• The Journal of the Korea Contents Association
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• v.15 no.3
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• pp.206-218
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• 2015

This single-blinded, nonequivalent control group pretest-posttest study was undertaken to evaluate the effectiveness of simulation education on clinical judgement, collaboration, communication skills, and perceived education practices and simulation design characteristics among student nurses in Korea. Participants were 47 students (19 in the experimental group and 28 in the control group) recruited by convenience sampling. The simulation based clinical reasoning education consisted of seven weekly, 120-minute high fidelity simulations. All participants completed the pretest and 7-week post measurements of a clinical judgment, collaboration, and communication skills with 4-week post measurement of collaboration, and participants in the experimental group provided a measurements of perceived education practices and simulation design characteristics. Data were analyzed using repeated measured ANOVA, and mixed linear model with SAS 9.2. Significant improvements were found in the experimental group for clinical judgment, collaboration, communication skill, and perceived education practices and simulation design characteristics. The study results show the impact of the perceived education practices and simulation design characteristics on facilitating the effectiveness of simulation education. The findings suggest a feasible and sound teaching method for student nurses and the need for further studies with a larger sample.

• Journal of Korean Critical Care Nursing
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• v.10 no.3
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• pp.41-52
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• 2017

Purpose : This concept analysis identified attributes and defined triage competency among emergency nurses. Method : Walker and Avant's approach was used to guide the concept analysis. A literature review was completed including 26 studies, 5 reports of related associations, and 5 books. Results : The concept of triage competency in emergency nurses was identified as five attributes: clinical judgment, expert assessment, management of medical resources, timely decision, and communication. Antecedents of the concept were triage education and emergency room experience. The consequences of the concept were efficiency of care, patient rating, and safety. Triage competency in emergency nurses was defined as the comprehensive ability to prioritize patients' urgency and allocate limited medical resources. Conclusion : This study is meaningful since it clarified triage competency among emergency nurses. The attributes and empirical indicators of this study will likely lay the foundation for development of triage competency metrics.

• The Journal of Korean Medicine
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• v.26 no.2 s.62
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• pp.105-125
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• 2005

Objectives: The purpose of this study was to identify resources put into clinical. activities and identify a new RBRVS for oriental medical services in the Korean National Health Insurance. Methods: Based on a survey of physician's time, physical effort & technical skill, mental effort & judgment, and stress that were used for patient treatments, relative input values for the relevant clinical activities were estimated and rearranged in a way to be compared. with the current values in health insurance. Results: We found the actual resource-based relative values for oriental medical services statistically different from the current values, with a narrower variation in value distribution. Conclusions: The findings suggest the C\lrrent RBRVS should be revised to reflect the actual input resources into physicians activities and to avoid a distortion of physicians behavior.

• Journal of The Korean Society of Clinical Toxicology
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• v.3 no.1
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• pp.1-10
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• 2005

Gastric lavage is now known to be ineffective, unnecessary or hazardous in some circumstances where it used to be performed as a routine. This article concerns the medico-legal aspect of forced gastric lavage. The Supreme Court 2005.1.28, 2003da14119 is the case where a patient, who ingested the organophosphate insecticide to attempt suicide and refused lavage. At first we discuss the effectiveness or hazards of lavage because a very high degree of proof -of negligence, not error of clinical judgment - would be required. Lavage, with or without the informed consent, performed negligently which result in harm could, of course, give rise to a claim in negligence. A doctor might also be held negligent in failing to perform an act which he/she had a duty to perform.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.37 no.2
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• pp.27-36
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• 2024

Objectives : This study is to find out clinical characteristics of patients with Tinnitus and Vertigo. Methods : 28 patients were recruited in this study who were ill with tinnitus accompanied vertigo. They told me the aspects of tinnitus and wrote out the Tinnitus Handicap Inventory(THI). Also, they were divided into central and peripheral vertigo. Through symptoms of tinnitus and vertigo, the discrimination of Heo-sil(虛實) was based on the specific aspect of tinnitus along with Zhuang fu bian zheng(臟腑辨證). Results : In tinnitus, high-narrow tone group is more than low-wide tone group and the rate of Heo symptom(虛證) group is higher than Sil symptom(實證) group. In vertigo, the rate of peripheral group is higher than central group. Conclusions : It is expected that this survey will help patients with both tinnitus and vertigo in their treatment progress and prognostic judgment.

• Translational and Clinical Pharmacology
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• v.26 no.3
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• pp.128-133
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• 2018

Appropriate prescription writing is one of the critical medical processes affecting the quality of public health care. However, this is a complex task for newly qualified intern doctors because of its complex characteristics requiring sufficient knowledge of medications and principles of clinical pharmacology, skills of diagnosis and communication, and critical judgment. This study aims to gather data on the current status of undergraduate prescribing education in South Korea. Two surveys were administered in this study: survey A to 26 medical schools in South Korea to gather information on the status of undergraduate education in clinical pharmacology; and survey B to 244 intern doctors in large hospitals to gather their opinions regarding prescribing education and ability. In survey A, half of the responding institutions provided prescribing education via various formats of classes over two curriculums including lecture, applied practice, group discussions, computer-utilized training, and workshops. In survey B, we found that intern doctors have the least confidence when prescribing drugs for special patient populations, especially pregnant women. These intern doctors believed that a case-based practical training or group discussion class would be an effective approach to supplement their prescribing education concurrently or after the clerkship in medical schools or right before starting intern training with a core drug list. The results of the present study may help instructors in charge of prescribing education when communicating and cooperating with each other to improve undergraduate prescribing education and the quality of national medical care.

• Women's Health Nursing
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• v.26 no.1
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• pp.19-27
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• 2020

Purpose: This study was conducted to develop a simulation-based postpartum care education program for women with postpartum hemorrhage and to verify the effects of the program on postpartum care. Methods: This program was developed according to the ADDIE model of instructional system design, which consists of analysis, design, development, implementation, and evaluation phases. This quasi-experimental study used a non-equivalent control group pre- and post-test design, and data were collected from April 23 to May 4, 2015. To verify the effects of the program, 33 nursing students in the experimental group participated in a simulation program, whereas 31 students in the control group were given a case study. Results: The experimental group had statistically significantly higher scores for clinical performance (t=-4.80, p<.001), clinical judgment (t=-4.14, p<.001), and learning satisfaction (t=-10.45, p<.001) than the control group. Conclusion: The results of this study indicate that the simulation-based postpartum care education program for women with postpartum hemorrhage was effective for developing students' competency, implying that a similar program should be integrated into the clinical training component of the maternal nursing curriculum.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.9
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• pp.4109-4114
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• 2015

Background: Full-field digital mammography (FFDM) with dense breasts has a high rate of missed diagnosis, and digital breast tomosynthesis (DBT) could reduce organization overlapping and provide more reliable images for BI-RADS classification. This study aims to explore application of COMBO (FFDM+DBT) for effect and significance of BI-RADS classification of breast cancer. Materials and Methods: In this study, we selected 832 patients who had been treated from May 2013 to November 2013. Classify FFDM and COMBO examination according to BI-RADS separately and compare the differences for glands in the image of the same patient in judgment, mass characteristics display and indirect signs. Employ Paired Wilcoxon rank sum test was used in 79 breast cancer patients to find differences between two examine methods. Results: The results indicated that COMBO pattern is able to observe more details in distribution of glands when estimating content. Paired Wilcoxon rank sum test showed that overall classification level of COMBO is higher significantly compared to FFDM to BI-RADS diagnosis and classification of breast (P<0.05). The area under FFDM ROC curve is 0.805, while that is 0.941 in COMBO pattern. COMBO shows relation of mass with the surrounding tissues, the calcification in the mass, and multiple foci clearly in breast cancer tissues. The optimal sensitivity of cut-off value in COMBO pattern is 82.9%, which is higher than that in FFDM (60%). They share the same specificity which is both 93.2%. Conclusions: Digital Breast Tomosynthesis (DBT) could be used for the BI-RADS classification in breast cancer in clinical.

• Journal of the Korea Institute of Information and Communication Engineering
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• v.22 no.9
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• pp.1208-1213
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• 2018

The study investigates how the structured debriefing method affects the learning flow, critical thinking disposition, and clinical performance of nursing students, using the Lasater Clinical Judgment Rubric (LCJR). Nursing students in the 4th grade of P University were divided into three groups, each trying out a different structured debriefing method: the experimental group - structured video debriefing using the LCJR question, the comparative group - structured oral debriefing, and the control group - structured group discussion debriefing. There was no significant difference between the three groups in learning flow (p=.640), critical thinking disposition (p=.420) and clinical performance ability (p=.360). Planning and intervention among the areas of clinical performance were significantly improved in the experimental group compared to the other two groups (p=.005). Structured debriefing when used with LCJR improves the learning flow and critical thinking disposition of students, while structured video debriefing improves clinical performance.

• Korean Journal of Radiology
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• v.24 no.2
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• pp.155-165
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• 2023

Objective: Little is known about the effects of using different expert-determined reference standards when evaluating the performance of deep learning-based automatic detection (DLAD) models and their added value to radiologists. We assessed the concordance of expert-determined standards with a clinical gold standard (herein, pathological confirmation) and the effects of different expert-determined reference standards on the estimates of radiologists' diagnostic performance to detect malignant pulmonary nodules on chest radiographs with and without the assistance of a DLAD model. Materials and Methods: This study included chest radiographs from 50 patients with pathologically proven lung cancer and 50 controls. Five expert-determined standards were constructed using the interpretations of 10 experts: individual judgment by the most experienced expert, majority vote, consensus judgments of two and three experts, and a latent class analysis (LCA) model. In separate reader tests, additional 10 radiologists independently interpreted the radiographs and then assisted with the DLAD model. Their diagnostic performance was estimated using the clinical gold standard and various expert-determined standards as the reference standard, and the results were compared using the t test with Bonferroni correction. Results: The LCA model (sensitivity, 72.6%; specificity, 100%) was most similar to the clinical gold standard. When expert-determined standards were used, the sensitivities of radiologists and DLAD model alone were overestimated, and their specificities were underestimated (all p-values < 0.05). DLAD assistance diminished the overestimation of sensitivity but exaggerated the underestimation of specificity (all p-values < 0.001). The DLAD model improved sensitivity and specificity to a greater extent when using the clinical gold standard than when using the expert-determined standards (all p-values < 0.001), except for sensitivity with the LCA model (p = 0.094). Conclusion: The LCA model was most similar to the clinical gold standard for malignant pulmonary nodule detection on chest radiographs. Expert-determined standards caused bias in measuring the diagnostic performance of the artificial intelligence model.