Validity and reliability assessment of a peer evaluation method in team-based learning classes

윤현배,박완범,명선정,문상휘,박준빈 한국의학교육학회 2018 Korean journal of medical education Vol.30 No.1

Purpose: Team-based learning (TBL) is increasingly employed in medical education because of its potential to promote active group learning. In TBL, learners are usually asked to assess the contributions of peers within their group to ensure accountability. The purpose of this study is to assess the validity and reliability of a peer evaluation instrument that was used in TBL classes in a single medical school. Methods: A total of 141 students were divided into 18 groups in 11 TBL classes. The students were asked to evaluate their peers in the group based on evaluation criteria that were provided to them. We analyzed the comments that were written for the highest and lowest achievers to assess the validity of the peer evaluation instrument. The reliability of the instrument was assessed by examining the agreement among peer ratings within each group of students via intraclass correlation coefficient (ICC) analysis. Results: Most of the students provided reasonable and understandable comments for the high and low achievers within their group, and most of those comments were compatible with the evaluation criteria. The average ICC of each group ranged from 0.390 to 0.863, and the overall average was 0.659. There was no significant difference in inter-rater reliability according to the number of members in the group or the timing of the evaluation within the course. Conclusion: The peer evaluation instrument that was used in the TBL classes was valid and reliable. Providing evaluation criteria and rules seemed to improve the validity and reliability of the instrument.

개발도상국 의사들의 역량강화를 위한 임상연수 프로그램의 효과

윤현배,신좌섭,이승희,김도환,김은정,조계현,황진영,Yoon, Hyun Bae,Shin, Jwa-Seop,Lee, Seung-Hee,Kim, Do-Hwan,Kim, Eun Jung,Cho, Kyehyeon,Hwang, Jinyoung 연세대학교 의과대학 2015 의학교육논단 Vol.17 No.2

Mongolia is suffering from the inadequate capacity of medical doctors due to a poor education and training system. The purpose of this article is to evaluate the effect of a clinical training program for capacity building of medical doctors in Mongolia, and to suggest an effective model for continuing professional development in developing countries. Based on the results of a needs assessment, Korean and Mongolian medical experts developed a clinical training program and trained the trainers on 32 topics regarding major clinical problems in 6 specialties, including cardiology, endocrinology, pediatrics, obstetrics and gynecology, neurology, and emergency medicine. Surveillance survey and pre/post-test were used on every topic to evaluate the satisfaction and achievement, respectively, of the trainees. Six months after the clinical training program, we interviewed a sample of medical professionals to evaluate the change and impact. A total of 612 (person-year) medical doctors participated in the training, and the average score for satisfaction was 7.69 out of 8. The average score of the pre-test was 46.9 out of 100, while the post-test was 82.4. After the training, the medical doctors were applying their new knowledge and skills to their practice, and using the materials as guidelines, which improved their practice and increased patient satisfaction. They also started their own training program and adopted new equipment at their hospitals. The satisfaction and achievement of the trainees were very high, and there was significant change in the medical practice, education system, and infrastructure after the training program. This training program can be an effective model for capacity building of medical doctors in developing countries.

서울대학교 의과대학 의예과 교육과정 개발과 편성 사례

윤현배,이승희,황진영,Yoon, Hyun Bae,Lee, Seung-Hee,Hwang, Jinyoung 연세대학교 의과대학 2017 의학교육논단 Vol.19 No.3

The main points of issue with the former premedical curriculum of Seoul National University College of Medicine (SNUCM) were the absence of educational objectives, decline in student motivation caused by uniform education, students' lack of a sense of belonging, and lack of humanistic education. In accordance with these issues, there were five aspects considered for the improvement of the premedical curriculum: reform based on the newly established educational objectives that corresponds with the 6-year medical school curriculum as a whole, expansion of elective courses and the development of personalized curriculum for the improvement of students' learning motives, expansion of social sciences and humanities curriculum for the development of students' capabilities as good doctors, active participation of medical professors in premedical education, and expansion of informal education and the student support program. According to the assessment done after the implementation of the reformed curriculum, premedical students were gratified with its establishment and management of multifarious liberal arts and major subjects. In preparation of the more rigorous entrance quota of the premedical school at SNUCM, there is ongoing reform of required major subjects and establishment of new subjects in the premedical curriculum in pursuit of unity with the 6-year medical curriculum. Moreover, there is ongoing development of an e-portfolio system for the association of premedical and medical education, integration of formal and informal curriculum, and reinforcement of student observation and formative evaluation. Further discussion on the assessment and betterment of premedical curriculum is needed.

언론연구 32년, 언론출판 32년

尹鉉培 관훈클럽 1996 관훈저널 Vol.- No.63

The Effect of Formative Program Evaluation on Continuous Program Improvement: A Case Study of a Clinical Training Program in Lao PDR

윤현배,신좌섭,이승희,김도환,황진영,김은정,Ketsomsouk Bouphavanh 대한의학회 2015 Journal of Korean medical science Vol.30 No.12

This study aimed to evaluate the effect of the formative program evaluation on the continuous improvement of a clinical training program for Lao health professionals. The training program was conducted 4 times consecutively for total 48 health professionals, and the formative program evaluation was carried out during the whole process. To evaluate the satisfaction and the transfer of the trainees, the questionnaire survey, the focus group interview, and the trainees’ medical records were used. After the end of each batch of the program, the evaluation data were analyzed, and its results were shared with the training management committee and the trainers, who, based on the results, reached a consensus on how to improve the program. The evaluation results and the comparison of them among the four batches of the program showed that there was a continuous increase of the satisfaction and the transfer of the trainees, especially in the early period of the program. The formative program evaluation which was conducted during the whole process of the clinical training program had a positive effect on the improvement of the program, especially in the early phase, by increasing the satisfaction and transfer of the trainees.

복막투석 : 1990년 이후 복막 투석을 시작한 환자의 생존 및 복막염에 관한 단일 기관 자료

윤현배 ( Hyun Bae Yoon ),박혜인조 ( Hay Ne Cho Park ),이하정 ( Ha Jeong Lee ),한승석 ( Seung Suk Han ),김세중 ( Se Joong Kim ),오국환 ( Kook Hwan Oh ),주권욱 ( Kwon Wook Joo ),김연수 ( Yon Su Kim ),안규리 ( Cu Rie Ahn ),한진석 ( Ji 대한신장학회 2008 춘계학술대회 초록집 Vol.28 No.1

장 유착 박리술 후 현저히 호전된 피막성 복막 경화증

윤현배 ( Hyun Bae Yoon ),박혜인조 ( Hayne Cho Park ),이하정 ( Ha Jeong Lee ),한승석 ( Seung Suk Han ),박규주 ( Kyu Joo Park ),문주영 ( Ju Young Moon ),안규리 ( Cu Rie Ahn ),오국환 ( Kook Hwan Oh ) 대한신장학회 2008 Kidney Research and Clinical Practice Vol.27 No.3

Encapsulating peritoneal sclerosis (EPS) is a rare but fatal complication of continuous ambulatory peritoneal dialysis (CAPD). There are some reports on the effect of immunosuppressant therapy including steroid, but the results have not always been promising. Recently, owing to the advance of surgical techniques, there are some reports of the EPS cases significantly improved after successful surgery. A 30-year old man developed EPS after 9 years of peritoneal dialysis, and switched to hemodialysis. In spite of repetitive conservative management and immunosuppressant therapy, there was no improvement. His body weight decreased from 50 kg to 40 kg (BMI 14.2 kg/m2) due to severe malnutrition, so we decided to perform surgery. Total intestinal enterolysis was done successfully without concomitant enterectomy, and his general condition improved dramatically. Four months after surgery, the serum albumin concentration increased from 3.1 g/dL to 4.3 g/dL, cholesterol from 92 mg/dL to 208 mg/dL, and hemoglobin from 9.2 g/dL to 12.5 g/dL. His body weight increased to 61 kg (BMI 21.6 kg/m2), and there was not any fluid collection or bowel obstruction seen on the abdominal CT scan. We experienced a case of EPS which was significantly improved after enterolysis. We report this case with review of the literature.

최근 18년간 단일 기관 진료 자료를 바탕으로 분석한 복막투석 환자의 생존율 및 예후 인자 탐색

윤현배 ( Hyun Bae Yoon ),박혜인조 ( Hayne Cho Park ),이하정 ( Ha Jeong Lee ),한승석 ( Seung Suk Han ),김세중 ( Se Joong Kim ),주권욱 ( Kwon Wook Joo ),김연수 ( Yon Su Kim ),안규리 ( Cu Rie Ahn ),한진석 ( Jin Suk Han ),김성권 ( Suhn 대한신장학회 2009 Kidney Research and Clinical Practice Vol.28 No.1

목적: 복막투석은 말기신부전증의 신대체요법으로 널리 사용되고 있으나, 국내 생존 관련 자료가 부족한 실정이다. 이에 저자들은 1990년 이후 서울대병원에서 시행한 복막투석 환자의 생존 및 복막염 관련 자료를 분석함으로써, 향후 진료와 연구에 기초 자료로 활용하고자 하였다. 방법: 1990년 1월 1일부터 2007년 6월 30일 사이에 서울대병원에서 복막투석을 시작한 15세 이상의 환자 가운데, 3개월 이상 복막투석을 시행한 670명을 대상으로, 2007년 12월 31일까지 관찰하였다. 이들의 성별, 나이, 신부전의 원인, 당뇨병, 심혈관 질환, Davies Comorbidity Score, 사망이나 복막투석 중단의 원인, 그리고 복막염에 대한 자료를 분석하였다. 생존율은 Kaplan-Meier 방법으로 분석하였고, 생존율에 영향을 미치는 독립적인 인자들을 구하기 위하여 multivariate Cox proportional hazard model을 이용하였다. 결과: 말기신부전증의 원인은 당뇨병이 33.7%로 가장 많았고, 심혈관계 질환은 20.4%에서 동반되었다. 사망 원인을 알 수 있는 58명 중, 심혈관계 질환이 24명 (41.3%), 감염이 20명 (34.4%)이었으며, 복막투석 중단의 원인으로는 복막염이 66.1%로 가장 많았다. 1995년부터 2007년까지 전체 연간 환자당 복막염 발생률은 0.270회였고, 1995년부터 1999년까지 0.365회인 반면, 2000년부터 2007년까지의 발생률은 0.230회로 감소한 것으로 나타났다. 복막염의 원인균은 그람 양성균이 42.6%로 가장 많았고, 그람 음성균이 23.8%, 균이 동정되지 않는 경우는 26.9%를 차지하였다. 평균 생존 기간은 107.5±4.2개월이었고, 5년 환자 생존율은 71.7%, 10년 생존율은 48.2%이었다. 한편, 평균 복막투석 기간은 106.5±4.3개월이었고, 5년 기술 생존율은 72.8%, 10년 기술 생존율은 43.8%였다. 복막투석 환자 사망에 영향을 미치는 독립적인 인자는 당뇨 (HR 1.973, p=0.001), 심혈관 질환 (HR 2.040, p<0.001), 복막투석을 시작할 당시 나이인 것으로 나타났으며, 40세 미만에 비하여 40세 이상 60세 미만의 위험도는 2.427 (p=0.016), 60세 이상의 위험도는 7.397 (p<0.001)이었다. 한편, 기술 실패에 영향을 미치는 독립적인 인자는 60세 이상의 나이 (HR 1.791, p=0.025)와 0.270회/년보다 높은 복막염 발생률 (HR 2.361, p<0.001)이었다. 결론: 서울대병원에서 시행한 복막투석의 환자 및 기술 생존율과 복막염 발생률은 국내외 보고에 비하여 비슷하거나 우수하였고, 당뇨병, 심혈관계 질환, 그리고 복막투석 시작 당시 나이가 환자 생존율에 영향을 미치는 독립적인 인자로 나타났으며, 나이와 복막염 발생률이 기술 생존율에 영향을 미치는 독립적인 인자로 나타났다. Purpose: We investigated the survival rate, factors associated with survival, and peritonitis incidence in PD patients who commenced PD at our center since 1990. Methods: We investigated 670 patients who started PD between January 1990 and June 2007. Data for sex, age, etiology of ESRD, comorbidities, follow-up duration, cause of death, and peritonitis were analyzed. Kaplan-Meier method was used to determine patient survival and technique survival rate. Results: The most common cause of death was cardiovascular disease, while peritonitis was the main reason for technique failure. The overall incidence of peritonitis between 1995 and 2007 was 0.270 episodes per patient-year, and there was a significant drop of peritonitis rate from 1995-1999 (0.365) to 2000-2007 (0.230). Patient survival after 5 and 10 years was 71.7% and 48.2% respectively. Technique survival after 5 and 10 years was 72.8% and 43.8%. Older age (age 40-59: HR 2.427, p=0.016; age≥60: HR 7.397, p<0.001), diabetes (HR 1.973, p=0.001), and cardiovascular disease (HR 2.040, p<0.001) were the independent risk factors of mortality, while older age (age≥60: HR 1.791, p=0.025) and higher peritonitis rate (HR 2.361, p<0.001) were the independent risk factors of technique failure. Conclusion: The patient survival, technique survival and peritonitis incidence of PD patients in our center showed outcomes comparable to other centers worldwide. Older age, diabetes, and cardiovascular disease were associated with lower patient survival, while older age and higher peritonitis rate were associated with higher technique failure.

통합교육과정에서 녹화된 강의 동영상을 활용한 동료평가분석 연구

유동미,윤현배,이승희 한국의학교육학회 2015 Korean journal of medical education Vol.27 No.1

Purpose: The purpose of this study is to evaluate the effect of the peer review in an integrated curriculum and to guide furtherimprovements of curriculum. Methods: In 2012, Seoul National University College of Medicine implemented a peer review system for 11 courses in an integratedcurriculum. For each lecture, two reviewers conducted the rating using a 10-item questionnaire on a 4-point scale. We analyzedthe correlation between total scores and each item and the inter-rater reliability between the two reviewers by Pearson correlation. Further, the link between peer review scores and the student lecture evaluation was analyzed. Results: The mean total score for the checklist rating was 31.3 (out of 40.0), and the mean score for each item ranged from 2.65to 3.35 (out of 4.00). The correlation coefficient between the total score and each item was high, ranging from 0.656 to 0.849,except for three items. The mean of difference scores between reviewers was 5.03, and the correlation coefficient was significantlyhigh, which ranged from 0.968 to 0.999. The peer reviews scores and student lecture evaluations generally correlated, but therewere some outlying exceptions; the correlation coefficient was 0.105 and 0.093. Conclusion: Peer review is a useful method for improving the quality of lectures in an integrated curriculum by monitoring theobjectives, contents, and methods of the lectures and providing feedback to the professors.

Recurrent Thrombotic Events after Catastrophic Antiphopholipid Syndrome

박혜인조,윤현배,이태우,정지용,진호준,김연수,김성권 대한내과학회 2012 The Korean Journal of Internal Medicine Vol.27 No.2