• 제목/요약/키워드: Clinical Practices

검색결과 493건 처리시간 0.025초

Study on the Development of Training Programs for Standardized Patients of the Practical Examination Portion of the National Dental Licensing Examination

  • Chun, Yanghyun;Kim, Young-Jae;Kim, Jooah;Kim, Yun Jin;Park, Byung Keon;Shim, June-Sung;Cho, Lee-Ra;Yang, Sujin;Shin, Donghoon
    • Journal of Korean Dental Science
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    • 제13권2호
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    • pp.43-51
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    • 2020
  • Purpose: The practical examination portion of the National Dental Licensing Examination (NDLE) is slated to be administered in the latter half of 2021 in the form of a clinical performance examination that comprehensively evaluates the patient-dentist interaction using standardized patients (SPs). The SPs should be equipped with the basic qualities and capacity as evaluators for a fair and reliable administration of the test. Materials and Methods: In this study, we analyzed the existing training materials for SPs who participated in domestic and overseas practical tests for the development of training materials for SPs through seminars and surveys of 11 dentistry schools and colleges. Result: First, SPs should be selected according to the basic quality criteria and capacity, which they must possess, and the preliminary basic training about the details which they must have knowledge of and be provided through videorecorded cases before the implementation of the preliminary field training. Second, the roles of SPs and the calibration process of the evaluation result forms are needed when conducting the preliminary field training for SPs. After watching video-recorded scenario cases, the SPs participate in discussions about the watched videos before proceeding to calibration practices of evaluation result forms. Third, because the Type A questionnaire of the practical examination of the NDLE is dependent on the SPs' capacity and training, the fairness of the practical test is largely dependent on the SPs. Therefore, practicing the roles as evaluators and evaluation training should be provided using practical test items that can improve the reliability of the test and show a high level of reproducibility about the same case. Conclusion: The findings of this study will be utilized for the development of training materials for SPs, so they can participate in the administration of a fair and reliable practical examination of the NDLE.

한의사 의료기기 사용과 관련된 판례 및 기존 연구 분석과 경향 변화 (A Study on the Precedents Changing Related to Using Medical Devices of Korean Medicine Doctors)

  • 박정수;오기창;권상혁;추홍민;김정상
    • 대한한방내과학회지
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    • 제42권6호
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    • pp.1303-1318
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    • 2021
  • Objectives: The aim of this study was to examine the debate on the use of medical devices between Western Medicine and Korean Medicine, as this is one of the greatest conflicts in Korea's medical profession. Judicial precedents and interpretations of authority serve as regulations because medical affairs law states that Korean Medicine practices are ambiguous. Method: We conducted a search in the Korean RISS, OASIS, and DBPIA databases using several keywords associated with medical devices, Korean Medicine, and Korean Medicine Doctors. The search period was until November 5 2021. The retrieved papers were classified according to the selection and exclusion criteria by checking the title, abstract, and text. For precedents, searches were done regarding comprehensive legal information, etc., and in the case of non-disclosure precedents, we requested access to the precedents by web-court requests. Results: A total of 80 documents were found as a result of the search, and 13 publications were included in the study. The selected publications were classified and analyzed by this research team into Korean medicine, Western medicine, and legal or state agency research. In the existing literature and judgments, the arguments that played a major role changed depending on the time the judgment was made. "Social conventions", "curriculum", "academic principles", and "health and hygiene dangers" were the key arguments. Conclusions: Further studies will be needed that can comprehensively arrange the existing literature and clinical results, and continuous study will be needed to verify that the use of medical devices by Korean medicine doctors is helpful for prognosis and accurate treatment of their patients.

체간 안정화 운동과 고관절 운동이 만성 요통 환자의 허리가동범위, 통증, 장애정도에 미치는 영향 (Effects of Trunk Stability Exercise and Hip Exercise on Lumbar Range of Motion, VAS, Disability Chronic Low Back Pain Patients)

  • 박찬호;양영식;정용식
    • 대한정형도수물리치료학회지
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    • 제28권2호
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    • pp.45-55
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    • 2022
  • Background: This study compared the effects of trunk stabilization exercise and hip joint exercises on the range of motion of the lumbar spine, pain severity, and severity of disability in patients with chronic lower back pain. Methods: A total of 30 participants were enrolled and divided into group 1 (n=10), group 2 (n=10), and group 3 (n=10) were performed by each group thrice a week for a total of 8 weeks. Group 1 performed warm-up exercise (15 min), trunk stabilization exercise (25 min), finish-up exercise (15mins). Group 2 performed warm-up exercise (15 min), hip exercise (25 mins, finish-up exercise (15mins). Group 3 warm-up exercise (15 min), trunk stabilization and hip exercise (25 min), Finish-up exercise (15 min). Participants were assessed for the range of motion of the lumbar spine, pain severity (visual analog scale score; VAS), and severity of disability (Oswestry disability index score; ODI) before and after the interventions. Results: All three groups showed a significant increase in the range of motion of the lumbar spine, but there was no significant difference among the groups. Moreover, the severity of pain and ODI were significantly decreased in all groups; however, the intergroup differences were non-significant. Conclusion: The results from this study confirmed the effectiveness of trunk stabilization and hip joint exercise in improving the lumbar range of motion, pain severity, and chronic lower back pain in patients. Thus, trunk and pelvic stabilization exercises and hip joint exercise can be used as clinical practices to treat and prevent chronic lower back pain.

보건소 간호사의 코로나19 팬데믹 초기단계의 실무경험: 간호역량 탐색 (Practical experiences of public health center nurses in the early stages of the COVID-19 pandemic: Exploration of nursing competencies)

  • 유정옥;전경자;송연이;최선임;김혜진
    • 한국보건간호학회지
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    • 제37권2호
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    • pp.247-260
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    • 2023
  • Purpose: The purpose of this study was to gain an in-depth understanding of the characteristics and competencies of practice experienced by public health center nurses(PHNs) during the early response phase of the coronavirus disease 2019(COVID-19) pandemic. Methods: PHNs were recruited from public health centers(PHC) in ten cities in Korea, using purposive sampling. They participated in semi-structured, in-depth interviews from December 21, 2020, to February 18, 2021. The interviews were transcribed verbatim and analyzed using qualitative content analysis. Results: Three themes and nine categories were drawn from the findings. The three themes that emerged from the data analysis were as follows: 'Handling expanding work scope and overwhelming workload beyond prepared competencies, willing to go anywhere.', 'Performing tasks of cooperation and communication required in the disaster management administrative system.', 'Demonstrated proficiency in clinical nursing practices, but recognized the need for further development of leadership and administrative capabilities.' Conclusions: The experiences of the subjects' have implications for the development of content for community nursing education that cultivates basic competencies to respond to real pandemic situations during undergraduate education. It is proposed that it would be necessary to establish a support system for developing specialized competencies in public health nursing.

국내 물리치료분야에 대한 질적 평가와 근거 수준 및 권고 등급 모형 개발 방안 (Qualitative Assessment and Development of Level of Evidence and Strength of Recommendation Models in the Field of Physical Therapy in Korea)

  • 조성현;이정우
    • 대한통합의학회지
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    • 제11권2호
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    • pp.231-242
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    • 2023
  • Purpose : This study aimed to identify ways to improve the quality of physical therapy research and ultimately review the current situation to improve evidence-based decision-making in physical therapy. Methods : For better evidence-based decision-making in physical therapy, researchers should review the quality assessment of articles in more detail and report their findings for valid and appropriate level of evidence and strength of recommendations. The level of evidence affects how well the findings are derived from well-designed literature. The evaluation of the evidence focuses primarily on the study design and the degree of bias that may compromise the validity of the findings. The final recommendation is based on a combination of the study design and literature quality. To uncover gems of information in each paper, a risk of bias assessment should be performed after the literature has been initially selected. Results : Researchers should consider the complexity of the intervention, appropriate grouping, and calculation of effect sizes for the intervention. Researchers conducting systematic reviews should provide a detailed description of the quality assessment performed and present a detailed analysis of their interpretation of the results. The results of systematic reviews and meta-analyses should be interpreted with caution and include a risk of bias assessment. Guidelines for the level of evidence and strength of recommendations should be developed and utilized more broadly to improve reporting practices in physical therapy. Conclusion : Researchers should be knowledgeable about the strengths and limitations of each study design and methodology. In the future, researchers will also need to improve their ability to critically evaluate their findings, given the potential for their results to influence clinical practice.

활동기준 원가 자료를 활용한 과별 전문의의 효율성 분석 : DEA-CCR 모형과 SBM 모형을 이용 (Efficiency Analysis of Specialists by Medical Specialty using Activity-Based Costing Data: Using the DEA-CCR model and SBM model)

  • 김도원;김태현
    • 한국병원경영학회지
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    • 제28권2호
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    • pp.44-65
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    • 2023
  • Purposes: As super-aging population and low fertility rates are threatening the sustainability of the National Health Insurance funds, enhancing the efficiency of hospital management is paramount. In the past, studies analyzing the efficiencies of hospitals primarily made inter-hospital comparisons, but it is important to assess hospitals' internal efficiency and develop improvement measures in order to attain practical improvements in hospital efficiencies. The purpose of this study is to analyze the efficiencies of specialists by medical specialty in a hospital in order to provide foundational data for efficient hospital management. Methodology/Approach: We used the activity-based costing (ABC) data and hospital statistical data from one tertiary hospital in Seoul to analyze the efficiency of specialists by medical specialty. Efficiency was analyzed and compared among specialists using the data envelopment analysis developed by Charnes, Cooper, and Rhodes (DEA-CCR) model and the slacks-based measure (SBM) models. The input variables were labor cost, material cost, and operational expenses, and the output variables were the number of outpatients, number of inpatients, outpatient revenue, and inpatient revenue. Findings: First, there was a marked deviation in efficiency across specialists. Second, there was a marked deviation in efficiency across medical specialties. Third, there was little difference in efficiency according to the specialist's sex, age, and job position. Fourth, the SBM model produced more conservative results and better explained efficiency parameters than the CCR model. Practical Implications: The efficiency of a specialist was more influenced by their medical specialty than their personal characteristics, namely sex, age, and job position. Therefore, Further research is needed to analyze the efficiencies of each subspecialty and identify factors that contribute to the variations in efficiencies across medical specialties, such as clinical practices and fee structures.

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Supporting Resilience and the Management of Grief and Loss among Nurses: Qualitative Themes from a Continuing Education Program

  • Esplen, Mary Jane;Wong, Jiahui;Vachon, Mary L.S.
    • Journal of Hospice and Palliative Care
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    • 제25권2호
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    • pp.55-65
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    • 2022
  • Caring for patients with cancer is highly stimulating and rewarding, attracting health professionals to the field who enjoy the challenge of managing a complex illness. Health professionals often form close bonds with their patients as they confront ongoing disease or treatment impacts, which may be associated with multiple losses involving function and/or eventual loss of life. Ongoing exposure to patient loss, along with a challenging work setting, may pose significant stress and impact health professionals' well-being. The prevalence rates of burnout and compassion fatigue (CF) are significant, yet health professionals have little knowledge on these topics. A 6-week continuing education program consisting of weekly small-group video-conferencing sessions, case-based learning, and an online community of practice was delivered to health care providers providing oncology care. Program content included personal, organization and team-related risk and protective factors associated with CF, grief models, and strategies to mitigate against CF. Content analysis was completed as part of the program evaluation. In total, 189 participants (93% nurses) completed the program, which was associated with significant improvements in confidence and knowledge of CF and strategies to support self and team resilience. Qualitative themes and vignettes from experiences with the program are presented. Key themes included knowledge gaps, a lack of support related to CF and strategies to support resilience, organization-and team-based factors that can inhibit expression about the impacts of clinical work, the health professional as a "person" in caregiving, and the role of personal variables, self-skill practices, and recommendations for education and support for self and teams.

A Study on the Awareness of Dental Hygienists on Maternity Protection and Work-Family Balance Assistance Policy

  • Seon-Hui Kwak;Bo-Mi Shin;Soo-Myoung Bae
    • 치위생과학회지
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    • 제23권4호
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    • pp.396-407
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    • 2023
  • Background: This study investigated the awareness and utilization of maternity protection and work-family balance support policies among dental hygienists in dental hospitals and clinics. Methods: We surveyed 200 dental hygienists. Twenty-two who did not meet the inclusion criteria were excluded, leaving 178 participants for analysis. The self-administered 48-item questionnaire gathered information on demographics, workplace details, policy awareness, government knowledge, and suggestions for improvement. Results: Awareness of maternity and family support programs significantly differed with age, marital status, number of children, and clinical experience. Dental hygienists in general hospitals and university hospitals reported greater ease of utilizing these policies compared to those in dental clinics. Among the participants, 27.7% took pre- and post-maternity leave, 26.6% took parental leave, 16.9% had reduced working hours during pregnancy, 15.8% had reduced working hours during childhood,and 8.5% during family leave. To promote program uptake, participants suggested mandatory implementation across workplaces (68.4%), expanded support for substitute workers (48.6%), and increased education and promotion of government support (42.4%). Conclusion: While most dental hygienists were aware of the Maternity Protection and Work-Family Balance Assistance Policy, utilizing it proved challenging due to several factors. Organizational policies or practices may not fully implement this policy, while workplace culture could discourage its use. Unfair treatment and the lack of available substitutes further hindered access. To prevent career interruptions for dental hygienists due to pregnancy, childbirth, childcare, and family care, and to maintain career continuity, the dental community and government should establish a multifaceted social support system. This system should prioritize several key areas: strengthening policy promotion, fostering a family-friendly atmosphere, improving management and supervision of policy implementation and developing a robust support system for substitute personnel.

Veterinary management protocol for non-human primates: quarantine, anesthesia, and postoperative care for mastoidectomy at animal research institutions

  • Yoon Beom Lee;Woori Jo;Eui-Suk Jeong;Tae Ku Kang;Gwang-Hoon Lee
    • 대한수의학회지
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    • 제63권4호
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    • pp.35.1-35.10
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    • 2023
  • Non-human primate (NHP) research faces challenges due to zoonosis risk and complex veterinary management yet lacks standardized guidelines for animal care. Therefore, we developed an advanced veterinary management protocol for NHP quarantine, anesthesia, and postoperative care. Three female 4 to 5-year-old cynomolgus monkeys were anesthetized and underwent various tests, including body weight, temperature, blood tests, urinalysis, microbiological monitoring, and physical and dental examinations. Ivermectin and medicated baths were administered to eradicate ectoparasites and endoparasites, and testing was repeated 30 days later. Following quarantine, we performed computed tomography and anesthesia maintenance for mastoidectomy. To relieve pain and maintain body weight, we administered tramadol intramuscularly 4 times/day for 3 days and meloxicam subcutaneously twice daily for 14 days. Feed replacements were provided. During the 33-day quarantine period, physical examinations revealed no abnormalities indicative of infectious diseases, and no specific clinical symptoms were observed. Through a preliminary test of anesthesia time, we selected ketamine 4 mg/kg + medetomidine 50 ㎍/kg for short experiments such as computed tomography, and ketamine 8 mg/kg + medetomidine 50 ㎍/kg for intubation. Ten days after mastoidectomy, NHPs consumed 100 kcal/kg and recovered their body weight. This study offers advanced veterinary management guideline for NHP research. Such protocols can lead to more standardized and ethical practices in NHP research, thereby enhancing the quality of studies on NHPs and the translation of findings to human health and disease.

Current practices of cervical epidural block for cervical radicular pain: a multicenter survey conducted by the Korean Pain Society

  • Chan-Sik Kim;Hyun-Jung Kwon;Sugeun Nam;Heeyoon Jang;Yeon-Dong Kim;Seong-Soo Choi
    • The Korean Journal of Pain
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    • 제37권3호
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    • pp.256-263
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    • 2024
  • Background: Cervical epidural block (CEB) is an effective intervention for managing cervical radicular pain. This study aimed to investigate the current status of performing CEB in South Korea. Methods: Pain physicians affiliated with the Korean Pain Society were asked to complete anonymous questionnaires regarding CEB between September and October 2022. The questionnaire consisted of 24 questions assessing the current status and methods of CEB in detail. Results: Of the 198 surveys collected, 171 physicians (86.4%) reported performing CEB. Among those, the majority (94.7%) used fluoroscopy during the procedure. The paramedian interlaminar (IL) approach was the most preferred method (50.3%). Respondents performing fluoroscopic-guided IL CEB were categorized into two groups based on clinical experience: those with ≤10 years of experience (≤10-year group, n = 91) and those with >10 years of experience (>10-year group, n = 71). The proportion of physicians obtaining informed consent in the ≤10-year group and >10-year group was 50.5% and 56.3%, respectively. When entering the epidural space during IL CEB, the contralateral oblique view was the second most frequently used in both groups (≤10-year group, 42.9%; >10-year group, 29.6%). In targeting the upper cervical lesions (C3-4), the proportion of respondents who used an IL space higher than C6-7 was 17.6% in the ≤10-year group and 29.5% in the >10-year experience group. Conclusions: This study demonstrated variability in the CEB technique used by pain physicians in South Korea. The findings highlight the need for education on informed consent and techniques to enhance safety.