Comparison of competency level of medical, non-medical students and its relevance for admission policy

Eunbae B. Yang 한국의학교육학회 2018 Korean journal of medical education Vol.30 No.3

Purpose: This study aims to analyze the competency of medical students and its relevance for admission policy in medical schools. Methods: This study examined the competency of 63 medical students from the 6-year program (group A) and 41 medical students from the 4-year program (group B) at Yonsei University using the Korea Collegiate Essential Skills Assessment (KCESA). The competency of groups A and B were compared to the corresponding competency levels of non-medical students (groups C and D). Group C is freshmen and D is senior students in universities. The KCESA is computer-based ability test composed of 228 items. The competency of participants were calculated on a T-scores (mean=50, standard deviation=10) based on KCESA norm-references. We conducted independent t-test for group comparisons of competency levels. Results: There are no differences in competency levels between groups A and B. Compared with the non-medical students (group B), the medical students showed a significantly stronger ability to use resources, information-technology and higher-order thinking. In the comparison between groups B and D, medical students showed lower levels of self-management, interpersonal, and cooperative skills. Conclusion: The cognitive ability serves as an important indicator for the decision on admission to a basic medical education program. The efforts should be made to foster the competency that medical students have been found to lack, such as self-management, interpersonal, and cooperative skills. The admission committee should assess the cognitive and non-cognitive competency of applicants in a balanced manner.

의학교육 수월성 제고를 위한 교육과정 재설계

양은배,Yang, Eunbae B. 연세대학교 의과대학 2014 의학교육논단 Vol.16 No.3

The purpose of this study is to analyze the medical education system of Korea and to propose a method of curriculum redesign. Although there have been many attempts by medical educators to improve the quality of medical education, the results have not been fruitful. First, there exists a limitation to the dualistic curriculum design based on Flexnerianism, and thus, this model does not provide an integrated experience to medical students. Therefore, we propose a unidimensional model for curriculum redesign. Second, it is impossible to promote excellence in medical education without solving the structural problems of teaching and learning, such as the teaching competency of the faculty, large-scale lectures, and team teaching systems. A curricular strategy that emphasizes mutual interaction and teaching accountability is necessary to promote meaningful learning. Third, the current clinical training system, the circulation model, provides incomplete training as well as a lack of sequence and articulation experiences. This system needs to be redesigned in a way that allows only those students who have mastered both the knowledge and the application of medical education to advance to the next step. Fourth, norm-referenced assessments of a medical college distort the learning process and create unconstructive system energy. A criterion-referenced assessment that values cooperation, independent study, and intrinsic motivation is more important for the reliability and validity of the assessment. Medical students should not focus on formative and informative learning. Medical colleges should investigate the multifaceted potential of the students and provide transformative learning to grow students into change agents. For this to take place, curriculum redesign-not new methods of medical education-is required.

Evaluation of the National Train-the-Trainer Program for Hospice and Palliative Care in Korea

Kang, Jina,Yang, Eunbae B.,Chang, Yoon Jung,Choi, Jin Young,Jho, Hyun Jung,Koh, Su Jin,Kim, Won Chul,Choi, Eun-Sook,Kim, Yeol,Park, Sung-Min Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.2

Background: To evaluate the effectiveness of the National Train-the-Trainers Program for Hospice and Palliative Care Experts (TTHPC) sponsored by the National Cancer Center of Korea between 2009 and 2012. This program was developed to improve the teaching skills of those in the field of hospice and palliative care (HPC). Materials and Methods: Training was offered in eight 1-day sessions between 2009 and 2012. The effect of the program was measured using Kirkpatrick's model of educational outcomes. First, levels 1 and 2 were evaluated immediately after the 1-day program (n=120). In 2012, the level-3 evaluation test was administered to trainers who offered at least one HPC training (n=78) as well as to their trainees (n=537). Results: The level-1 evaluation addressed participant reactions to and satisfaction with the program. Participants (n=120) were generally satisfied with the content, the method, and the overall course (mean range: 3.94-4.46 on a five-point Likert scale). The level-2 evaluation (learning) showed that participants gained knowledge and confidence related to teaching HPC (4.24 vs. 4.00). The level-3 evaluation (behavioral), which assessed trainers' application of teaching skills to HPC, showed that trainees rated the teaching methods of trainers (mean range: 4.03-4.08) more positively than did trainers (p<0.05). Female trainers were more likely than were male trainers to plan sessions in consideration of their trainees' characteristics (4.11 vs. 3.58; p<0.05), and nurse trainers were more likely than physician trainers to use a variety of instructional methods (4.05 vs. 3.36; p<0.05) Conclusions: We conducted systematic evaluations based on Kirkpatrick's model to assess the effectiveness of our train-the-trainers program. Our educational program was practical, effective, and followed by our HPC experts, who needed guidance to learn and improve their clinical teaching skills.

"한국의 의사상, 2014"의 역량 규정에 대한 의과대학의 교육현실과 기대수준 분석

양은배,신혜경,서덕준,한재진,Yang, Eunbae B.,Shin, Hyekyung,Suh, Dukjoon,Han, Jae Jin 연세대학교 의과대학 2018 의학교육논단 Vol.20 No.3

The aim of this study is to determine whether the 65 competencies, defined in "the role of Korean doctor, 2014", are suitable for basic medical education phase in Korea. It seeks to analyze the gap among the educational reality and expectation, assessment situation of the competencies above. We also try to define issues of the development, application and assessment phases of competency-based medical education (CBME) at individual medical schools. We designed survey tools based on the Miller's assessment pyramid (knowledge, explanation, demonstration, and performance) for each of the 65 competencies. The survey distributed to 41 medical schools in April 2015 and 38 replies were received (92.7%). Competencies that matched both the educational reality and expectation were numbers 1 (patient care), 33 (social accountability), and 49 (professionalism). However, all the other competencies ranked lower in current status than that of desirable level. 54 out of 65 competencies (83.07%) remained at the knowledge and explanation level when each competence were assessed. In the development, application, and assessment phases of CBME, common issues that medical schools commonly noted were difficulty linking competencies to curriculum preparation and student assessment, the lack of faculty's understanding, difficulty to reach consensus among faculties, and absence of teaching and learning methods and assessment tools that fits CBME. For the successful settle down of CBME, there is a need for efforts to develop the model of graduate outcomes, to share information and experience, and to operate faculty development program by the medical education communities.

의과대학 연구력 향상 교육과정에 대한 학생 인식 및 연구 활성화 요인

김인숙,양은배,Kim, Insook,Yang, Eunbae B. 연세대학교 의과대학 2015 의학교육논단 Vol.17 No.2

Including the research in the medical curriculum is regarded as an important issue for medical education. Research experience at medical school has a positive impact on students and it motivates them to undertake further research in the future. The purpose of this study is to explore the factors to activate the research of medical school students. We investigated students' perception of the research curriculum in medical school. The survey for this study was conducted among 41 targeted medical school students from across the Republic of Korea. A total of 370 students from 26 medical schools responded. Benefits through research activities were to study about the areas of interest, as researchers had the opportunity to interact with professors and career. Students, furthermore, had difficulties in research due to data collection, the lack of research space and research funding. Requirements to activate the research were the time to participate in research activities, opening regular research courses, preparation of practical research program and motivation for such research. The medical school would need to improve the medical curriculum through the analysis of the environment and situation the school is facing based upon the in-depth analysis results of what the medical school is pursuing through the research activities, what the students want, what the potential difficulties are, and what the requirements are to improve the research curriculum.

의예과 교육의 역사적 발전과 교육과정 편성 방향 고찰

정한나,양은배,Jung, Hanna,Yang, Eunbae B. 연세대학교 의과대학 2017 의학교육논단 Vol.19 No.3

Despite the importance of how the premedical education curriculum is organized, the basic direction of the curriculum has not been evaluated at a fundamental level. In order to explore the basic directions of the premedical education curriculum, this study examined medical education as a university education, the historical basis of premedical education, and the direction of the premedical education curriculum. Historically, as medical education was incorporated into the university education system, premedical education developed based on basic science and liberal arts education. Accordingly, the direction of the premedical education curriculum began to split into two approaches: one believing in a basic science-based education intended to serve as the foundation of medical training, and the other believing in a liberal arts-based education intended to cultivate the qualities of a doctor. In recent years, however, the binary division in the direction of premedical education has ceased to exist, and the paradigm has now shifted to an agreement that premedical education must cultivate the basic scientific competence required for learning medical knowledge as well as the social qualities that a doctor should have, which are cultivated through the liberal arts. Furthermore, it has been asserted that the direction of premedical education should move toward the qualities that will be required in the future. With the fourth industrial revolution underway, the role of doctors is now being re-examined. This means that today's medical education must change in a future-oriented way, and the direction of the premedical education curriculum must be on the same page.

인턴제도 폐지 논의 이후의 의학교육 변화

양은배,김병수,신좌섭,Yang, Eunbae B.,Kim, Byung Soo,Shin, Jwa-Seop 연세대학교 의과대학 2015 의학교육논단 Vol.17 No.1

In light of changes in today's medical environment, whether to dismantle the 50-year-old internship training system in the Republic of Korea is under debate. Although the question remains open, discussions on such issues have drawn attention to the quality of the clinical clerkship and student career advisory programs in medical colleges. The purpose of this study is to analyze the experiential clerkship and career exploration issues. Ensuring excellence of the clerkship and career advisory sessions is an essential responsibility of educational institutions regardless of whether the intern training system is dismantled. Important objectives of the experimental clerkship include reinforcing prerequisites established by law, introducing a student practice license, developing a standardized clinical assessment and student portfolio requirement, and publishing a guidebook for clinical directors. For career exploration, it is necessary to broaden participants' experiences of specialties and to manage the variety of student career guidance programs. It is imperative for the Korean Association of Medical Colleges, in collaboration with medical colleges, to play a leading role in focusing more attention and effort on such issues.

The Effectiveness of an Instructor's Intervention Using Questioning Strategy in Physiology Class

Ann, Duck Sun,Hwang, Eun Young,Yang, Eunbae B. Yonsei university college of medicine 2011 의학교육논단 Vol.13 No.1

This study was done to analyze students' learning and its lasting effect by teaching strategy involving questioning. This study was performed with 68 students who were enrolled in a physiology class of the Yonsei University College of Medicine in Seoul, Korea, in 2003. The students were randomly divided into 2 groups. One group was taught in a way where students asked questions and the instructor answered the questions. For the other group of students, the instructor asked questions, and the students answered the questions. We performed a pre-test before the study begins and post-tests immediately, 3 weeks, and 6 weeks after the study. The results were analyzed by using analysis of covariance and repeated measures analysis of variance. A higher learning effect was observed in a group where questions were asked by students compared with the other group. The post-test results showed no significant difference in the lasting effect of learning according to the teaching strategy. Students' learning significantly improved when students asked questions and the instructor answered the questions compared with the strategy of the instructor asking questions and students answering to the questions.

의학 직업전문성의 특성과 실천 원리

황은영,양은배,Hwang, Eun Young,Yang, Eunbae B. 연세대학교 의과대학 2010 의학교육논단 Vol.12 No.1

It is the most important thing at present for physicians to posses the qualification of medical professionalism. A lot of medical schools have made all-out efforts to develop leaders of medicine, who will be able to meet the needs of medical professionalism in this complex medical environment. The purpose of this study is to review the cognitive base of medical professionalism leading the curriculum development of medical professionalism. The discussion of medical professionalism started in the 20th century. During the 1960s, there were attempts to reshape the concepts and attributes of medical professionalism. The government began to intervene in the autonomy of physician and the self regulation policy of medical society in 1970s. Physician may be asked to play as a healer and professional (what?) during their medical practice. The fundamental role of healer such as care, compassion, honesty, integrity, confidentiality, ethical behaviors, and respect with patients were nothing fresh to tell even though the age was changed. The attributes of professional which are physician's autonomy, self regulation, teamwork, and responsibility to society has been changed dramatically over the past five decades. In general, medical educators agreed that professionalism is demonstrated through a foundation of clinical competence, communication skills, and ethical and legal understanding, upon which is built application of the principles of professionalism: excellence, accountability, altruism, and humanism. If physicians fail to show professionalism in society, they will confront the crisis which can be under the government control. The only way to keep their autonomy is to practice medical professionalism. So far today, medical schools have laid more stress on competence than value standards in educational systems and it was restricted for medical students to learn the value standards for medical practice. To understand and practice the medical professionalism, it is the most realistic way to solve the complicated medical problems.

성과중심교육과정 개발절차에 대한 고찰

안재희,양은배,Ahn, Jae Hee,Yang, Eunbae B. 연세대학교 의과대학 2013 의학교육논단 Vol.15 No.1

An outcome-based curriculum is perceived to be one alternative educational approach in medical education. Nonetheless, it is difficult for curriculum developers to convert from traditional curriculum to an outcome-based curriculum because research documenting its development process is rare. Therefore, this study aims to introduce the development process and method of outcome-based curriculum. For the purpose of this study, we used diverse data analyses, such as an existing literature search, development model analysis, and case analysis. We identified five phases from the analysis. First, the curriculum developers analyze the physician's job or a high performer in a medical situation. Second, curriculum developers extract outcomes and competencies through developing a curriculum, affinity diagraming, and critical incident interviews. Third, curriculum developers determine the proficiency levels of each outcome and competency evaluation methods. Fourth, curriculum developers conduct curriculum mapping with outcomes and competencies. Fifth, curriculum developers develop an educational system. Also, it is important to develop an assessment system for the curriculum implementation in the process of developing the outcome-based curriculum. An outcome-based curriculum influences all the people concerned with education in a medical school including the professors, students, and administrative staff members. Therefore, curriculum developers should consider not only performance assessment tools for the students but also assessment indicators for checking curriculum implementation and managing curriculum quality.