• Archives of Plastic Surgery
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• 제40권4호
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• pp.312-319
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• 2013

Over the past decade, driven by advances in educational theory and pressures for efficiency in the clinical environment, there has been a shift in surgical education and training towards enhanced simulation training. Microsurgery is a technical skill with a steep competency learning curve on which the clinical outcome greatly depends. This paper investigates the evidence for educational and training interventions of traditional microsurgical skills courses in order to establish the best evidence practice in education and training and curriculum design. A systematic review of MEDLINE, EMBASE, and PubMed databases was performed to identify randomized control trials looking at educational and training interventions that objectively improved microsurgical skill acquisition, and these were critically appraised using the BestBETs group methodology. The databases search yielded 1,148, 1,460, and 2,277 citations respectively. These were then further limited to randomized controlled trials from which abstract reviews reduced the number to 5 relevant randomised controlled clinical trials. The best evidence supported a laboratory based low fidelity model microsurgical skills curriculum. There was strong evidence that technical skills acquired on low fidelity models transfers to improved performance on higher fidelity human cadaver models and that self directed practice leads to improved technical performance. Although there is significant paucity in the literature to support current microsurgical education and training practices, simulated training on low fidelity models in microsurgery is an effective intervention that leads to acquisition of transferable skills and improved technical performance. Further research to identify educational interventions associated with accelerated skill acquisition is required.

• 임상간호연구
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• 제18권2호
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• pp.228-238
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• 2012

Purpose: The purpose of this study was to examine how an Advanced Cardiac Life Support (ACLS) simulation application via smartphone effects nurses' ACLS knowledge and learning satisfaction. Methods: The participants were selected from nurses in medical Intensive Care Unit (ICU), surgical ICU and emergency room. The experimental group consists of fifty nurses who were self-learned with ACLS simulation application via smartphone and the control group of seventy-one nurses who used traditional learning materials. Outcome variables included nurses' knowledge and learning satisfaction which were collected before and after the intervention. Results: The scores of ACLS knowledge were higher in the control group compared to the experimental group (p=.001) while learning satisfaction showed no statistical difference (p=.444). In learning satisfaction, the experimental group showed higher interest than the control group (p=.019) while the control group rated higher on the item, 'the contents of education was reliable' (p=.007). Conclusion: ACLS knowledge score was graded higher in control group that used traditional learning method than the experimental group that used the smartphone application. This study showed that training with the new material significantly increased nurses' interest in ACLS education. Hence, more applications for smartphones should be developed to provide self-learning environment for nurses and improve care quality.

• 대한물리치료과학회지
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• 제9권4호
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• pp.83-94
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• 2002

Within physical therapy education, there has been increased attention to curricula and course that emphasize problem solving, clinical reasoning, and synthesis of information across traditional discipline-specific boundaries. This article describes the development implementation, and outcomes of a problem-based learning course in Physical therapy. The course was designed to help students to integrate the various elements of a physical therapy curriculum and to enhance their abilities to respond to an ever-changing health care environment. An evaluation of the course by the first 50 students who completed it revealed both strengths and weaknesses. Students responded that the course enhanced their professional behavior, including interpersonal communication skills, team work, and follow-through with professional responsibilities. The learning package was developed by the authors and implemented to a college students during three weeks of the first semester of 2001. Most studies which conducted PBL module development were short period or temporary PBL package application and evaluation rather than a whole semester's. While, this study carried on partial integrated PBL curriculum development and application with recomposing content of the two subjects to one subject Physical therapy which includes four PBL packages. This package was developed from a simple concept to complex and partial integrated PBL curriculum application systematically variable learning methods such as discussion, practice, lecture, video. There are 2 classes, each class has 25 students, in the college. Each class has 5 small groups consisting 5 students. Two tutors proceeded discussion charging each class also, they used multiple methods and materials like tutorials, self-directed learning, lecture, and video. The package is 5 grades and 5 hours per week and the rate of discussion, lecture is 4, 1 respectively. One of the most change is the increase of interaction between students and tutors. Whenever students need information and suggestion, they can visit tutors who provide reading materials and guide for the direction of self learning. Therefore, this study describes the PBL package development process and application during one semester recomposing contents of two subjects to Physical therapy concepts. Besides, it will contribute to active application of existing each subject to tutors who intend to convert as PBL methods. The study has significant meaning to show potentiality of partially integrated PBL application, using systematic PBL package development from two subjects contents. However, when students' need of yearning is over the extent of Introduction of Physical therapy and Rehabilitation medicine, tutors should set learning extent. So, there is limitation to attain completely integrated PBL education within one subject, therefore, it is high lighted to proceed development of integrated curriculum to maximize learning effects of PBL. It is exected that partial integrated PBL package development and application will distribute to prosper excellent physiotherapist in practice.

• 현장농수산연구지
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• 제19권1호
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• pp.153-163
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• 2017

This study is aimed at researching on psychopathological characteristics of agriculture-specialized college students, in a specific educational environment, consulting some students who show maladjusted characteristics, verifying its effects and providing basic data for college life instructions. The complete survey MMPI was conducted for 676 freshmen and juniors attending K agriculture-specialized college located in Jeollabuk-do. To analyze the results, basic statistics, bivariate correlation analysis, and multiple regression analysis were implemented. The results of this study are as follows; First, the level of overall clinical scale was lower than 50 points, standard point, and freshmen showed higher depression (D), hysteria (Hy) and psychasthenia (Pt) in general. Such results are different from the other study results. It is considered an anxiety in early stage, resulted from a living in a dormitory. For the juniors who came back from one-year practice, anxiety about employment seems little because they are already employed. Second, The effects of personal consultation for maladjusted students were proved (p<.01). The students who got consultation showed improvement effect from 'very bad condition' to 'considerable depression', which is low score. This study has a meaning in preventing from any accident, by screening maladjusted students who are supposed to learn in a specific situation, by relieving their symptoms through consultation and letting them concentrate on learning.

• ETRI Journal
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• 제37권2호
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• pp.222-232
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• 2015

In this paper, we propose a dual-phase approach to improve the process of heart disease prediction in a mobile environment. Firstly, only the confident frequent rules are extracted from a patient's clinical information. These are then used to foretell the possibility of the presence of heart disease. However, in some cases, subjects cannot describe exactly what has happened to them or they may have a silent disease - in which case it won't be possible to detect any symptoms at this stage. To address these problems, data records collected over a long period of time of a patient's heart rate variability (HRV) are used to predict whether the patient is suffering from heart disease. By analyzing HRV patterns, doctors can determine whether a patient is suffering from heart disease. The task of collecting HRV patterns is done by an online artificial neural network, which as well as learning knew knowledge, is able to store and preserve all previously learned knowledge. An experiment is conducted to evaluate the performance of the proposed heart disease prediction process under different settings. The results show that the process's performance outperforms existing techniques such as that of the self-organizing map and gas neural growing in terms of classification and diagnostic accuracy, and network structure.

• 한국보건간호학회지
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• 제32권2호
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• pp.221-234
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• 2018

Purpose: This mixed method study was conducted to analyze the changes in nursing students' practice environment due to comprehensive nursing care services. Methods: For the quantitative study, a checklist and practicum evaluation surveys completed by 85 students were analyzed using SPSS utilizing a Mann-Whitney U test. For the qualitative study, 13 students with experience of practice in comprehensive nursing care service units participated in focus group interviews. The data were analyzed using a content analysis method. Results: From the qualitative findings, four themes and eight sub-themes were identified. The four themes were , , , and . The quantitative findings found that students could observe and perform fewer nursing tasks and the students' satisfaction with practice was lower in the comprehensive nursing care service unit. Conclusion: This study was meaningful in that it analyzed the experiences of nursing students in comprehensive nursing care services.

• Journal of Medicine and Life Science
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• 제17권3호
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• pp.86-93
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• 2020

The study aimed to understand medical students' experiences of emotional changes, including their method of adapting to experiences, and the effect of the experiences in shaping their identities. We interviewed 12 medical students who were finishing their 1-year clinical internship in 2016. Data on their opinions and reasons for emotional changes during their school life were obtained. The descriptive phenomenological approach was applied to analyze the interviews. Their stress came from disappointment in themselves, competitive environment, observing a change in their personalities, meeting their parents' expectations, and interpersonal relations. The interviewees adjusted to the medical study by exercising self-control in their studies and daily lives, by practicing self-acceptance and observing their state of mind, and by breaking free from the competition-driven environment and obsession with grades. In addition, they cultivated endurance and found external support. Finally, they achieved self-efficacy and were comfortable in their identity as medical students. They still had to address the stress from working relationships and the difficulty in balancing studies and life. The medical students' self-evaluation and compulsive tendencies increased during the medical course due to the burden of studies. They evolved by learning self-control and introspection and seeking ways to adapt. Understanding this growth process of medical students will improve student support in medical schools.

• 한국간호교육학회지
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• 제27권4호
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• pp.423-435
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• 2021

Purpose: The purpose of this study is to identify the educational needs of a severe trauma treatment simulation program based on mixed reality which combines element of both virtual reality and augmented reality. Methods: Focus group interviews were conducted with ten military hospital nurses on February 4 and 5, 2021. The collected data were analyzed using a qualitative content analysis. As a framework for data analysis, the educational needs were clustered into the following four categories: teaching contents, teaching methods, teaching evaluation, and teaching environment. Results: The educational needs for each category that emerged were as follows: three subcategories including "realistic education reflecting actual clinical practice" and "motivating education" for teaching contents; five subcategories including "team-based education," "repeated education that acts as embodied learning," and "stepwise education" for teaching methods; six subcategories including "debriefing through video conferences," "team evaluation and evaluator in charge of the team," "combination of knowledge and practice evaluation" for teaching evaluation; six subcategories including "securing safety," "similar settings to real clinical environments," "securing of convenience and accessibility for learners," and "operating as continuing education" for teaching environment. Conclusion: The findings of this study can provide a guide for the development and operation of a severe trauma treatment simulation program based on mixed reality. Moreover, it suggests that research to identify the educational needs of various learners should be conducted.

• 한국차세대컴퓨팅학회논문지
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• 제15권5호
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• pp.64-74
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• 2019

비강체 정합은 임상적 필요성은 높으나 계산 복잡도가 높고, 정합의 정확성 및 강건성을 확보하기 어려운 분야이다. 본 논문은 비지도 학습 환경에서 3차원 뇌 자기공명 영상 데이터에 딥러닝 네트워크를 이용한 비강체 정합 기법을 제안한다. 서로 다른 환자의 두 영상을 입력받아 네트워크를 통하여 두 영상 간의 특징 벡터를 생성하고, 변위 벡터장을 만들어 기준 영상에 맞추어 다른 쪽 영상을 변형시킨다. 네트워크는 U-Net 형태를 기반으로 설계하여 정합 시 두 영상의 전역적, 지역적인 차이를 모두 고려한 특징 벡터를 만들 수 있고, 손실함수에 균일화 항을 추가하여 3차원 선형보간법 적용 후에 실제 뇌의 움직임과 유사한 변형 결과를 얻을 수 있다. 본 방법은 비지도 학습을 통해 임의의 두 영상만을 입력으로 받아 단일 패스 변형으로 비강체 정합을 수행한다. 이는 반복적인 최적화 과정을 거치는 비학습 기반의 정합 방법들보다 빠르게 수행할 수 있다. 실험은 50명의 뇌를 촬영한 3차원 자기공명 영상을 가지고 수행하였고, 정합 전·후의 Dice Similarity Coefficient 측정 결과 평균 0.690으로 정합 전과 비교하여 약 16% 정도의 유사도 향상을 확인하였다. 또한, 비학습 기반 방법과 비교하여 유사한 성능을 보여주면서 약 10,000배 정도의 속도 향상을 보여주었다. 제안 기법은 다양한 종류의 의료 영상 데이터의 비강체 정합에 활용이 가능하다.

• 한국콘텐츠학회논문지
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• 제20권7호
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• pp.674-682
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• 2020

최근 산업화 및 인구과밀화로 인해 대기오염에 대한 문제가 세계적 관심사로 대두되고 있다. 대기 오염은 인간의 건강에 다양한 악영향을 초래할 수 있는데, 그 중 본 연구에서 관심을 둔 천식과 같은 호흡계 질환은 직접적 영향을 받을 수 있다. 기존의 연구에서는 임상 데이터를 활용하여 상대적으로 적은 표본을 기반으로 천식과 같은 질환에 대기 오염 인자가 어떠한 영향을 미치는지를 파악하였다. 이는 수집 표본 별 일관성이 없는 결과를 초래할 소지가 다분하며, 의료계 종사자 이외에는 연구의 시도가 어렵다는 점에서 큰 한계를 가지고 있다. 본 연구에서는 정부에서 공개하는 대기 환경 데이터와 천식 발병 빈도 수에 대한 데이터를 기반으로, 실제 천식 발병 빈도를 예측하는 것에 연구의 주안점을 두었다. 본 연구는 시차를 적용한 피어슨 상관계수를 통해 각 대기오염 인자가 천식 발병에 어느 정도의 시차를 가지고 유의한 영향을 주는지를 검증하였다. 검증결과를 기반으로 구축된 학습데이터는 딥러닝 알고리즘에 활용되며, 천식 발병 빈도의 예측에 최적화 된 모델을 설계하였다. 모델의 평균 대비 오차율은 약 11.86%로 타 머신러닝 기반의 알고리즘 대비 우수한 성능을 나타냄을 확인하였다. 제안한 모델은 국가 보험 체계 및 보건 예산 관리에서의 효율화 및 병원에서의 의료 인력 배치 및 수급에의 효율성 또한 제공할 수 있다. 또한 만성 천식 질환자에 대한 대기 환경별 발병 위험에 대한 조기 경보를 통해 국민 건강 증진에 기여할 수 있다.