Validating the Korean shorter Diagnostic Thinking Inventory in medical education: a pilot study

시지현 한국의학교육학회 2024 Korean journal of medical education Vol.36 No.1

Purpose: Developing clinical reasoning across the medical curriculum requires valid, reliable, and feasible assessment tools. However, few validated tools are available for the convenient and efficient quantification of clinical reasoning. Thus, this study aimed to create a shorter version of the Diagnostic Thinking Inventory (DTI) and validate it in the Korean medical education context (DTI-SK).Methods: The DTI-SK was constructed using content validity and a translation and back-translation process. It comprises two subcategories and 14 items. Its validity and reliability were explored using exploratory and confirmatory factor analyses, mean comparisons of four medical student groups (med 1 to med 4), and internal consistency using Cronbach’s α. Two hundred medical students were invited to participate through email, and the survey was administered for 2 weeks.Results: Data from 136 students were analyzed. Exploratory factor analysis revealed two factors with eigenvalues greater than 1.0 and they together explained 54.65% of the variance. Confirmatory factor analysis demonstrated that the model had acceptable level of fit and convergent validity. Discriminant validity was confirmed using heterotrait-monotrait criterion. Group comparisons demonstrated that the med 4 students showed significantly higher scores than the med 1 and 2 students. The inventory exhibited strong internal consistency for all items (Cronbach’s α=0.906).Conclusion: The findings indicated that the DTI-SK is a reliable and valid tool for measuring medical students’ clinical reasoning in the context of Korean medical education.

프로젝트 기반 협력학습이 의대생의 자기조절 학습능력개발에 미친 효과

시지현 한국교육방법학회 2020 교육방법연구 Vol.32 No.1

The study of designing learning contexts where learners can train and develop their self-regulated learning ability has recently been attracting attentions. This study investigated the effects of the project-based collaborative learning context on self-regulated learning development of medical students in one medical school. In this learning context, the students worked in a mixed group composed of the students with different levels of self-regulated learning ability (high, medium and low). It also explored the relationship among co-regulation that occurred during collaboration, their pre and post self-regulated learning abilities as well. The development of self-regulated learning ability and the relationship were investigated according to the level of their pre self-regulated learning ability as well. For this, 50 second-year medical students who enrolled in the ‘scientific thinking and medical research’ course participated in this study. Ten mixed groups were composed, each group with 5 students, one from the high level, two from the medium level, and two from the low level based on the results of the self-regulated learning questionnaire implemented at the beginning of the course. In the class, the students in a mixed group conducted authentic research for ten weeks. After finishing their research, they filled out the same self-regulated learning questionnaire and co-regulation questionnaire online. According to the results, this collaborative learning context is effective to develop students’ self-regulated learning ability. In addition, the learners with lower self-regulated learning ability showed a similar level of co-regulated activities to the learners with higher self-regulated learning ability and this co-regulated activities had the correlation with the development of self-regulated learning ability. Such connection was particularly strong for the students with the medium level of pre self-regulated learning ability. These results can provide important implications for instructional design for development of learners’ self-regulated learning ability. 최근 학습자의 자기조절 학습능력을 개발하기 위한 방안으로 학습자가 자기조절학습을 훈련할 수 있는 학습맥락설계에 관한 연구가 주목 받고 있다. 이에 본 연구는 한 의과대학에서 실제적인 의학연구를 진행하는 프로젝트 기반 협력학습에서 소그룹 구성을 자기조절학습능력 상중하 수준의 학습자를 모두 포함하는 혼합그룹으로 구성하여 이러한 학습맥락이 학습자의 자기조절 학습능력개발에 어떠한 영향을 미치는 지를 살펴보았다. 또한 자기조절학습능력이 상이한 학습자로 구성된 소그룹에서 발생하는 협력조절이 학습자의 사전 사후 자기조절학습능력과 어떤 관계를 보이는지도 살펴보았다. 그리고 사전 자기조절 학습능력 수준별 자기조절 학습능력 개발 및 협력조절과의 관계도 살펴보았다. 본 연구에는 한 의과대학에서 프로젝트 기반 협력학습으로 설계된 ‘과학적 사고와 의학연구’과목을 수강한 의예과 2학년 학생 50명이 참여하였고 이들은 학기 초에 실시된 사전 자기조절학습검사 점수에 따라 상 중 하 세 집단으로 나누어져 상위집단에서 한명, 나머지 중 하위 집단에서 각각 두 명씩 5명씩 한조를 이루어 10주 동안 프로젝트를 수행하였다. 프로젝트를 끝낸 후 사후 자기조절학습능력과 협력조절에 관한 데이터는 설문을 통해 수집하였다. 연구결과에 의하면 자기조절 학습능력이 상이한 학습자로 구성된 소그룹에서 복잡한 과제를 수행하는 협력학습맥락은 학습자의 자기조절 학습능력 개발에 효과적 것으로 드러났다. 또한 자기조절학습능력이 높은 학습자와 함께 협력조절활동에 참여하는 것은 자기조절학습능력이 보다 낮은 학습자들도 조절활동에 비슷한 수준으로 참여하게 하며 이러한 협력조절은 자기조절 학습능력개발과 관련이 있는 것으로 드러났다. 특히, 중간 수준의 자기조절 학습능력을 가진 집단에서 이러한 관계가 가장 크게 드러났다. 본 연구의 결과는 자기조절 학습능력을 개발시킬 수 있는 여러 방안에 대한 논의가 필요한 시점에서 학습자의 자기조절학습능력 개발을 위한 교수설계에 중요한 시사점을 제공해 줄 수 있을 것으로 생각된다.

의학교육자의 교수역량 개발을 위한 교육요구도 조사

시지현 한국의학교육학회 2015 Korean journal of medical education Vol.27 No.3

Purpose: This study conducted a needs assessment for developing teaching competencies of medical educators by assessing their perceived ability to perform teaching competencies as well as their perceived importance of these competencies. Additionally, this study examined whether there were any differences in needs assessments scores among three faculty groups. Methods: Hundred and eighteen professors from Dong-A University College of Medicine were surveyed, and the data from 44 professors who answered all the questions were analyzed using IBM SPSS 21. The needs assessment tool measured participants’ perceived ability to perform teaching competencies and perceived importance of these competencies. The Borich formula was used to calculate needs assessment scores. Results: The most urgent needs for faculty development were identified for the teaching competencies of “diagnosis and reflection,” followed by “test and feedback,” and “facilitation.” Additionally, two, out of 51, items with the highest needs assessment scores were “developing a thorough course syllabus” and “introducing students to the course syllabus on the first day of class.” The assistant professor group scored significantly higher on educational needs related to “facilitation,” “affection and concern for students,” and “respect for diversity” competencies than the professor group. Furthermore, the educational needs scores for all the teaching competencies except “diagnosis and reflection,” “global mindset,” and “instructional management” were higher for the assistant professor group than the other two faculty groups. Conclusion: Thus, the educational needs assessment scores obtained in this study can be used as criteria for designing and developing faculty development programs for medical educators.

Course-based research experience of undergraduate medical students through project-based learning

시지현 한국의학교육학회 2020 Korean journal of medical education Vol.32 No.1

Purpose: This study aimed to design and implement an introductory-level course-based research experience (CRE) through project-based learning (PBL) for undergraduate medical students and investigate their learning experience and research skill development, with the ultimate objective of exploring whether CRE can be effectively utilized for undergraduate research experience. Methods: This study included 40 second-year premedical students enrolled in “Scientific thinking and medical research,” which was developed as an introductory-level CRE through PBL. It was a three-credit course and the students met twice a week for one semester. The students’ learning experiences were examined with a 15-item survey including three open-ended questions, while their research skills were assessed through the research reports using a research skill rubric at the end of the course. Results: The findings showed that the students perceived the course structure as appropriate and helpful. They also considered the group work experience to be positive and productive. Learner satisfaction items also earned positive responses in general. Regarding the research skill assessment, the mean value of the research skill scores of each group was 19.11 out of 27 and the mean value of each research skill score was 2.12 out of 3. Conclusion: Overall, the students were satisfied with their research experience, and their research skills were developed, suggesting that this introductory CRE through PBL can be effectively and efficiently utilized for undergraduate research experience.

의과대학 문제기반학습에서 튜터의 티칭스타일에 대한 연구

시지현 제주대학교 교육과학연구소 2018 교육과학연구 Vol.20 No.1

Although problem-based learning has been in use for about 20 years, tutor behavior as a facilitator is still difficult for professors who are familiar with traditional teaching and learning methods. Thus, this study aimed to explore teaching styles of problem-based learning (PBL) tutors in one medical school. It also examined if there are differences in their teaching styles according to the level of professorship, sex, an previous tutor experience for a multifaceted understanding of teaching styles of PBL tutors. Fifty-one tutors participated in this study during the 2015 fall -2016 fall academic year and they were all faculty members(female 21, male 30). They included eighteen assistant professors, fifteen associate professors, and eighteen professors, and were also divided into two groups (high and low) according to their previous tutor experiences. After running PBL sessions, all tutors were invited to self-evaluate their teaching style through Teaching Style Inventory developed by Leung et al.(2003) and it was distributed by email. According to the results, the tutors adopted the student-centered teaching style more than the teacher-centered teaching style. The facilitative teaching style was most utilized while the assertive style was less utilized. In addition, female tutors applied more student-centered teaching styles and associate professors applied the most effective teaching style as tutors. Lastly as the tutor experience increased, the teacher-centered teaching style was reduced and their teaching styles seemed to shift from collaborative to facilitative, which is ideal for PBL tutors. These results provide important insight for the development of tutor training programs. 문제기반학습이 도입된 지 약 20년이 지났지만 문제기반학습에서 요구되는 퍼실리테이터로서의 튜터 행동은 여전히 전통적인 교수학습방법에 익숙한 교수들에게는 쉽지 않은 일이다. 이에 본 연구는 국내 한 의과대학의 문제기반 학습에서 튜터의 티칭스타일을 진단해보았다. 또한 튜터의 티칭스타일에 대한 보다 다각적인 이해를 위해 튜터의 직급, 성별 및 사전 튜터경험에 따라 티칭스타일에 차이가 있는지도 살펴보았다. 본 연구에는 국내 한 의과대학에서 2015년 가을에서 2016년 가을까지 의학과 1학년을 대상으로 실시된 8회의 문제기반학습에 참여한 51명(여: 21명, 남: 30명)의 튜터가 참여하였다. 참여한 튜터는 조교수가 18명, 부교수가 15명, 교수가 18명이었고, 사전 튜터경험에 따라 두 그룹(high vs. low)으로 나뉘어졌다. 튜터의 티칭스타일은 Leung과 동료들(2003)이 개발한 티칭스타일 진단도구(Teaching Style Inventory)를 활용하여 진단되었고, 설문조사는 매 문제기반학습이 끝난 후 이메일 통해 실시되었다. 연구결과에 의하면 튜터들은 문제기반학습에서 요구되는 학습자중심 티칭스타일을 적용하고 있고, 특히 촉진적(facilitative) 티칭스타일을 가장 많이 활용하고 있고, 직접적(assertive) 티칭스타일을 가장 적게 활용하고 있는 것으로 드러났다. 또한 여자 튜터가 좀 더 학습자중심 티칭스타일을 많이 적용하는 것으로 드러났으며, 교수직급별로는 부교수들이 가장 효과적인 티칭스타일을 적용하고 있는 것으로 드러났다. 마지막으로 튜터 경험이 많아질수록 교수자중심 티칭스타일은 줄어들고 협력적(collaborative)에서 촉진적 티칭스타일로 전환되는 것으로 드러났다. 이러한 결과는 튜터를 위한 교수개발프로그램 설계에 중요한 시사점을 제시해준다.

The role of collective efficacy and co-regulation in medical students’ performance in small group contexts

시지현 한국의학교육학회 2020 Korean journal of medical education Vol.32 No.2

Purpose: This study investigated the role of collective efficacy and co-regulation in terms of students’ performance during small group projects in a medical research program. The effect of collective efficacy in student performance was expected to be mediated by co-regulation. Methods: A total of 50 students who enrolled in a medical research program worked on their medical research project in small groups over a period of 9 weeks. After they had submitted their final research project reports as groups at the end of the course, the collective efficacy and co-regulation surveys were conducted online. Results: The mediation model was significant and explained 26.61% of the variance in student performance. The total effect of collective efficacy on student performance was significant and the indirect effect through co-regulation was also significant. Conclusion: These results suggest that collective efficacy influenced student performance through co-regulation in group learning contexts. Considering the fact that more and more collaborative learning now occurs in medical education, the result of this study can provide significant insights for enhancing students’ performance in small group contexts.

An analysis of medical students’ reflective essays in problem-based learning

시지현 한국의학교육학회 2018 Korean journal of medical education Vol.30 No.1

Purpose: This study aimed to explore students’ learning experience in problem-based learning (PBL) particularly in terms of what they learned and how they learned in one Korean medical school by analyzing their reflective essays with qualitative research methods. Methods: This study included 44 first-year medical students. They took three consecutive PBL courses and wrote reflective essays 3 times anonymously on the last day of each course. Their reflective essays were analyzed using an inductive content analysis method. Results: The coding process yielded 16 sub-categories and these categories were grouped into six categories according to the distinctive characteristics of PBL learning experience: integrated knowledge base, clinical problem solving, collaboration, intrinsic motivation, self-directed learning, and professional attitude. Among these categories, integrated knowledge base (34.68%) and professional attitude (2.31%) were the categories mentioned most and least frequently. Conclusion: The findings of this study provide an overall understanding of the learning experience of Korean medical students during PBL in terms of what they learned and how they learned with rich descriptive commentaries from their perspectives as well as several thoughtful insights to help develop instructional strategies to enhance the effectiveness of PBL.

Exploring medical educators’ readiness and the priority of their educational needs for online teaching

시지현,공현희,Sang Hwa Lee 한국의학교육학회 2021 Korean journal of medical education Vol.33 No.1

Purpose: This study investigated medical educators’ readiness for online teaching by exploring their perceived ability and importance of online teaching competencies and identified the highest priority of their educational needs. Methods: In this study, 144 medical education faculty members from a university were invited to participate. The faculty online teaching readiness scale was virtually distributed at the end of the spring semester of 2020 and 38 faculty members responded for 2 weeks. The collected data were analyzed with descriptive statistics, paired t-tests, Borich Needs Assessment, and the Locus for Focus model. Results: The overall average perceived ability was 2.76, while the overall average perceived importance was 3.36. The course design and the technical competency categories showed the highest and lowest educational needs, respectively. Five competencies were given the highest priority of educational needs. Conclusion: The results revealed that the medical educators are not ready for online teaching; thus, urgent educational needs for online teaching competencies exist.

협력학습에서 의대생의 집단 효능감 수준이 협력조절, 인지부하, 학습자 만족도 및 학습결과에 미치는 영향

시지현 교육종합연구원 2019 교육종합연구 Vol.17 No.2

This study aimed to investigate the effects of the levels of medical students’collective efficacy on co-regulation, cognitive load, learner satisfaction and learning outcomes in a collaborative learning situation. The 40 second-year medical students who enrolled in‘scientific thinking and medical research’course and 9 professors participated in this study. They were grouped in a total of 9 with a group of 4-5 with one professor. The collective efficacy level of the groups was assessed through a survey after learner grouping at the beginning of the semester. They were divided into two(high and ow) groups according to the survey results except the one that showed the median value. The co-regulation, cognitive load, learner satisfaction, and learning outcomes were measured at the end of the semester and independent t-tests were conducted. The results showed that the group with higher level of collective efficacy showed higher level of co-regulation, cognitive load and learner satisfaction. The results of this study confirm the importance of collective efficacy in collaborative learning and suggest that it is necessary to monitor the level of collective efficacy from its beginning for effective collaborative learning.

인지부하이론의 관점에서 네 가지 교수효율성 비교 연구

시지현 ( Ji Hyun Si ) 한국교육정보미디어학회(구 한국교육정보방송학회) 2013 교육정보미디어연구 Vol.19 No.4

Pass와 Van Merrienboer(1993)가 제안한 교수(수행)효율성과 그 이후로 제안된 훈련효율성, 교수전반에 걸친 3차원 교수효율성, 그리고 시간을 포함한 3차원 교수효율성은 측정된 변인에 따라, 특정 교수조건의 효율성에 대해 인지부하이론의 관점에서 각기 다른 정보를 제시해 준다. 이는 특정목적에 맞게 설계된 교수조건은 그 특정목적에 적절한 교수효율성 공식을 사용해서 그 효율성을 판단해야 한 필요가 있음을 보여준다. 이에 본 연구는 네 가지 교수효율성 공식이 각기 측정되는 변인에 따라, 특정 목적에 맞게 설계된 교수조건에서 변화하는 학습자들의 인지과정에서의 차이점을 찾아내기 위한 진단 도구로써 사용될 수 있는지를 실증적으로 살펴보고자 한다. 이를 위해 외재적 인지부하를 적응적 교수설계와 모달리티 효과를 바탕으로 최소화한 교수조건을 제시하여 그 학습결과에 대해 네 가지 교수효율성 공식으로 교수효율성을 산출해서 비교해보았다. 연구결과에 의하면 훈련 효율성과 교수과정 전반에 걸친 3차원 교수효율성이 외재적 인지부하를 최소화 하려는 교수조건의 효율성을 가장 잘 반영해 주고 있는 것으로 나타났다. 특히, 교수과정 전반에 걸친 3차원 교수효율성이 교수 과정 전체에 관여된 인지부하를 변인으로 고려하므로, 각 교수조건의 상대적 효율성을 가장 잘 설명하고 있는 것으로 드러났다. 좀 더 많은 후속연구가 필요하지만 앞에서 논의된 네 가지 교수효율성은 특정 목적에 맞게 설계된 교수조건의 효율성을 식별하기 위한 진단 도구로서 사용될 수 있는 것으로 판단된다. Pass and van Merrienboer(1993) developed a computational approach to measure the instructional efficiency (performance efficiency) based on test performance and mental effort invested to attain this test performance. This computational formular aided researchers and instructional designers in comparing the effects of different instructional conditions on learning. Since Pass and van Merrienboer(1993), the computational formulas for training efficiency and two 3-dimensional instructional efficiencies have also been suggested. Each instructional efficiency provides different information on the effects of different instructional conditions on learning according to the measured variables. This implies that the efficiency of instructional conditions should be evaluated by an appropriate efficiency formula to their purpose. The purpose of this study is, therefore, to explore usefulness of the four instructional efficiencies as a diagnostic tool to evaluate efficiency of instructional conditions developed according to a certain purpose. For this purpose, the instructional conditions that minimized the extraneous load by adaptive instructions to individual learners and multimedia contents(modality effect) were developed and the four instructional efficiencies were calculated based on the measures of performance and mental effort during the learning and test periods under this instructional condition. The results showed that the 3D-instructional efficiency based on the measures of test performance and mental effort during learning and test situations provided the most useful information on the value of the instructional conditions as it incorporated both learning and test effort throughout the whole instruction process. Although more research is necessary to generalize this finding, it seems that this study demonstrated under what condition each instructional efficiency is appropriate to use to analyze relative efficiency of instructional conditions.