Academic Medicine은 환자 중심 의료이다

안신기,An, Shinki 연세대학교 의과대학 2019 의학교육논단 Vol.21 No.2

The tripartite mission of 'academic medicine' is education, research, and patient care. Academic medical centers (AMCs) are carrying out the mission and ultimately aiming to improve the health of people and communities. Globally, AMCs are facing a tremendous financial risk stemming from the changes in health insurance reimbursement plans and a shortage of human resources. Innovative AMCs in the United States are trying to transform their physician-centered, and siloed structure into a patient-centered, and integrated structure. They are also building integrated systems with primary healthcare groups to provide continuous patient care from primary to tertiary levels and making strategic networks based on value-based payment and the patient-centered model. These changes have been proven to improve outcomes of patient care and increase fiscal revenues, which are both crucial in supporting education and research. To address the shortage of human resources, programs are being built to develop newly appointed faculty for the future. AMCs have different approaches to bringing changes into their organizations; however, there is a common emphasis on 'a patient-centered approach,' which helps them set more explicit organizational values and make strategic decisions based on their values. Korean AMCs are facing similar challenges to AMCs in the United States in spite of many differences between the countries' healthcare systems. The innovative efforts of AMCs in the United States to address the challenges will be helpful, well-worked examples for Korean AMCs with similar challenges.

연세대학교 의과대학 의학전문직업성 교육 경험의 반성적 고찰

안신기,부성희,An, Shinki,Bu, Sunghee 연세대학교 의과대학 2012 의학교육논단 Vol.14 No.1

For decades medical educators have continually emphasized medical professionalism, which is reflective response to the challenges of a rapidly changing medical environment. This study aimed to review the experience of implementing medical professionalism education at Yonsei University College of Medicine (YUCM). YUCM introduced a new curriculum in 2004 designed by Curriculum Development Project 2004 (CDP2004), a project that was launched in 2001. CDP2004 reorganized lectures as organ-based integrated lectures, introduced an introductory course for clinical medicine and medical humanities courses for premedical and medical students. Problem-based learning (PBL), elective courses, and self-study sessions in the afternoon were implemented in order to equip students with a self-directed learning attitude as medical professionals. Professors were asked by the CDP2004 curriculum to spend more time on student education and to adopt new teaching methods. Experiences of the CDP2004 curriculum reveals 1) difficulty of motivating professors to be PBL tutors 2) students' dissatisfaction with the medical humanities course (major critique was that the course was impractical and unrealistic), and 3) students' optimistic understanding about their future role as medical professionals in influencing and helping people in spite of their perception of the general medical environment not as promising. To foster professionalism, the following are necessary in our experiences: 1) faculty development of medical humanities and medical professionalism, 2) establishment of an environment throughout the whole institution to support medical professionalism education and to integrate the concept into praxis, 3) emphasis on the fact that medical professionalism education is not contradictory to biophysical medical education.

연세대학교 의과대학 학습공동체 교육과정 개발 및 운영 분석

김혜원,안신기,Kim, Hae Won,An, Shinki 연세대학교 의과대학 2021 의학교육논단 Vol.23 No.3

Learning communities in medical education have demonstrated favorable outcomes in terms of students' learning, professional development, and wellness. Despite these strengths and the widespread adoption of learning communities in US medical schools, there has been little interest in medical learning communities in Korea. In this context, the present study examined the development and implementation of the Yonsei Medical Learning Community (YMLC) and analyzed its outcomes and areas of improvement. The Yonsei University College of Medicine has operated a learning community as part of the undergraduate medical education curriculum since 2014. The YMLC is the first program of its type in Korea. The overall structure of the YMLC consists of four distinct communities (pillars), which are named after four distinguished alumni, and each pillar is organized into five learning community classes. Each class is vertically integrated across students in different medical school years, and one faculty advisor is matched to about 30 students. As the YMLC focuses on fostering reflective practice in students and providing them with opportunities to build teamwork and experience social relatedness, two educational approaches have been adopted: reflective writing and mentoring and community activities. In this study, we obtained and analyzed second-year students' feedback on the YMLC curriculum and identified its achievements, merits, and areas that need improvement. The results have shown that over 75% and 60% of respondents reported satisfaction with reflective writing and mentoring and community activities, respectively. The educational activities of the learning community helped students regularly reflect on their learning and progress and establish close relationships with faculty advisors. However, several areas of improvement regarding content, format, and logistical issues were also identified. The present findings may provide valuable information for other institutions to develop learning communities relevant to their own context.

코로나19 팬데믹 상황에서 국내 의과대학생이 경험한 일상생활 변화, 정신건강 문제 및 스트레스 대처

김혜원,여상희,안신기,Kim, Hae Won,Yeo, Sanghee,An, Shinki 연세대학교 의과대학 2022 의학교육논단 Vol.24 No.3

This study aimed to examine the influence of the coronavirus disease 2019 (COVID-19) pandemic on areas of Korean medical students' lives, assess concerns, and investigate the strategies they used to cope with stress due to the pandemic. An online survey with a total of 53 items on the impact of COVID-19, concerns, and coping strategies was sent to medical students, and responses were collected from April 27, 2021 to May 30, 2021. In total, 1,329 students were included in the study. Analysis was performed using the chi-square test, independent-sample t-test, and one-way analysis of variance, and the post-hoc Scheffé test or Games-Howell test was performed for multiple comparisons. The main negative impacts of the pandemic were on hobbies/leisure activities and mental health, and medical students expressed the highest levels of concern regarding restriction of movement, returning to everyday life, and risk of infection for family and friends. Female students more strongly agreed that COVID-19 had increased their depressed mood and anxiety (p<0.001 and p=0.003, respectively). Furthermore, the negative impacts of the pandemic on different areas of life significantly affected current levels of depressed mood and anxiety. To cope with pandemic-related stress, students used several strategies such as talking with family or friends (91.5%), sleeping (83.1%), exercising (72.8%), using social networking services (60.8%), drinking alcohol (37.8%), and practicing meditation/mindfulness (24.4%); the effectiveness of these strategies ranged from 3.45 to 4.19 on a 5-point Likert-type scale (1-5). The study findings suggest that COVID-19 has influenced the mental health of medical students and raised concerns in many areas of their lives. Students used various strategies to cope with the pandemic-related stress; since the effectiveness of frequently used approaches varied, it is essential to guide medical students to develop effective coping strategies.

신규간호사 교육 프로그램(Nurse Residency Program) 운영을 위한 교육비용 산출 모형 개발 및 모의 적용

정한나 ( Hanna Jung ),안신기 ( Shinki An ) 한국병원경영학회 2020 병원경영학회지 Vol.25 No.4

Purpose: This study aims to develop a cost model for NRP (Nursing Residency Program) operation and ultimately provide evidence for financial factors for NRP operation in the future by simulating a cost model. Methodology: This study developed a model for the NRP education cost calculation model based on the review of Hansen's model, which has systematically reported on the development and operation of NRP, and discussions with nursing education experts at a university-affiliated hospital. With the simulation, it was intended to predict nurses' supply and demand in the long term and to calculate changes in long-term education costs. Findings: Firstly, turnover model, term model, cost model necessary for calculating a model for the NRP education cost calculation model was set up. Secondly, the simulation showed the following results; 1) the proportion of newly graduated nurses less than 5 years of working decreases gradually over time, which will make the composition of nurses more balanced. 2) In the first year of the partial introduction of NRP, the cost of training new nurses was about 2.1 times higher than before. After the introduction, the training cost in the 13th year began to be lesser than before the introduction, and in the 25th year, it decreased by 28.1% compared to before the introduction. Practical Implications: Firstly, NRP would be an effective way to solve the higher turnover and frequent departure of new nurses and the imbalance of nurses' composition. Secondly, although the costs of NRP are incurred in the early stages, in the end, NRP training costs are reduced compared to before the introduction of NRP. It is necessary to systematically understand the contribution effect of NRP by analyzing the economic value of NRP considering financial and non-monetary returns in the future and providing a basis for decision-making related to NRP implementation.

I-E-O 모형에 근거한 의학교육 종단자료 구축을 위한 모형 설계

정한나,이이레,김혜원,안신기,Jung, Hanna,Lee, I Re,Kim, Hae Won,An, Shinki 연세대학교 의과대학 2022 의학교육논단 Vol.24 No.2

The purpose of this study was to establish a model for constructing longitudinal data for medical school, and to structure cohort and longitudinal data using data from Yonsei University College of Medicine (YUCM) according to the established input-environment-output (I-E-O) model. The study was conducted according to the following procedure. First, the data that YUCM has collected was reviewed through data analysis and interviews with the person in charge of each questionnaire. Second, the opinions of experts on the validity of the I-E-O model were collected through the first expert consultation, and as a result, a model was established for each stage of medical education based on the I-E-O model. Finally, in order to further materialize and refine the previously established model for each stage of medical education, secondary expert consultation was conducted. As a result, the survey areas and time period for collecting longitudinal data were organized according to the model for each stage of medical education, and an example of the YUCM cohort constructed according to the established model for each stage of medical education was presented. The results derived from this study constitute a basic step toward building data from universities in longitudinal form, and if longitudinal data are actually constructed through this method, they could be used as an important basis for determining major policies or reorganizing the curricula of universities. These research results have implications in terms of the management and utilization of existing survey data, the composition of cohorts, and longitudinal studies for many medical schools that are conducting surveys in various areas targeting students, such as lecture evaluation and satisfaction surveys.

삽입형 심실제세동기 치료 : 6예 경험에 대한 보고 Initial Clinical Experience in 6 Patients

이동일,안신기,김종윤,김명희,김수영,이문형,김성순 대한순환기학회 1999 Korean Circulation Journal Vol.29 No.9

방사선 치료를 위한 심박동기 위치 변경 1례 : 터널방법 A Tunneling Method

정보영,이동일,안신기,이문형,김명희,김수영,김성순 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.9

Cisapride에 의해 유발된 Torsades de Pointes

김종윤,이유미,안신기,이문형,김성순 대한순환기학회 1999 Korean Circulation Journal Vol.29 No.9

정상인의 전혈(Whole blood)에서 Triflusal(Disgren^(�))에의한 혈소판 응집 억제 효과

강석민,정광회,김태용,안신기,하종원,임세중,이문형,백금련,장양수 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.5