성과 중심 교육에서의 학생 평가

임선주 대한수의학회 2014 대한수의학회 학술대회발표집 Vol.2014 No.-

정보기술을 활용한 의학교육시스템의 설계와 개발: 부산대학교 의학전문대학원 사례

임선주,이상엽,백선용,우재석,감비성,Im, Sun Ju,Lee, Sang Yeoup,Baek, Sun Yong,Woo, Jae Seok,Kam, Beesung 연세대학교 의과대학 2014 의학교육논단 Vol.16 No.1

The development of information technology (IT) has led to changes in medical education. IT has been used for e-learning and e-teaching, e-assessment, e-logistics, and e-administration. Pusan National University School of Medicine has developed its own educational information system using IT to support students' learning and assessment and to manage curricular activities. Based on our experience, we propose six suggestions for designing new software, specifically regarding simplifying the design for users, communication with the programmer, a rapid cycle from design to implementation, orientation support for users, backup and security support, and obtaining patents. Collaborating with the Department of Medical Informatics within the School of Medicine has advantages, and an alliance among medical schools can simplify the development of software. In any case, curricular innovation should precede the introduction of technology because all technologies should support curricular goals.

트랠리스 양자화와 산술 부호화를 이용한 웨이브렛 변환 부호화

임선주,정태호,김정우,이근영 성균관대학교 1998 학술회의지원논문목록집 Vol.1998 No.-

A method is presented for encodins memoryless sources using trellis coded quantization(TCQ). The trellis symbols are entropy-coded using arithmetic coding. We also present a rnodification of the codebook which resuls in improved rate-distortion performance at low bit rates. The arithmetic and trellis coding method is used for encoding wavelet transform image. The proposed method the performance of the arithmetic coded TCQ for wavelet transform image has better rate-distortion performance compared with JPEG. uniform threshold quantization and finite state scalar quantization.

진주지역 여성회관의 기능별 면적 구성에 관한 연구

임선주,고성룡 대한건축학회지회연합회 2005 대한건축학회연합논문집 Vol.7 No.3

A case of hepatopulmonary syndrome in a child with fatty liver disease secondary to hypopituitarism aftercraniopharyngioma resection

임선주,박현석,이형두,박재홍,박희주 대한소아청소년과학회 2007 Clinical and Experimental Pediatrics (CEP) Vol.50 No.8

간-폐 증후군이란 진행된 간경변을 가진 환자에서 폐혈관의 확장으로 인해 동맥혈 산소 포화도가 감소하는 것을 특징으로 한다. 간경화 환자에서 동맥 산소 포화도의 감소가 보고된 이후로 간-폐 증후군은 말기 간질환을 가진 성인의 13-47% 정도에서 발생한다고 보고하고 있으나, 소아에서 발생한 국내 보고는 없다. 또한 시상하부 및 뇌하수체 기능 저하를 보이는 환자에서 비알코올성 지방간이 급격하게 간부전으로 진행되는 증례가 최근에 보고되고 있다. 저자들은 지방간을 가진 소아에서 두 개인두종 절제술 후에 발생한 뇌하수체기능저하증으로 인해 간질환이 급격하게 진행하여 간-폐 증후군으로 발현된 증례를 경험하였기에 보고하는 바이다. 두부 수술 후에 시상하부 및 뇌하수체 기능 저하를 보이는 환아에서는 내분비 질환이나 대사 장애 뿐 아니라, 간질환에 대한 추적 관찰이 필요할 것이다. Hepatopulmonary syndrome is a triad that includes: hepatic dysfunction, intrapulmonary vascular dilatation and abnormal arterial oxygenation. The incidence of intrapulmonary vascular dilatations, in adults with end-stage liver disease, has been reported to be 13% to 47%, however the incidence in children is unclear and the cases in Korean children have never been reported. The hepatopulmonary syndrome may occur as a result of chronic liver disease following nonalcoholic steatohepatitis in children with hypothalamic or pituitary dysfunction. We report a case of hepatopulmonary syndrome in a 13-year- old child who had rapidly progressive liver dysfunction secondary to panhypopituitarism after craniopharyngioma resection. Careful monitoring and treatment of endocrine abnormalities and metabolic status, as well as liver function, are required in all children undergoing pituitary tumor resection.

기관내 삽관술 교육에서 직접적 피드백의 효과

임선주,윤소정,강신영,이상엽,김해규,정해진 한국의학교육학회 2007 Korean journal of medical education Vol.19 No.4

Purpose: This study was conducted to investigate the effect of direct verbal feedback from an expert during endotracheal intubation skills training using a mannequin compared to practice alone without feedback. Methods: 154 fourth-year medical students at the Pusan National University were divided into control or feedback groups. Both groups were taught by experts using a mannequin at a clinical skills learning center. The feedback group(n=66) received verbal feedback from the expert throughout training. Skills acquisition was tested during a Clinical Performance Examination. Results: There were no differences between the control and feedback groups in terms of prior experiences with endotracheal intubation, confidence level to perform the skill, and grades received from previous clinical clerkships. The average score of the feedback group was significantly higher than that of the control group(14.06 versus 11.98, p<0.05). When the students were divided into ‘exceeds expectations’, ‘meets expectations’ and ‘needs development’ groups according to a global rating, more students from the feedback group were in the ‘exceeds expectations’ group and less were in the ‘needs development’ group compared to the control group(p<0.05). The results showed no significant relation with training date. Conclusion: This study demonstrated that direct verbal feedback from an expert during training significantly improves the performance of endotracheal intubation skill. Feedback acts as an essential component of clinical education; and its effect is prominent, especially in students who require further development.

COVID-19 팬데믹에서 나타난 의학교육의 과제와 전략

임선주,Im, Sunju 연세대학교 의과대학 2021 의학교육논단 Vol.23 No.3

The coronavirus disease 2019 (COVID-19) pandemic has profoundly impacted all aspects of undergraduate, postgraduate, and continuing medical education. Only the focus of medical education-care for patients and communities-has remained an integral part of all of the above sectors. Several challenges have been experienced by learners and educators as the education and training of future doctors has continued in the midst of this crisis, including the cancellation of face-to-face classes and training, reduced patient encounter opportunities, fairness issues in online assessments, disruption of patient interview-based exams, reflections on the role of doctors in society, and mental health-related problems linked to isolation and concerns about infection. In response to these disruptions, educators and institutions have rapidly deployed educational innovations. Schools have adopted educational strategies to overcome these challenges by implementing novel education delivery methods in an online format, providing clinical experiences through simulation or telehealth methods, introducing online assessment tools with formative purposes, encouraging learners' involvement in nonclinical activities such as community service, and making available resources and programs to sustain learners' mental health and wellness. During the COVID-19 pandemic, educators and institutions have faced drastic changes in medical education worldwide. At the same time, the quantitative expansion of online education has caused other problems, such as the lack of human collaboration. The long-term effects of the COVID-19 pandemic on medical education need to be studied further.

사회교육시설로서 여성회관의 시설현황 연구

임선주,Lim, Sun-Joo 한국교육녹색환경연구원 2006 교육·녹색환경연구 Vol.5 No.1

Recently, women's social activities in our society have been greatly increased and legal system and mechanism of social structure to pursue a society where gender equality shall be realized has been discussed lively in a detail manner. Nevertheless, the rate of social advancement of Korean women shows much lower than that of the western industrialized countries. The aim of this study is to examine such problem and to look for a solution thereof. As the subject for this survey, such social welfare facility as women's hall was selected, and then its state of facilities was investigated. The results from this survey revealed that women's hall, which had been started constructing since 1950s, began to spread out nationwide reaching the 1990s, and that women's hall was greatly used as a major public facility that supports women's social activities in each region, and that women's hall, which had been started as a social welfare facility, was a multifunctional facility performing functions such as welfare, education, culture and community, and that educational function among these had been changed a little by little in the aspect of contents and purpose according to the changes of times, however, education for women was treated as a major important function in the women's hall and operated accordingly.

식이 단백 유발 직결장염의 임상적 고찰

임선주,김성헌,배상남,박재홍,Im, Sun Ju,Kim, Seong Heon,Bae, Sang Nam,Park, Jae Hong 대한소아소화기영양학회 2005 Pediatric gastroenterology, hepatology & nutrition Vol.8 No.2

목 적: 식이 단백 유발 직결장염(DPIPC)은 영아 초기에 발생하여 양호한 경과를 취하는 질환으로 모유나 우유 내 성분에 의한 알레르기 반응이 주요 원인으로 추정되고 있다. DPIPC의 임상적 특징과 자연 경과 및 식이 조절의 필요성에 대하여 알아보고자 하였다. 방 법: 2002년 5월부터 2004년 6월까지 부산대학교병원 소아과에 혈변을 주소로 검사를 받은 영아 중 DPIPC로 진단된 13명을 대상으로 임상적 특징을 후향적으로 분석하였다. 결 과: 남아가 7명(53.8%), 여아가 6명(46.2%)이었고, 혈변이 발생한 시기는 평균 $96.8{\pm}58.8$일이었다. 혈변의 빈도는 평균 $2.6{\pm}2.5$회/일이었고, 혈변의 발현 후 진단까지의 평균 기간은 $35.5{\pm}55.0$일이었다. 환자의 식이는 모유 수유가 9명(69.2%), 인공 영양이 2명(15.4%), 혼합 영양이 2명(15.4%)이었다. 알레르기의 가족력은 1명에서 있었고, 환자에서 다른 알레르기 질환의 동반은 없었다. 어머니의 식이 습관으로 소량의 우유 복용이나 견과류 또는 어패류의 섭취가 각각 3명에서 있었다. 혈액 검사에서 백혈구수가 $10,555{\pm}3,145/mm^3$, 호산구 비율이 $6.3{\pm}3.0%$, 절대 호산구수가 $659.0{\pm}532.2/mm^3$였다. 13명 중 6명에서 대장 내시경 검사를 시행되었고, 전 예에서 직장과 S상 결장의 점막에 국소적인 발적과 소결절형성이 관찰되었다. 이 중 5명에서 대장 조직 검사를 시행했으며, 만성 염증과 음와 농양이 동반된 경우가 3명이었고, 전 예에서 결절성 림프양 증식이 있었다. 광학 현미경으로 400배의 고배율 시야에서 관찰하였을 때, 대장 점막의 호산구의 수는 4예에서 10개 이하였고 1예에서 10~20개였다. 13명 모두 식이의 변화나 약물을 사용하지 않고 혈변은 $58.7{\pm}67.0$일 후에 자연 소실되었다. 결 론: 건강한 어린 영아에서 실 모양 또는 고춧가루를 흩어놓은 듯한 혈변이 있을 때는 DPIPC를 의심해야 하고, 환자나 환자의 어머니에서 식이 변화가 없이도 혈변은 대부분 1세 이전에 소실되며 혈변 이외에 다른 문제를 야기하지 않는다는 점에서 DPIPC 환자나 어머니에게 일률적으로 식이 제한을 하는 것은 재고할 필요가 있다. Purpose: Dietary protein induced proctocolitis (DPIPC) can be considered as a cause of rectal bleeding or blood streaked stool in otherwise healthy-looking infants in the first several months of life. Failure to appreciate this entity may lead to inappropriate diagnostic or therapeutic intervention. This study aimed to ascertain the clinical features, treatment and prognosis of DPIPC. Methods: We reviewed 13 infants retrospectively, presented with bloody stool in early infancy. They were diagnosed as DPIPC clinically in Pusan National University Hospital from May 2002 to June 2004. Results: Seven males and six females were included. The mean age at onset of bleeding was $96.8{\pm}58.8days$. The mean frequency of hematochezia was $2.6{\pm}2.5$ times a day. Duration from onset of symptom to diagnosis was $35.5{\pm}55.0days$ and duration from onset of symptom to resolution of bleeding was $58.7{\pm}67.0days$. Nine (69.2%) were exclusively breast-fed infants and two (15.4%) were formula-fed infants. All but one infant did not have family history of other allergic diseases. A dietary history of ingestion of cow's milk, nut or shellfish was present in three mothers. Peripheral eosinophil count was normal to slightly elevated (total WBC count $10,555{\pm}3,145/mm^3$, relative eosinophil count $6.3{\pm}3.0%$, absolute eosinophil count $659.0{\pm}532.2/mm^3$). Sigmoidoscopy revealed lymphonodular hyperplasia with surrounding hemorrhagic spots in the rectosigmoid colon in 6 infants. Histopathologic finding of colonic biopsies in 5 infants showed chronic inflammation with lymphoid follicular hyperplasia (5 infants), crypt abscess (3 infants), or mild infiltration of eosinophils (less than 20/high power field) in the lamina propria. Spontaneous resolution of rectal bleeding occurred in all infants without dietary change or medicine. Conclusion: Most infants with DPIPC experience a very benign course and have spontaneous resolution of rectal bleeding without changes in the mother's diet. In the case of strong evidence for DPIPC we suggest deferring further invasive investigation and continuing breast feeding.

나쁜 소식 전하기와 관련된 개인적 특성이 학생들의 의사소통기술에 영향을 미치는가?

임선주,윤소정,이상엽,정해진,감비성,윤형곤,최현주,강신영,이선희,김해규 한국의학교육학회 2008 Korean journal of medical education Vol.20 No.3

Purpose: Delivering bad news is a task that occurs in most medical practices, rendering communication skills essential to competent patient care. The purpose of this study was to identify factors that are associated with scores on an assessment of medical students' communication skills in delivering bad news to help develop more effective curricula to enhance these essential skills. Methods: One hundred fifty-four fourth-year medical students at Pusan National University were included. Skills for delivering bad news were assessed using the SPIKES protocol in the CPX. The students were categorized into three main groups according to total scores: ‘Exceeds expectations(E)’, ‘Meets expectations(M)’, and ‘Needs development(N)’. Personal experiences with misfortune and attitudes toward breaking bad news were surveyed, and school records were collected. The differences between the E and N groups were analyzed based on performance test and survey. Results: Compared with students in the N group, E group students acquired significantlyhigher scores on the items of Perception, Invitation, a division of Knowledge, Empathy and Strategy, and Summary but not on Setting and a part of Knowledge. E group students had better records in classes and clerkships. There were no differences in personal experiences and attitudes toward breaking bad news between the groups. Conclusion: Personal experience with delivering bad news does not guarantee better communication, and attitudes toward this task do not influence student performance. We expect that deliberate educational programs will have a positive impact on improving communication skills for delivering bad news.