의사국가시험의 만족도와 의과대학의 임상실기평가에 관한 현황조사

박장희,김운묵,이원철,이윤성 한국보건의료인국가시험원 2004 보건의료교육평가 Vol.1 No.1

It has been an issue whether the current medical examination system can evaluate medical students' competencies efficiently. This study was performed to survey on the satisfaction for the current medical examination system and present situation for clinical skill test in medical schools. We conducted a survey for this research and the subjects of this study were deans, medical professors, resident and medical students. We met with interesting results. First, most respondents answered the current medical examination system couldn't evaluate the medical students' competencies efficiently. Second, many residents thought preparing for paper-pencil test was not helpful for training, while experiencing clinical skill test was helpful for it. Third, the current contents and methods to evaluate clinical skill in the medical schools were variable and desirable. We concluded it was high time to change our medical examination system for evaluating the clinical skill performance of medical students.

Dreyfus scale-based feedback increased medical students’ satisfaction with the complex cluster part of a interviewing and physical examination course and improved skills readiness in Taiwan

Shiau-Shian Huang,Chia-Chang Huang,Ying-Ying Yang,Shuu-Jiun Wang,Boaz Shulruf,Chen-Huan Chen 한국보건의료인국가시험원 2019 보건의료교육평가 Vol.16 No.-

PurposeIn contrast to the core part of the clinical interviewing and physical examination (PE) skills course, corresponding to the basic, head-to-toe, and thoracic systems, learners need structured feedback in the cluster part of the course, which includes the gastrointestinal, neuromuscular, and musculoskeletal systems. This study evaluated the effects of using Dreyfus scale-based feedback, which has elements of continuous professional development, instead of Likert scale-based feedback in the cluster part of training in Taiwan. MethodsInstructors and final-year medical students in the 2015-2016 classes of National Yang-Ming University, Taiwan comprised the regular cohort, whereas those in the 2017-2018 classes formed the intervention cohort. In the intervention cohort, Dreyfus scale-based feedback, rather than Likert scale-based feedback, was used in the cluster part of the course. ResultsIn the cluster part of the course in the regular cohort, pre-trained standardized patients rated the class climate as poor, and students expressed low satisfaction with the instructors and course and low self-assessed readiness. In comparison with the regular cohort, improved end-of-course group objective structured clinical examination scores after the cluster part were noted in the intervention cohort. In other words, the implementation of Dreyfus scale-based feedback in the intervention cohort for the cluster part improved the deficit in this section of the course. ConclusionThe implementation of Dreyfus scale-based feedback helped instructors to create a good class climate in the cluster part of the clinical interviewing and PE skills course. Simultaneously, this new intervention achieved the goal of promoting medical students’ readiness for interviewing, PE, and self-directed learning.

Comparing the cut score for the borderline group method and borderline regression method with norm-referenced standard setting in an objective structured clinical examination in medical school in Korea

이상화 한국보건의료인국가시험원 2021 보건의료교육평가 Vol.18 No.-

Purpose: Setting standards is critical in health professions. However, appropriate standard setting methods do not always apply to theset cut score in performance assessment. The aim of this study was to compare the cut score when the standard setting is changed fromthe norm-referenced method to the borderline group method (BGM) and borderline regression method (BRM) in an objective structured clinical examination (OSCE) in medical school. Methods: This was an explorative study to model the implementation of the BGM and BRM. A total of 107 fourth-year medical students attended the OSCE at 7 stations for encountering standardized patients (SPs) and at 1 station for performing skills on a manikinon July 15th, 2021. Thirty-two physician examiners evaluated the performance by completing a checklist and global rating scales. Results: The cut score of the norm-referenced method was lower than that of the BGM (P<0.01) and BRM (P<0.02). There was nosignificant difference in the cut score between the BGM and BRM (P=0.40). The station with the highest standard deviation and thehighest proportion of the borderline group showed the largest cut score difference in standard setting methods. Conclusion: Prefixed cut scores by the norm-referenced method without considering station contents or examinee performance canvary due to station difficulty and content, affecting the appropriateness of standard setting decisions. If there is an adequate consensuson the criteria for the borderline group, standard setting with the BRM could be applied as a practical and defensible method to determine the cut score for OSCE.

Correlation between academic self-efficacy and burnout originating from distance learning among nursing students in Indonesia during the coronavirus disease 2019 pandemic

Ngatoiatu Rohmani,Rosi Andriani 한국보건의료인국가시험원 2021 보건의료교육평가 Vol.18 No.-

Purpose: Distance learning, which became widespread in response to the coronavirus disease 2019 (COVID-19) pandemic, has been a burdensome challenge for students and lecturers. This study investigated the relationship between academic self-efficacy and burnout in first-year nursing students who participated in distance learning during the COVID-19 pandemic. Methods: The study included 69 first-year nursing students at Jenderal Achmad Yani University in Yogyakarta, Indonesia. Data were collected in September 2020 through self-efficacy and burnout questionnaires that were distributed via email and social media for 2 weeks. The responses were analyzed using the gamma test. Results: Most respondents were women (78.3%), with an average age of 19 years. Most nursing students had a moderate level of academic self-efficacy (72.5%), while only 13.0% of respondents had a low level of academic self-efficacy. However, 46.4% of students experienced severe burnout during distance learning. Cross-tabulation showed that students with moderate self-efficacy were more likely to experience severe burnout (24 respondents) (P<0.01 and r=-0.884). Exhaustion was the burnout dimension most closely associated with academic self-efficacy. Conclusion: Students perceived distance learning as burdensome and reported high levels of exhaustion, which may negatively impact their academic achievement. Interventions to improve academic self-efficacy may foster students’ confidence, potentially leading to reduced burnout levels. Nurse educators should reflect upon innovative learning strategies to create a favorable learning environment for nursing students.

Comparison of the use of manikins and simulated patients in a multidisciplinary in situ medical simulation program for healthcare professionals in the United Kingdom

Marrit Meerdink,Joshua Khan 한국보건의료인국가시험원 2021 보건의료교육평가 Vol.18 No.-

Purpose: Simulation training is increasingly popular in healthcare education, and often relies on specially designed manikins. However, it is also possible to work with actors, or simulated patients (SPs), which may provide a greater sense of realism. This study aimed to compare these 2 approaches, to ascertain which makes healthcare professionals feel most comfortable, which leads to the greatest improvement in confidence, and which is most beneficial to learning. Methods: This study was embedded in a pre-existing multidisciplinary in situ simulation program. A multidisciplinary group of learners from a range of backgrounds—including nurses, doctors, and other allied health professionals—were asked to complete a questionnaire about their learning preferences. We collected 204 responses from 40 simulation sessions over 4 months, from September to December 2019. Of these 204 responses, 123 described using an SP and 81 described using a manikin. Results: We found that 58% of respondents believed they would feel more comfortable working with an actor, while 17% would feel more comfortable using a manikin. Learners who used both modalities reported a significant increase in confidence (P<0.0001 for both). Participants felt that both modalities were beneficial to learning, but SPs provided significantly more benefits to learning than manikins (P<0.0001). The most common reason favoring SP-based simulation was the greater realism. Conclusion: In scenarios that could reasonably be provided using either modality, we suggest that educators should give greater consideration to using SP-based simulation.

Attitudes toward rehabilitating inmates among occupational therapy students in the United States

Sarah Catherine Tucker,Hon Keung Yuen 한국보건의료인국가시험원 2019 보건의료교육평가 Vol.16 No.-

PurposeThis study was to examine occupational therapy (OT) students’ attitudes toward rehabilitating inmates and validate an instrument used to measure their attitudes. MethodsOT students (n=128) from one university in Alabama, United States, completed an online survey exploring their attitudes toward rehabilitating inmates, which was assessed using the Rehabilitation Orientation Scale (ROS), a 7-point scale. Dimensional structure, internal consistency reliability, construct validity, and relations to other variables of the ROS was evaluated using factor analyses, Cronbach’s alpha, known-groups method, and univariable correlations, respectively. ResultsUnidimensionality of the ROS was confirmed with an alpha coefficient of 0.90. The mean ROS score of the respondents was 5.1; a score toward 7 indicated a more supportive attitude. About 60% of the respondents reported supportive attitudes (i.e., an ROS score ≥5). Respondents’ ROS scores were significantly higher than those of the public and criminal justice professionals. Female students reported a more supportive attitude than males. Multiple regression analysis indicated that respondents’ consideration of working in prison settings after graduation and their perception that OT has a role in prison settings were significantly associated with support for rehabilitating inmates, after controlling for gender and an acquaintance with someone who has been incarcerated. ConclusionResults indicated that the ROS demonstrated adequate psychometric properties as it applied to this population. The majority of respondents reported supportive attitudes toward rehabilitating inmates. Consideration of working in prison settings after graduation and the perception that OT has a role in prison settings were 2 independent factors associated with respondents’ attitudes toward rehabilitating inmates.

Malaysian pharmacy students’ perspectives on the virtual objective structured clinical examination during the coronavirus disease 2019 pandemic

Mohamed Hassan Elnaem,Muhammad Eid Akkawi,Nor Ilyani Mohamed Nazar,Norny Syafinaz Ab Rahman,Mohamad Haniki Nik Mohamed 한국보건의료인국가시험원 2021 보건의료교육평가 Vol.18 No.-

Purpose: This study investigated pharmacy students’ perceptions of various aspects of virtual objective structured clinical examinations (vOSCEs) conducted during the coronavirus disease 2019 pandemic in Malaysia. Methods: This cross-sectional study involved third- and fourth-year pharmacy students at the International Islamic University Malaysia. A validated self-administered questionnaire was distributed to students who had taken a vOSCE a week before. Results: Out of the 253 students who were approached, 231 (91.3%) completed the questionnaire. More than 75% of the participants agreed that the instructions and preparations were clear and helpful in familiarizing them with the vOSCE flow. It was found that 53.2% of the respondents were satisfied with the flow and conduct of the vOSCE. However, only approximately one-third of the respondents believed that the tasks provided in the vOSCE were more convenient, less stressful, and easier to perform than those in the conventional OSCE. Furthermore, 49.7% of the students favored not having a vOSCE in the future when conducting a conventional OSCE becomes feasible again. Internet connection was reported as a problem hindering the performance of the vOSCE by 51.9% of the participants. Students who were interested in clinical pharmacy courses were more satisfied than other students with the preparation and operation of the vOSCE, the faculty support, and the allocated time. Conclusion: Students were satisfied with the organization and operation of the vOSCE. However, they still preferred the conventional OSCE over the vOSCE. These findings might indicate a further need to expose students to telehealthcare models.

Agreement between medical students’ peer assessments and faculty assessments in advanced resuscitation skills examinations in South Korea

정진우,Song Yi Park,Kyung Hoon Sun 한국보건의료인국가시험원 2021 보건의료교육평가 Vol.18 No.-

Purpose: In medical education, peer assessment is considered to be an effective learning strategy. Although several studies have examined agreement between peer and faculty assessments regarding basic life support (BLS), few studies have done so for advanced resuscitation skills (ARS) such as intubation and defibrillation. Therefore, this study aimed to determine the degree of agreement between medical students’ and faculty assessments of ARS examinations. Methods: This retrospective explorative study was conducted during the emergency medicine (EM) clinical clerkship of fourth-year medical students from April to July 2020. A faculty assessor (FA) and a peer assessor (PA) assessed each examinee’s resuscitation skills (including BLS, intubation, and defibrillation) using a checklist that consisted of 20 binary items (performed or not performed) and 1 global proficiency rating using a 5-point Likert scale. The prior examinee assessed the next examinee after feedback and training as a PA. All 54 students participated in peer assessment. The assessments of 44 FA/PA pairs were analyzed using the intraclass correlation coefficient (ICC) and Gwet’s first-order agreement coefficient. Results: The PA scores were higher than the FA scores (mean±standard deviation, 20.2±2.5 [FA] vs. 22.3±2.4 [PA]; P<0.001). The agreement was poor to moderate for the overall checklist (ICC, 0.55; 95% confidence interval [CI], 0.31 to 0.73; P<0.01), BLS (ICC, 0.19; 95% CI, -0.11 to 0.46; P<0.10), intubation (ICC, 0.51; 95% CI, 0.26 to 0.70; P<0.01), and defibrillation (ICC, 0.49; 95% CI, 0.23 to 0.68; P<0.01). Conclusion: Senior medical students showed unreliable agreement in ARS assessments compared to faculty assessments. If a peer assessment is planned in skills education, comprehensive preparation and sufficient assessor training should be provided in advance.

Is online objective structured clinical examination teaching an acceptable replacement in post-COVID-19 medical education in the United Kingdom?: a descriptive study

Vashist Motkur,Aniket Bharadwaj,Nimalesh Yogarajah 한국보건의료인국가시험원 2022 보건의료교육평가 Vol.19 No.-

Purpose Coronavirus disease 2019 (COVID-19) restrictions resulted in an increased emphasis on virtual communication in medical education. This study assessed the acceptability of virtual teaching in an online objective structured clinical examination (OSCE) series and its role in future education. Methods Six surgical OSCE stations were designed, covering common surgical topics, with specific tasks testing data interpretation, clinical knowledge, and communication skills. These were delivered via Zoom to students who participated in student/patient/examiner role-play. Feedback was collected by asking students to compare online teaching with previous experiences of in-person teaching. Descriptive statistics were used for Likert response data, and thematic analysis for free-text items. Results Sixty-two students provided feedback, with 81% of respondents finding online instructions preferable to paper equivalents. Furthermore, 65% and 68% found online teaching more efficient and accessible, respectively, than in-person teaching. Only 34% found communication with each other easier online; Forty percent preferred online OSCE teaching to in-person teaching. Students also expressed feedback in positive and negative free-text comments. Conclusion The data suggested that generally students were unwilling for online teaching to completely replace in-person teaching. The success of online teaching was dependent on the clinical skill being addressed; some were less amenable to a virtual setting. However, online OSCE teaching could play a role alongside in-person teaching.

Effect of online education on the knowledge on, attitudes towards, and skills in patient safety for nursing students in Korea: a mixed-methods study

조단비,이원,김소윤,최성경 한국보건의료인국가시험원 2022 보건의료교육평가 Vol.19 No.-

Purpose The purpose of this study was to evaluate the impact of synchronous online education on the patient safety competency (knowledge, attitudes, and skills) of nursing students in Korea and to explore what they thought about this educational method. Methods A single-group pre-and post-test design and summative content analysis were implemented. On November 14th, 2020, 110 nursing students completed synchronous online patient safety education. Patient safety competency was measured before and after the intervention using the revised Patient Safety Competency Self-Evaluation tool. The descriptive statistics, paired t-test, and Wilcoxon signed-rank test were used to analyze the data. Students also expressed their opinions about this education based on open-ended questions. Results All the patient safety competency scores significantly increased after intervention. A summative content analysis of the open-ended questions yielded 5 categories: educational materials, education level, education time, interaction, and educational media. Conclusion This study found that synchronous online patient safety education improves nursing students’ knowledge on, attitudes towards, and skills in patient safety. Nursing students also expressed a variety of positive aspects of the online education method. To improve the efficacy of synchronous online patient safety education, there is a need for further empirical studies on the appropriate class duration and difficulty of the content. It is essential to find a way to combine online education with various learning activities.