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Application and Effectiveness of a Preceptorship for the Improvement of Clinical Education (임상실습 교육개선을 위한 일 실습지도자 활용모델 (preceptorship model)의 적용 및 효과에 관한 연구 -암센타, 재활센타, 중환자실 실습을 중심으로-)

  • 이원희;김소선;한신희;이소연;김기연
    • Journal of Korean Academy of Nursing
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    • v.25 no.3
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    • pp.581-596
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    • 1995
  • Clinical practice in nursing education provides an opportunity for students, through the process of ap-plying theoretical knowledge to practice, and to learn nursing skills as well as being socialized into nursing and as such decrease the reality shock of actual nursing practice. Because of a shortage of nursing faculty, the job of achieving the objectives of the clinical practice had been turned over to the head nurses. This resulted in many problems, such as, unclear location of responsibilities and inadequate feedback from head nurses. Therefore this study was done to introduce and evaluate the use of preceptors as a way to minimize the above problems, and to maximize the achievement of the clinical practice objectives. Using an adaptation of Zerbe's (1991) three-tiered team model, clinical practice was done using a preceptor, a head nurse and a clinical instructor, each with different and well defined roles. The subjects of this study were 67 senior students of the College of Nursing of Y University in Seoul whose clinical practice in adult nursing was carried out between May 1, 1994 and December 8, 1994. There were 22 preceptors who had at least two years of clinical experience and who were recommended by their head nurses. They were given additional education on the philosophy and objectives of the College of Nursing, on communication skills, on the theory and practice of education, and on nursing diagnosis and education evaluation. The role of the preceptor was to work one-to-one with students in their practice. The role of the head nurse was to supervise and evaluate the preceptors. The role of the clinical instructor was to provide the education program for the preceptors, to provide ad-vice and suggestions to the preceptors and to maintain lines of communication with the college. With each of these roles in place, it was thought that the effectiveness and efficiency of the clinical practice could be increased significantly. To evaluate the effectiveness of the preceptorship, the three - tiered model, Lowery's Teacher Evaluation Opinion Form translated and adapted to Korea was used to measure student statisfaction. The Clinical Practice Compentency Evaluation Tool developed by Lee et ai was also used to measure student competencies. The results of this study are as follows 1. The satisfaction with clinical practice was higher with the introduction of the perceptors than it was before they were used. (t=-5.96, p=<.005) 2. The clinical practice competencies were higher with the introduction of the preceptors than it was before they were used(t=-5.l3, p<.005) 3. In order to analyze areas not measured by the quantitative tools additional analysis of the open questions was done. The results of this analysis showed that : 1) The students felt positive about their sense of security, confidence, handling of responsbility, and being systematic. They also felt positive about improvements in knowledge, opportunities for direct care, and socialization. 2) The students felt negative about the technical part of their role, lack of knowledge by the preceptor, unprofessional attitudes on the part of the preceptor, difficulty in the role of the professional nurse(student). 3) The preceptors felt positive about their responsibility, motivation, and relationship with the college. 4) The preceptors felt negative about their bur-den. Introduction of the preceptorship model will lead to change and improvement in the negative factors discussed above, solve problems in the present clinical education system, increase continuity in the education of the students, help with socialization of the students and motivation of the preceptors to up-grade their education and increase their confidence. These objectives must be obtained to further the development of professional nursing, and thus, making the preceptorship a reality is our job for the future.

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RESISTANCE TO DEMINERALIZATION OF ENAMEL OF PRIMARY TEETH ACCORDING TO RESTORATIONS: IN VITRO STUDY USING QLF (유치 수복물에 따른 주변 법랑질의 탈회 저항성: QLF를 이용한 연구)

  • Kwon, Hae-Sook;Hyun, Hong-Keun;Kim, Young-Jae;Kim, Jung-Wook;Jang, Ki-Taeg;Kim, Chong-Chul;Hahn, Se-Hyun;Lee, Sang-Hoon
    • Journal of the korean academy of Pediatric Dentistry
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    • v.37 no.1
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    • pp.44-52
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    • 2010
  • The objective of this in vitro study was to detect and monitor demineralization and remineralization of primary teeth according to restorative materials using quantitative light-induced fluorescence (QLF). A single bur hole was drilled on the each sound forty eight primary anterior teeth, and the specimens were divided into three groups. The cavity was restored with $Filtek^{TM}$ Z250(Group 1), F2000(Group 2), $Ketac^{TM}$ N100(Group 3) following the manufacturer's instructions. The teeth were subjected to the demineralizing buffer for 3 days, and then subjected to a remineralizing buffer for 14 days. The change of mineral loss(${\Delta}Q$) according to the stages was evaluated by QLF and the following results were obtained: 1. When demineralization was done, ${\Delta}Q$ was increased as follows. : Group 1 ($-110.79\;{\pm}\;27.77$) < Group 2 ($-104.84\;{\pm}\;28.95$) < Group 3 ($-90.16\;{\pm}\;21.87$) : Resistance to demineralization was statistically significant in Group 3. 2. There was a statistically significant increase in ${\Delta}Q$ of all groups since 1st day of remineralization 3. The rate of remineralization, ${\Delta}$(${\Delta}Q$)/day, showed significant high value in each group on the 1st day then decreased rapidly. 4. There was no statistically significant difference in the degree of remineralization among restorative materials.

Evaluation of canal preparation for apical sealing with various Ni-Ti rotary instruments (수 종의 Ni-Ti 회전 기구들을 이용한 치근단 폐쇄 향상을 위한 근관 확대 평가)

  • Shin, Yoo-Seok;Shin, Su-Jung;Song, Min-Ju;Kim, Eui-Seong
    • Restorative Dentistry and Endodontics
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    • v.36 no.4
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    • pp.300-305
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    • 2011
  • Objectives: The aim of this study was to evaluate the various NiTi rotary instruments regarding their ability to provide a circular apical preparation. Materials and Methods: 50 single canal roots were selected, cut at the cementodentinal junction and the coronal 1/3 of the canals was flared using Gates Glidden burs. Samples were randomly divided into 5 experimental groups of 10 each. In group I, GT files, Profile 04 and Quantec #9 and #10 files were used. In Group II Lightspeed was used instead of Quantec. In Group III, Orifice shaper, Profile .06 series and Lightspeed were used. In Group IV, Quantec #9 and #10 files were used instead of Lightspeed. In Group V, the GT file and the Profile .04 series were used to prepare the entire canal length. All tooth samples were cut at 1 mm, 3 mm and 5 mm from the apex and were examined under the microscope. Results: Groups II and III (Lightspeed) showed a more circular preparation in the apical 1mm samples than the groups that used Quantec (Group I & IV) or GT files and Profile .04 series.(Group V)(p < 0.05) There was no significant difference statistically among the apical 3, 5 mm samples. In 5 mm samples, most of the samples showed complete circularity and none of them showed irregular shape. Conclusions: Lightspeed showed circular preparation at apical 1 mm more frequently than other instruments used in this study. However only 35% of samples showed circularity even in the Lightspeed Group which were enlarged 3 ISO size from the initial apical binding file (IAF) size. So it must be considered that enlarging 3 ISO size isn't enough to make round preparation.

Evaluation of retrievability using a new soft resin based root canal filling material (레진 계통의 근관 충전재의 제거 용이성에 대한 평가)

  • Shin Su-Jung;Lee Yoon;Park Jeong-Won
    • Restorative Dentistry and Endodontics
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    • v.31 no.4
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    • pp.323-329
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    • 2006
  • The aim of this study was to evaluate the retrievability of Resilon as a root canal filling material Twenty-seven human single-rooted extracted teeth were instrumented utilizing a crown down technique with Gates-Glidden burs and ProFile system. In group1 (n = 12) canals were obturated with gutta percha and AH-26 plus sealer using a continuous wave technique and backfilled. In group 2 (n = 15) Resilon was used as a filling material. Then teeth were sealed and kept in $37^{\circ}C$ and 100% humidity for 7 days. For retreatment, the samples were re-accessed and filling material was removed using Gates-Glidden burs and ProFiles. Teeth were sectioned longitudinally to compare the general cleanliness and amount of debris $({\times}\;75)$ using SEM. Chi-square test was used $({\alpha}\;=\;0.05)$ to analyze the data. The total time required for removal of filling materials was expressed as mean ${\pm}SD$ (min) and analyzed by the Student t-test $({\alpha}\;=\;0.05)$, Required time for retreatment was $3.25\;{\pm}\;0.32$ minutes for gutta percha/ AH 26 plus sealer and $3.05\;{\pm}\;0.34$ minutes for Resilon. There was no statistically significant difference between the two experimental groups. There was no significant difference between the groups in the cleanliness of the root canal wall. This study showed that Resilon was effectively removed by Gates-Glidden burs and ProFiles.

Temperature change and performance of bur efficiency for two different drill combinations (두 가지 임플란트 드릴 조합에 따른 온도 변화 및 효율 비교)

  • Hwang-Bo, Heung;Park, Jae-Young;Lee, Sang-Youn;Son, Keunbada;Lee, Kyu-Bok
    • The Journal of Korean Academy of Prosthodontics
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    • v.60 no.2
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    • pp.143-151
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    • 2022
  • Purpose. The purpose of this study was to evaluate the performance efficiency of two different drill combinations according to the heat generated and drilling time. Materials and methods. In this study, cow ribs were used as research materials. To test the specimen, cow bones were rid of fascia and muscles, and a temperature sensor was mounted around the drilling area. The experimental group was divided into a group using a guide drill and a group using a Lindmann drill according to the drill used before the initial drilling. The drilling sequence of the guide drilling group is as follows; guide drill (ø 2.25), initial drill (ø 2.25), twist drill (ø 2.80), and twist drill (ø 3.20). The drilling sequence of the Lindmann drilling group is as follows; Lindmann drill (ø 2.10), initial drill (ø 2.25), twist drill (ø 2.80), and twist drill (ø 3.20). The temperature was measured after drilling. For statistical analysis, the difference between the groups was analyzed using the Mann-Whitney U test and the Friedman test was used (α = .05). Results. The average performance efficiency for each specimen of guide drilling group ranged from 0.3861 to 1.1385 mm3/s and that of Lindmann drilling group ranged from 0.1700 to 0.4199 mm3/s. The two drill combinations contained a guide drill and Lindmann drill as their first drills. The combination using the guide drill demonstrated excellent performance efficiency when calculated using the drilling time (P < .001). Conclusion. Since the guide drill group showed better performance efficiency than the Lindmann drill group, the use of the guide drill was more suitable for the primary drilling process.

A Study on the Flora and Its Naturalized Plants of Mt. Teomo·Hyeolgu(Incheon, Ganghwa-gun) in the Western Part of DMZ, Korea (서부 DMZ일원 퇴모·혈구산(인천광역시 강화군)의 식물상 및 귀화식물에 관한 연구)

  • Lee, Jong-Won;Yun, Ho-Geun;Kim, Dong-Hak;Song, Jin-Hun;Kim, Sang-Jun;Gil, Hee-Young
    • Korean Journal of Environment and Ecology
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    • v.36 no.1
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    • pp.1-29
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    • 2022
  • This study surveyed the Mt. Teomo·Hyeolgu and surrounding areas in Ganghwa Island, located in Ganghwa-gun, Incheon, to identify vascular flora and alien plants to be used as basic data for systematic management of the remarkable plants and biodiversity conservation. The survey was carried out 13 times from March 2019 to October 2020. The identified vascular flora of Mt.Teomo·Hyeolgu was 101 families, 321 genera, 517 species, 13 subspecies, 38 varieties, 5 forms, and 573 taxa. They accounted for about 12.35% of a total of 4,641 taxa of vascular plants in Korea. The identified Northern lineage plants, endemic plants, and rare plants on the Korean Peninsula as designated by IUCN were 68 taxa, 10 taxa, and 9 taxa, respectively. 69 taxa were classified as floristic target species. Three taxa, including Maui sedge [Carex thunbergii var. appendiculata (Trautv. & C.A.Mey.) Ohwi] were identified s Class IV and 14 taxa, including Violet Stanavoi clematis (Clematis fusca var. violacea Maxim.) were identified as Class III. The naturalized plants that appeared in the study site were 63 taxa, including daisy fleabane [Erigeron annuus(L.) Pers.], common ragweed [Ambrosia artemisiifoliaL.] and Canadian fleabane [Conyza canadensis(L.) Cronquist]. The above three species were found to have spread throughout Ganghwa Island and surrounding areas such as Seokmo Island, Gyodong Island, and Gimpo city. As introduced disturbing plants like prickly lettuce [Lactuca scariola L.], bur cucumber [Sicyos angulatus L.] and field dock [Rumex acetosella L.] have been newly reported in the Mt. Teomo·Hyeolgu area, mid- to long-term conservation measures should be established for native plants, such as remarkable plants, and also management measures like physical removal should be prepared at an early stage.

Comparison of marginal fit before and after porcelain build-up of two kinds of CAD/CAM zirconia all-ceramic restorations (두 종류의 CAD/CAM 지르코니아 전부도재관의 도재 축성 전후의 변연적합도 비교)

  • Shin, Ho-Sik;Kim, Seok-Gyu
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.5
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    • pp.528-534
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    • 2008
  • Purpose: Marginal fit is one of the important components for the successful prosthodontic restoration. Poor fitting margin of the restoration causes hypersensitivity, secondary caries, and plaque accumulation, which later result in prosthodontic failure. CAD/CAM zirconia all-ceramic restorations, such as $LAVA^{(R)}$ (3M ESPE, St.Paul, MN) and $EVEREST^{(R)}$ (KaVo Dental GmbH, Biberach, Germany) systems were recently introduced in Korea. It is clinically meaningful to evaluate the changes of the marginal fit of the CAD/CAM zirconia systems before and after build-up. The purposes of this study are to compare the marginal fit of the two CAD/CAM all-ceramic systems with that of the ceramometal restoration, before and after porcelain build-up Material and methods: A maxillary first premolar dentiform tooth was prepared with 2.0 mm occlusal reduction, 1.0 mm axial reduction, chamfer margin, and 6 degree taperness in the axial wall. The prepared dentiform die was duplicated into the metal abutment die. The metal die was placed in the dental study model, and the full arch impressions of the model were made. Twenty four copings of 3 groups which were $LAVA^{(R)}$, $EVEREST^{(R)}$, and ceramometal restorations were fabricated. Each coping was cemented on the metal die with color-mixed Fit-checker $II^{(R)}$ (GC Cor., Tokyo, Japan). The marginal opening of each coping was measured with $Microhiscope^{(R)}$ system (HIROX KH-1000 ING-Plus, Seoul, Korea. X300 magnification). After porcelain build-up, the marginal openings of $LAVA^{(R)}$, $EVEREST^{(R)}$,and ceramometal restorations were also evaluated in the same method. Statistical analysis was done with paired t-test and one-way ANOVA test. Results: In coping states, the mean marginal opening for $EVEREST^{(R)}$ restorations was $52.00{\pm}11.94\;{\mu}m$ for $LAVA^{(R)}$ restorations $56.97{\pm}10.00\;{\mu}m$, and for ceramometal restorations $97.38{\pm}18.54\;{\mu}m$. After porcelain build-up, the mean marginal opening for $EVEREST^{(R)}$ restorations was $61.69{\pm}19.33\;{\mu}m$, for $LAVA^{(R)}$ restorations $70.81{\pm}12.99\;{\mu}m$, and for ceramometal restorations $1115.25{\pm}23.86\;{\mu}m$. Conclusion: 1. $LAVA^{(R)}$ and $EVEREST^{(R)}$ restorations in comparison with ceramometal restorations showed better marginal fit, which had significant differences (P < 0.05) in coping state and also after porcelain build-up . 2. The mean marginal opening values between $LAVA^{(R)}$ and $EVEREST^{(R)}$ restorations did not showed significant differences after porcelain build-up as well as in coping state (P > .05). 3. $EVEREST^{(R)}$, $LAVA^{(R)}$ and ceramometal restorations showed a little increased marginal opening after porcelain build-up, but did not show any statistical significance (P > .05).

THE EFFECTS OF THE PLATELET-DERIVED GROWTH FACTOR-BB ON THE PERIODONTAL TISSUE REGENERATION OF THE FURCATION INVOLVEMENT OF DOGS (혈소판유래성장인자-BB가 성견 치근이개부병변의 조직재생에 미치는 효과)

  • Cho, Moo-Hyun;Park, Kwang-Beom;Park, Joon-Bong
    • Journal of Periodontal and Implant Science
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    • v.23 no.3
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    • pp.535-563
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    • 1993
  • New techniques for regenerating the destructed periodontal tissue have been studied for many years. Current acceptable methods of promoting periodontal regeneration alre basis of removal of diseased soft tissue, root treatment, guided tissue regeneration, graft materials, biological mediators. Platelet-derived growth factor (PDGF) is one of polypeptide growth factor. PDGF have been reported as a biological mediator which regulate activities of wound healing progress including cell proliferation, migration, and metabolism. The purposes of this study is to evaluate the possibility of using the PDGF as a regeneration promoting agent for furcation involvement defect. Eight adult mongrel dogs were used in this experiment. The dogs were anesthetized with Pentobarbital Sodium (25-30 mg/kg of body weight, Tokyo chemical Co., Japan) and conventional periodontal prophylaxis were performed with ultrasonic scaler. With intrasulcular and crestal incision, mucoperiosteal flap was elevated. Following decortication with 1/2 high speed round bur, degree III furcation defect was made on mandibular second(P2) and fourth(P4) premolar. For the basic treatment of root surface, fully saturated citric acid was applied on the exposed root surface for 3 minutes. On the right P4 20ug of human recombinant PDGF-BB dissolved in acetic acid was applied with polypropylene autopipette. On the left P2 and right P2 PDGF-BB was applied after insertion of ${\beta}-Tricalcium$ phosphate(TCP) and collagen (Collatape) respectively. Left mandibular P4 was used as control. Systemic antibiotics (Penicillin-G benzathine and penicillin-G procaine, 1 ml per 10-25 1bs body weight) were administrated intramuscular for 2 weeks after surgery. Irrigation with 0.1% Chlorhexidine Gluconate around operated sites was performed during the whole experimental period except one day immediate after surgery. Soft diets were fed through the whole experiment period. After 2, 4, 8, 12 weeks, the animals were sacrificed by perfusion technique. Tissue block was excised including the tooth and prepared for light microscope with H-E staining. At 2 weeks after surgery, therer were rapid osteogenesis phenomenon on the defected area of the PDGF only treated group and early trabeculation pattern was made with new osteoid tissue produced by activated osteoblast. Bone formation was almost completed to the fornix of furcation by 8 weeks after surgery. New cementum fromation was observed from 2 weeks after surgery, and the thickness was increased until 8 weeks with typical Sharpey’s fibers reembedded into new bone and cementum. In both PDGF-BB with TCP group and PDGF-BB with Collagen group, regeneration process including new bone and new cementum formation and the group especially in the early weeks. It might be thought that the migration of actively proliferating cells was prohibited by the graft materials. In conclusion, platelet-derived growth factor can promote rapid osteogenesis during early stage of periodontal tissue regeneration.

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Studies on the Natural Distribution and Ecology of Ilex cornuta Lindley et Pax. in Korea (호랑가시나무의 천연분포(天然分布)와 군낙생태(群落生態)에 관한 연구(研究))

  • Lee, Jeong Seok
    • Journal of Korean Society of Forest Science
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    • v.62 no.1
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    • pp.24-42
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    • 1983
  • To develop Ilex cornuta which grow naturally in the southwest seaside district as new ornamental tree, the author chose I. cornuta growing in the four natural communities and those cultivated in Kwangju city as a sample, and investigated its ecology, morphology and characteristics. The results obtained was summarized as follows; 1) The natural distribution of I. cornuta marks $35^{\circ}$43'N and $126^{\circ}$44'E in the southwestern part of Korea and $33^{\circ}$20'N and $126^{\circ}$15'E in Jejoo island. This area has the following necessary conditions for Ilex cornuta: the annual average temperature is above $12^{\circ}C$, the coldness index below $-12.7^{\circ}C$, annual average relative humidity 75-80%, and the number of snow-covering days is 20-25 days, situated within 20km of from coastline and within, 100m above sea level and mainly at the foot of the mountain facing the southeast. 2) The vegetation in I. cornuta community can be divided that upper layer is composed of Pinus thunbergii and P. densiflora, middle layer of Eurya japonica var. montana, Ilex cornuta and Vaccinium bracteatum, and the ground vegetation is composed of Carex lanceolata and Arundinella hirta var. ciliare. The community has high species diversity which indicates it is at the stage of development. Although I. cornuta is a species of the southern type of temperate zone where coniferous tree or broad leaved, evergreen trees grow together, it occasionally grows in the subtropical zone. 3) Parent rock is gneiss or rhyolite etc., and soil is acidic (about pH 4.5-5.0) and the content of available phosphorus is low. 4) At maturity, the height growth averaged $10.48{\pm}0.23cm$ a year and the diameter growth 0.43 cm a year, and the annual ring was not clear. Mean leaf-number was 11.34. There are a significant positive correlation between twig-elongation and leaf-number. 5) One-year-old seedling grows up to 10.66 cm (max. 18.2 cm, min. 4.0 cm) in shoot-height, with its leaf number 12.1 (max. 18, min), its basal diameter 2.24 mm (max. 4.0 mm, min. 1.0 mm) and shows rhythmical growth in high temperature period. There were significant positive correlations between stalk-height and leaf-number, between stalk-height and basal-diameter, and between number and basal diameter. 6) The flowering time ranged from the end of April to the beginning of May, and the flower has tetra-merouscorella and corymb of yellowish green. It has a bisexual flower and dioecism with a sexual ratio 1:1. 7) The fruit, after fertilization, grows 0.87 cm long (0.61-1.31 cm) and 0.8 cm wide (0.62-1.05 cm) by the beginning of May. Fruits begin to turn red and continue to ripen until the end of October or the beginning of November and remain unfading until the end of following May. With the partial change in color of dark-brown at the beginning of the June fruits begin to fall, bur some remain even after three years. 8) The seed acquision ratio is 24.7% by weight, and the number of grains per fruit averages 3.9 and the seed weight per liter is 114.2 gram, while the average weight of 1,000 seeds is 24.56 grams. 9) Seeds after complete removal of sarcocarp, were buried under ground in a fixed temperature and humidity and they began to develop root in October, a year later and germinated in the next April. Under sunlight or drought, however, the dormant state may be continued.

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