits for the general education are sufficient but it's contribution is lacking(44.44%). The most lacking element in the general education courses is socio-cultural comprehension(45.65%). The knowledge of humanities and social sciences is very important in developing the basic qualities(56.52%). The important learning experiences related to these is the introspection into human beings(32.16%). Credits for medical humanities classes in premedical and medical course are noticeably insufficient(45.65, 54.35%, respectively). The appropriate program of informal curriculum for fostering the qualities is meeting with various medical specialists(44.44%, 47.83%, respectively). There is almost no difference among the major groups under(p<.05.) Conclusion: To assist medical students to be equipped with the basic qualities of medical professionalism, the realm of medical humanities should be made mandatory; and the general education courses need to be reformed, especially in the premedical curriculum. In particular, continuous cooperation between faculties in medicine, liberal arts, and/or social sciences need to exist with the conglomeration of these into fewer medical humanities majors in Korea.

Correlation between clinical clerkship achievement and objective structured clinical examination (OSCE) scores of graduating dental students on conservative dentistry

방재범,최경규 대한치과보존학회 2013 Restorative Dentistry & Endodontics Vol.38 No.2

Objectives: This study aimed to investigate the effect of clinical clerkship-associated achievements, such as performance of procedures at the student clinic, observation,and attitude towards a clerkship, on the objective structured clinical examination (OSCE) scores of dental students graduating in restorative dentistry. Materials and Methods: The OSCEs consisted of two stations designed to assess students’ clinical skills regarding cavity preparation for a class II gold inlay and a class IV composite restoration. The clerkship achievements, consisting of the number of student clinical procedures performed, observation-related OSCE, and scores of their attitudes towards a conservative dentistry clerkship, were assessed. Correlation and multiple regression analyses were conducted. Results: The correlation coefficient between the OSCE scores for cavity preparation for a class II gold restoration and clerkship attitude scores was 0.241 (p < 0.05). Regarding a class IV composite restoration, OSCE scores showed statistically significant correlations with the observation (r = 0.344, p < 0.01) and attitude (r = 0.303, p < 0.01) scores. In a multiple regression analysis, attitudes towards a clerkship (p = 0.033) was associated with the cavity preparation for a class II gold inlay OSCE scores, while the number of procedure observations (p = 0.002)was associated with the class IV composite restoration OSCE scores. Conclusions:The number of clinical procedures performed by students, which is an important requirement for graduation, showed no correlation with either of the OSCEs scores. (Restor Dent Endod 2013;38(2):79-84)

채점자의 입실이 OSCE 응시자 성적과 수행에 미치는 영향

방재범 한국의학교육학회 2008 Korean journal of medical education Vol.20 No.3

Purpose: It is uncertain whether the rater's presence during administration of the objective structured clinical examination(OSCE) has any impact on examinee performance. To clarify this issue, the effects of a rater's presence during testing on OSCE score and examinee responses were analyzed. Methods: The OSCE comprised 24 stations of 12 duplicated cases. Twenty-eight of 83 fourth-year medical students were placed in four rater-absent stations(pediatrics, 2 stations; internal medicine, 2 stations). The scores of the rater-absent group were assessed after review of recorded videotapes. We obtained student responses on the rater's presence by means of a questionnaire. Statistical analysis (t-test) was performed using SPSS 14.0. Results: The scores of the rater-absent group compared with the rater-present group were 78.57±16.27 vs. 70.55±19.57(p=0.066) for pediatrics, 66.07±14.74 vs. 64.36±14.88(p=0.621) for internal medicine, and 67.75±5.43 vs. 69.13±4.85(p=0.099) for total score, respectively. Subjects in the rater-absent group felt that they were in a real-life clinical situation(p=0.013) and concentrated better(p=0.006), and more students requested to take the OSCE without a rater in the station(p=0.000) than those in rater-present group. Conclusion: Although there was no significant difference in OSCE scores between the rater-absent and rater-present examinee groups, subjects at rater-absent stations felt more of a real clinical situation and could concentrate more effectively than those at rater-present stations. To this end, videotaped OSCE assessments should be considered to increase the validity of the examination.

진료수행평가에서 실시간 및 비디오 녹화 채점 비교 분석

방재범,이영환,이근미 대한의료커뮤니케이션학회 2013 의료커뮤니케이션 Vol.8 No.1

Purpose: The aim of this study was to test the reliability of the scores on medical students' CPX by real time and videotaped rating. Methods: We focused on 5 cases (hypertension, dyspnea, hematuria, fever, hemoptysis) CPX performed by forty 4-year medical students in September 2008. We analyzed the difference of scores by between real time and videotaped rating of the same raters. Results: In total scores, two cases, dyspnea (53.10±9.424, 50.95±9.669) and fever (56.73±15.910, 52.55±15.194)were statistically different between real time and videotaped rating. In dyspnea case, physical examination scores (11.60.±3.523, 10.53±3.523) were different while history taking scores of fever case (33.00±8.228,29.88±8.659) were different. Conclusion: The use of videotaped CPX rating could offer more various merits than real time rating on examiner's time, fairness of assessment needed to between different raters, candidates, sites, and then feedback to revise examinee's performance, and so on. However, there are still some works to solve such as taking more times to mark perfectively and supporting high level video-audio devices to watch and hear clearly.

임상술기능력평가와 교과목간의 학업성취도 분석을 통한 소아치과학의 교육과정 평가

방재범,임재영,박재홍,Bang, Jaebeum,Rim, Jaeyoung,Park, Jaehong 대한소아치과학회 2013 大韓小兒齒科學會誌 Vol.40 No.4

This study aimed to evaluate the courses of pediatric dentistry based on correlation analysis between scores of objective structured clinical examination (OSCE) and related subjects for 79 fourth-year students. The score of theory were related to preclinical (r = 0.449, p = 0.000) and clerkship (r = 0.437, p = 0.000) each, but the scores of clerkship were not related to OSCE. To make the students skillful for clerkship, more professor's firsthand teaching on treating patients and adequate numbers of clinical professors are required. Patients who come to the university dental hospital prefer to be treated by professors rather than students. In these circumstances, educational conditions should be arranged by ensuring the number of professors for teaching students to improve their clinical competence through direct instruction and feedback to students. In addition, pragmatic improvement plans, which allow continuous education and evaluation about basic techniques to be examined in the clinical practice course, should be compromised with the more concrete evaluation of the curriculum in order to evaluate theoretical knowledge and technical trainings to be well exercised and deepened in the practical clinical field. 본 연구는 졸업시점의 치의학전문대학원생 79명을 대상으로 소아치과학 OSCE(Objective Structured Clinical Examination)성적과 이전까지 이수한 소아치과학 교과목들 성적간의 관계를 분석함으로써 소아치과학 교육과정 운영을 평가하고 발전적 시사를 도출하는 데에 목적이 있다. 소아치과학이론 교과목은 이전 이수과목인 임상전단계실습 성적(r = 0.449, p = 0.000), 이후 이수과목인 임상실습성적(r = 0.437, p = 0.000)과 상관관계가 있었다. 하지만 졸업시점의 OSCE성적은 단지 임상전단계실습 과목 성적(r = 0.302, p = 0.003)과 상관관계를 보였다. 이는 OSCE 신뢰도가 Cronbach's ${\alpha}0.733$을 고려하면 OSCE 자체 문제보다는 교육과정 상에 있어서 임상실습 교과목 운영에 문제가 있음을 추론할 수 있다. 치과대학병원에서 교수의 특진을 선호하고 학생들에 의한 진료를 기피하는 진료 현장에서 학생들에 대한 직접적인 지도와 피드백을 통해 임상역량을 강화하기 위해서는 학생 지도를 위한 교수 수 확보와 같은 교육여건이 마련되어야 한다. 또한 이론적 지식 및 술기교육이 임상진료 현장에서 잘 적용되고 심화되기 위해서는 교육과정에 대한 보다 구체적인 평가와 함께 임상실습 단계에 있어서도 기본적 술기에 대한 지속적인 교육과 평가가 점검되도록 하는 실질적 개선 방안이 모색되어야 한다.

치의학 전공과 비전공 대학생 간의 치과관련 국민건강보험 혜택에 대한 지식 비교

방재범,백승헌,황지영,오희진 경희대학교 경영연구원 2020 의료경영학연구 Vol.14 No.3

This study is to find out the difference of knowledge about the national health insurance benefits for dental care for dentistry-majors and non-majors. To do this, 83 dental-major and 130 non-dentistry major undergraduate students were surveyed. The survey questionnaire consisted of 15 questions in total based on information released on the web-site of Health insurance review and assessment service and Korea Ministry of Government Legislation. The contents of the survey questionnaire include the degree of perception about the National Health Insurance's knowledge of dental disease, the content of the National Health Insurance's dental benefits items, knowledge of the areas available for dental care, satisfaction with the National Health Insurance and publicity media. The results are as follows. First, undergraduate students did not know exactly about the national health insurance benefits for dental care. Second, the degree of dental-related national health insurance knowledge of research subjects showed statistically significant differences. Third, undergraduate students' satisfaction with dental-related national health insurance benefits was low. Based on these results, it was confirmed that proper education and promotion of the national health insurance coverage benefits were needed to maintain and prevent oral health of the people.

Analysis of Opportunity Costs Based on Survey for Pharmacy Education Eligibility Test : 약학교육 자격 시험을 위한 기회 비용 분석

방재범(Bang, Jae-beom),한나영(Han, Na-young),오정미(Oh, Jung-mi),정규혁(Chung, Kyu-hyuck),오희진(Oh, Hee-jin),권혁기(Kwon, Hyuk-ki),김병주(Kim, Byoung-joo) 한국교육학회 2022 敎育學硏究 Vol.60 No.3

본 연구는 약학교육 자격시험의 기회비용을 설문조사에 근거하여 분석하는 것이다. 약학교육 자격 시험(PEET)은 대부분의 약학대학에서 학생의 적성과 기술을 확인하기 위해 필요하다. 본 연구의 목적은 자체 보고서 조사를 바탕으로 PEET 준비를 위한 기회 비용을 평가하는 것이다. 설문지는 약학과 교육학 분야 전문가들이 개발하여 최종 검증하였다. 기회비용은 간접비용으로서의 시간 측정값, 실제 시험 준비에 필요한 직접비용 등을 합산하여 분석하였다. 설문에는 9개 대학에서 총 392명의 학생이 응답하였으며, 이 중 PEET 준비에 따른 기회비용 분석을 포함하여 설문에 응답한 학생은 245명이었다. 응답자의 대부분(92.60%)은 사교육에 대한 의존도가 매우 높았다. 직접 비용에서는 교과 수업료와 주거비가 가장 큰 비중을 차지하였다. 평균 준비기간은 17.76개월로서 상대적으로 나이가 많거나 시골 지역 일수록 준비기간이 유의미하게 길었다. 간접비용은 준비기간 중 최소한으로 산정되었다. 최종적으로 평균 기회비용은 5,506만원이었며, 연령이 높을수록 통계적으로 유의미하게 증가하였다. 다만 생활지역, 약대 입학전 전공, 준비 시작 시기, 가구소득, 경제적 지원 등은 관련이 없었다. The Pharmacy Education Eligibility Test (PEET) is required by most pharmacy schools for ascertaining students aptitude and skills. The aim of this study was to assess the opportunity costs for the PEET preparation based on self-report survey. The questionnaire was developed and finally verified by experts in pharmacy and education. Opportunity costs were analyzed by summing the measurement of time, as indirect costs, and direct costs required to prepare the exam. A total of 392 students from 9 universities responded to the survey, of which 245 students were included the analysis of opportunity costs for the PEET preparation. A total of 392 students from 9 universities responded to the survey, of which 245 students responded to it, including opportunity cost analysis according to PEET preparation. Most of the respondents (92.60%) were very high dependent on private education. Tuition fee for subject classes and housing expenses accounted for the largest portion of direct cost. The average period was 17.76 months, and the preparation period was significantly longer with older age and rural living. Indirect costs were calculated as the minimum amount of activity during the preparation period. Finally, the average opportunity costs were 55,057 South Korean thousand won and statistically significant as the age were higher. However, it was not related to living region, major before pharmacy school entrance, time of preparation start, household income, and economic support.

웹기반과 고충실도 시뮬레이션에서 의과대학생들의 팀 역할 수행과 임상수행능력 비교

방재범(Jae Beum Bang),윤유상(Yoo Sang Yoon),이영환(Young Hwan Lee),이삼범(Sam Beom Lee) 한국의학교육학회 2014 Korean journal of medical education Vol.26 No.4

Purpose: The importance of team dynamics with regard to clinical performance is being emphasized to improve patient safety and the quality of health care. The aim of this study was to examine the correlation and differences in team dynamics and team clinical performance in a web-based simulation (WS) and high-fidelity simulation (HS) in the medical students. Methods: The simulations were held for 15 teams of fourth year medical students (n=52). They were given two clinical cases, dyspnea (case 1) and chest pain (case 2) by WS and then HS. The scores on the team dynamics and the team’s clinical performance were analyzed by paired t-test and multiple regression using SPSS version 21.0 (IBM Corp.). Results: The teamwork scores on case 2 (22.67±6.58) were higher than for case 1 in the HS (20.47±7.22). Team clinical performance scores were the same the WS and HS. Team clinical performances were significantly associated with team dynamics in both cases by HS. Teamwork scores of team dynamics were each explanation on case 1 (74.9%), case 2 (63.4%) in the HS. Conclusion: The team dynamics and clinical performance can improve if undergraduate medical students have more opportunities. They should be trained in these endeavors to become future doctors for which scenario-based simulations could be valuable.

황해 퇴적물 내 유기오염물질(PCBs, OCPs 및 PAHs)의 농도 및 분포 특성

방재현(Jaehyun Bang),나공태(Kongtae Ra),양동범(Dongbeom Yang),김경태(Kyung-Tae Kim),신경훈(Kyung-Hoon Shin) 한국해양환경·에너지학회 2010 한국해양환경·에너지학회 학술대회논문집 Vol.2010 No.6

본 연구는 2008년 황해 표층 퇴저물에 존재하는 잔류성 유기오염물질(PCBs, OCPs, PAHs)의 분포 및 특성을 알아보았다. 이들 물질에 대한 금지와 규제에도 불구하고 퇴적물 내 PCB 및 OCPs가 미량으로 존재하고 있었다. PCBs는 약 1.4-9.8(ng/g dw)의 범위로 5.8ng/g의 평균값을 보였는데 주로 황해 중앙부에 상대적으로 높은 농도를 나타냈다. PAHs의 경우 H line(위도 36˚)을 제외하고 비슷한 농도로 분포하였다. 이 세 종류의 유기오염물질은 서로 다른 분포특성을 보였는데, 이는 황해 내 유입되는 유기오염물질의 경로가 서로 다른 것으로 사료된다. Persistent organic pollutants such as PCBs, OCPs and PAHs of sediments from the Yellow Sea in 2008 were determined to study characteristics distribution of them. 19 stations of surface sediments were collected using a box-corer. Those organic pollutants were analyzed by GC-ECD for PCBs and OCPs and by GC-MS, respectively. Yellow Sea had relatively low concentrations for PCBs, OCPs and PAHs. Total concentrations of PAHs and PCBs in sediment were ranged from 61.46 to 214.4 (mean 135.68) ng/g dw and from 1.4 to 9.8 (mean 5.8) ng/g dw, respectively. Weak relationships among them were observed. It suggests that potential source of PCBs, OCPs and PAHs should be different.

2년간의 의과대학 학생의 해외임상실습 경험

이삼범,방재범,이영환 영남대학교 의과대학 2009 Yeungnam University Journal of Medicine Vol.26 No.1

결과적으로 영남대학교 의과대학에서는 3학년 학생을 대상으로 2008년도에 처음으로 해외임상실습을 시행하게 되어 2년간 새로운 경험을 하게 되었으며 외국의 병원까지도 교류의 기회를 넓히게 되었다. 향후에는 좀 더 영역을 넓히고 전 학생이 참가할 수 있는 프로그램을 개발하여 글로벌 의사양성이라는 교육목표를 완수하려는 지속적인 관심과 노력이 필요할 것으로 생각한다. Background : The aims of medical education have recently been changing in Korea, which has been accompanied by efforts to modify the rotating clerkship courses, improve the quality of clinical education, and make global doctors. We report the experiences of medical students going through an international elective clerkship for during past two years. Materials and Methods : Third year medical students could apply to the international elective clerkship course during a 4 week period after their third-year rotating clerkship at a university hospital. This was done twice - in 2008 and in 2009. Applicant students were allowed to select hospitals anywhere in the world. We analyzed their choices including data on nation, state or city, hospital or institute, contacted hospitals by medical college, differences of two years, etc. Results : Twelve students (10.9%) of a total of 75 third-year students applied to 3 nations and 4 hospitals in 2008. Nine students applied to the Tampa General Hospital at the University of South Florida (USF) in the USA, which was arranged by their medical college. In 2009, a total of five (4.2%) of 77 students applied to 2 nations and 3 hospitals, including three at the University of South Florida, one in another city in the USA, and one in another nation because of the increased financial burden due to a higher exchange rate. Conclusion : Medical students started their first international elective clerkship courses during the past two years. Experiences were interesting and meaningful to the students and the medical college. Greater effort and support to developing a new paradigm and to enlarge the scope of the program for making global doctors are required in the future.