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.

의사 쉐도잉 프로그램이 의과대학생의 전문직간 협력 준비도와 환자안전 태도에 미치는 영향

윤소정 ( Sojung Yune ),임선주 ( Sunju Im ),이상엽 ( Sangyeoup Lee ) 사단법인 아시아문화학술원 2021 인문사회 21 Vol.12 No.2

본 연구는 의사 쉐도잉 프로그램이 의과대학 학생들의 환자안전에 대한 태도와 전문직간 협력 준비도에 미치는 영향과 그 경험의 의미를 알아보았다. 이를 위해 쉐도잉 프로그램의 사전사후에 전문직간 협력 준비도와 환자안전에 대한 태도 검사를 시행하였으며, 프로그램 종료후 성찰에세이를 작성하도록 하였다. 대응표본 t 검정과 Netminer 4.0을 활용한 키워드 분석을 실시하였다. 그 결과 전문직간 협력 준비도와 환자안전에 대한 태도 검사의 전체 점수에서는 차이를 보이지 않았다. 성찰에세이에서는 ‘의사는 정보 제공을 통해 환자의 걱정을 해소해주는 존재’, ‘전문직간 협력으로 완성되는 진료 현장’, ‘참여를 통한 의료인 체험’의 3가지 주요한 토픽이 나타났다. 의사 쉐도잉 프로그램은 학생들이 의료인의 역할과 협업의 중요성을 인식하고 의료인의 한 사람으로서의 정체성을 확립하는데 도움을 주는 것으로 분석되었다. This study investigated how the physician shadowing program affects the medical school students’ attitudes toward patient safety and the readiness for cooperation among experts, and what the meaning of the experience in the physician shadowing program is. Before and after the program, the readiness of cooperation among experts and the attitude toward patient safety were tested, and a reflection essay was written after the program was completed. Paired t-test and keyword analysis using Netminer4.0 were conducted. As a result, there was no difference in the overall score of the test in preparation for cooperation among experts and attitude toward patient safety. In the reflection essay, three major topics were revealed: ‘physicians are the ones who relieve patients’ worries by providing information’, ‘the field of treatment completed through cooperation between experts’, and ‘experience as a medical person through participation’. The physician shadowing program was found to help students recognize the role of medical professionals and the importance of collaboration, and to establish their identity as a medical professional.

한국형 온라인 수업준비도 검사의 타당화 및 의과대학 교수 특성에 따른 온라인 수업준비도의 차이

여상희 ( Sanghee Yeo ),임선주 ( Sunju Im ),윤소정 ( Sojung Yune ) 사단법인 아시아문화학술원 2021 인문사회 21 Vol.12 No.6

본 연구의 목적은 한국의 의과대학 교육상황에 맞는 온라인 수업준비도 척도를 타당화 하고, 교수의 전공계열과 교육 경험에 따른 차이를 비교하는 것이다. 온라인 수업준비도 검사의 타당화를 위해 요인분석을 실시하였으며, 전국 의과대학 교수 250명을 대상으로 온라인 수업준비도 검사를 실시하고 그 결과를 Mann-Whitney 검정으로 분석하였다. 연구 결과, 한국형 의과대학 온라인 교수준비도 척도는 교수자 시간관리, 온라인 수업설계, 온라인 수업도구 사용, 온라인 수업태도 교육, 수업시간 외 학생과의 의사소통, 수업에서의 상호작용, 수업사전준비의 7개의 하위 요인으로 구성되었다. 의과대학 교수의 전공계열에 따른 온라인 수업준비도에는 의미 있는 차이가 나타났으나, 교육경험에 따른 차이는 나타나지 않았다. 이후 의과대학 전공계열 특성별 온라인 수업 준비도 제고를 위한 교수 개발 프로그램이 마련되어야 할 것이다. The purpose of this study is to validate the faculty’s readiness to teach online scale and to compare the differences by the major field and educational experience. For this, the factor structure of the readiness to teach online scale was validated using factor analysis, and the scale was conducted on 250 faculties at medical schools nationwide, and the results were analyzed by the Mann-Whitney test. As the results are the scale consists of seven factors: time management, online class design, using online teaching tools, online teaching attitude education, after-hours communication, class interaction, and before class preparation. There was a significant difference in readiness to teach online by the major field of professors, but no difference in the educational experience. After that, a faculty development program should be prepared to improve readiness to teach online by medical school major field.

환자-의사 의사소통 수업의 한의학전문대학원 학생에 대한 효과

이혜윤(Hye-Yoon Lee),임선주(Sunju Im),윤소정(So Jung Yune),이상엽(Sang Yeoup Lee) 대한한의학회 2021 대한한의학회지 Vol.42 No.3

Messick의 타당도 틀을 활용한 임상실습 전 실기시험의 타당도 평가

이혜윤,윤소정,이상엽,임선주,Lee, Hye-Yoon,Yune, So-Jung,Lee, Sang-Yeoup,Im, Sunju 연세대학교 의과대학 2021 의학교육논단 Vol.23 No.3

Students must be familiar with clinical skills before starting clinical practice to ensure patients' safety and enable efficient learning. However, performance is mainly tested in the third or fourth years of medical school, and studies using the validity framework have not been reported in Korea. We analyzed the validity of a performance test conducted among second-year students classified into content, response process, internal structure, relationships with other variables, and consequences according to Messick's framework. As results of the analysis, content validity was secured by developing cases according to a pre-determined blueprint. The quality of the response process was controlled by training and calibrating raters. The internal structure showed that (1) reliability by generalizability theory was acceptable (coefficients of 0.724 and 0.786, respectively, for day 1 and day 2), and (2) the relevant domains had proper correlations, while the clinical performance examination (CPX) and objective structured clinical examination (OSCE) showed weaker relationships. OSCE/CPX scores were correlated with other variables, especially grade point average and oral structured exam scores. The consequences of this assessment were (1) making students learn clinical skills and study themselves, while causing too much stress for students due to lack of motivation; (2) reminding educators of the need to apply practical teaching methods and to give feedback on the test results; and (3) providing an opportunity for faculty to consider developing support programs. It is necessary to develop the blueprint more precisely according to students' level and to verify the validity of the response process with statistical methods.

한국의 환자중심 의사 역량 연구

전우택,정한나,김영전,김찬웅,윤소정,이건호,임선주,이선우,Jeon, Woo-Taek,Jung, Hanna,Kim, Young-Jon,Kim, Chanwoong,Yune, Sojung,Lee, Geon Ho,Im, Sunju,Lee, Sun-Woo 연세대학교 의과대학 2022 의학교육논단 Vol.24 No.2

With increasing demands for medical care by society, the medical system, and general citizens and rapid changes in doctor's awareness, the competencies required of doctors are also changing. The goal of this study was to develop a doctor's competency framework from the patient's perspective, and to make it the basis for the development of milestones and entrustable professional activities for each period of medical student education and resident training. To this end, a big data analysis using topic modeling was performed on domestic and international research papers (2011-2020), domestic newspaper articles (2016-2020), and domestic social networking service data (2016-2020) related to doctor's competencies. Delphi surveys were conducted twice with 28 medical education experts. In addition, a survey was conducted on doctor's competencies among 1,000 citizens, 407 nurses, 237 medical students, 361 majors, and 200 specialists. Through the above process, six core competencies, 16 sub-competencies, and 47 competencies were derived as subject-oriented doctor's competencies. The core competencies were: (1) competency related to disease and health as an expert; (2) competency related to patients as a communicator; (3) competency related to colleagues as a collaborator; (4) competency related to society as a health care leader (5) competency related to oneself as a professional, and (6) competency related to academics as a scholar who contributes to the development of medicine.

의대생의 인성과 환자안전태도와의 관계에서 학습윤리의식의 매개효과

박귀화(Park Kwi Hwa),이상엽(Sang-Yeoup Lee),임선주(Sunju Im),윤소정(Yune So Jung) 학습자중심교과교육학회 2020 학습자중심교과교육연구 Vol.20 No.17

본 연구에서는 의과대학생들을 대상으로 인성과 학습윤리의식, 환자안전태도 간의 관계를 분석하는 것을 목적으로 한다. 그리고 인성과 환자안전태도간의 관계에서 의과대학생의 학습윤리의식이 어떠한 영향을 미치는지를 밝히고자 하였다. 부산과 경기권에 위치한 2개 의과대학에 재학 중인 학생 560명을 대상으로 설문조사를 실시하여, 최종 430명(회수율 76.8%)이 응답하였다. 대학생용 인성검사, 의과대학생의 학습윤리의식검사, 환자안전태도검사가 시행되었으며, 결과 분석은 SPSS 21.0과 AMOS 21.0을 활용한 상관분석과 구조방정식 모형 분석을 하였다. 그 결과 환자안전태도, 학습윤리의식, 인성 간에는 의미 있는 정적 상관관계가 나타났다. 그리고 인성이 환자안전태도에 미치는 영향에서 학습윤리의식의 매개효과가 나타났다. 환자안전태도를 갖춘 ‘좋은 의사’를 양성하기 위해서는 인성과 학습윤리의식의 포괄적인 범위의 교육이 이루어져야 할 필요가 있다. 또한 의과대학에서 학습윤리 교육을 강화하는 것은 인성이 환자안전태도로 발현되는데 중요한 역할을 하게 될 것이다. 본 연구결과는 이후 향후 의과대학생을 위한 환자안전역량 교육 프로그램 개발의 기초적 자료로 활용될 수 있을 것이다. The purpose of this study is to analyze the relationship between personality, learning ethics consciousness, and patient safety attitude among medical students. And we wanted to reveal how the learning ethics consciousness of medical students affect the relationship between personality and patient safety attitude. A survey was conducted on 560 students attending two medical schools located in Busan and Gyeonggi Province, and the final 430 (76.8% of the collection rate) responded. A personality test for college students, medical students attitudes towards academic misconduct test, and a patient safety attitude test were conducted. The result analysis was performed with correlation and structural equation model analysis using SPSS 21.0 and AMOS 21.0. The results showed meaningful positive correlation between patient safety attitude, learning ethics consciousness, and personality. And the mediated effect of learning ethics consciousness was shown in the effect of personality on patient safety attitude. In order to develop a good doctor with patient safety attitude, a comprehensive range of education needs to be provided for personality and learning ethics. Strengthening learning ethics education in medical schools will also play an important role in the development of personality as a patient safety attitude. The findings could later be used as a basic data for the development of patient safety competency education programs for future medical students.

의대생의 성격유형(MBTI)에 따른 블렌디드 해부학실습의 만족도와 학업성취도 연구

하예지 ( Yeji Ha ),김건호 ( Keonho Kim ),김동원 ( Dongwon Kim ),이경율 ( Kyungyul Lee ),임선주 ( Sunju Im ) 인문사회 21 2023 인문사회 21 Vol.14 No.1

연구 목적: 해부학 실습은 의학교육에 필수적이다. 연구진은 학생들의 마이어스-브릭스 유형 지표(MBTI)와 관련하여 블렌디드 해부학 실습의 만족도와 학업성취도에 대한 연구를 수행하였다. 연구 방법: 2021년 해부학을 수강한 의예과 107명을 대상으로 MBTI 성격유형, 해부학 실습만족도를 조사하였다. 계획과 안내, 사전학습(e-anatomy), 실습운영, 실습지도, 동료와의 협력, 실습평가, 자기평가 및 실습성과가 포함된 25개의 설문지를 리커트 척도로 개발하였다. 성격의 빈도, 만족도의 평균과 표준편차, 성격에 따른 만족도와 학업성취도의 차이를 조사하였다. 연구 내용: ISTJ 학생들이 18명(16.8%)으로 빈도가 가장 높았다. 만족도 실습성과(4.661)가 가장 높았고, 실습운영(3.393)이 가장 낮았다. 사전학습(e-anatomy)(0.042), 실습평가(0.032), 자기평가(0.052)는 외향형(E)과 내향형(I) 간에 유의한 차이를 보였다. 감각형(S)의 학업성취도는 직관형(N)보다 유의미하게 높았다. 결론 및 제언: 성격유형은 만족도와 학업성취도에 영향을 미친다. 따라서 의대는 각 성격유형의 특성을 고려하여 해부학 실습을 개선할 필요가 있다. Anatomy cadaver dissection practice is essential for Medical education. We conducted studies about satisfaction and academical achievements of blended anatomy cadaver practice related to students’ Myers-Briggs Type Indicator (MBTI). We took surveys including MBTI and satisfaction in anatomy cadaver practice to 107 second-year premedical students, who studied anatomy in 2021. We developed 25 questionnaires with Likert’s scale, which contain plannig and introduction, pre-learning (e-anatomy), practice operation, practice guidance, collaboration with colleagues, practice assessment, self-evaluation, and practice outcome. We investigated frequency of personality, mean and standard deviation of satisfaction, differences of satisfaction according to personality, differences of academic achievement according to personality. As a result, ISTJ personality was the most frequent (N=18, 16.8%). Highest mean score in the satisfaction was practice outcome (4.661), whereas lowest mean score was practice operation (3.393). Pre-learning (e-anatomy) (0.042), practice assessment (0.032), and self-evaluation (0.052) showed meaningful differences between personalities of extraversion and introversion. Academic achievement of sensing type students was meaningfully higher than intuition type students. In conclusion, personality types affect satisfaction and academic achievement. Therefore, medical schools need to improve anatomy cadaver practice in consideration of the characteristics of each personality type.