• 의학교육논단
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• 제20권3호
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• pp.128-134
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• 2018

Medical education, competency, and outcome-based medical education started as part of the basic medical education curriculum in advanced countries 20 years ago, and such an approach was adopted in residency training. General competency training is at the core of residency training in advanced countries, and it goes beyond competency and outcome-based training to the extent that in a milestone training system, competency development is expected and measured with set competency achievements at each level. Recently, for the purpose of ensuring that doctors uphold patient safety and fulfill their obligations, entrustable professional activities (EPA) were applied at the beginning of residency when doctors move away from clinical trials and start actual care. The adoption of EPA in all residency training curriculum has spread very rapidly in the United States, United Kingdom, and Canada. Presently, Korea lags behind other countries significantly as the adoption of competency and outcome-based medical education in residency training has just begun. It is time to identify the current state of the Korean residency training system, and then design and practice a well-established system with a long-term view based on cooperation across the whole medical industry.

• 의학교육논단
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• 제20권3호
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• pp.135-140
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• 2018

In clinical clerkships, residents function as trainees, workers, and teachers for other medical students. Although residents care for patients in harsh environments and encounter precarious patient-safety situations, they are working towards becoming competent specialists. Residency education programs are very important in cultivating specialists able to adapt to the rapidly-changing medical environment, and are also necessary to improve the quality of specialist training. Competent specialists not only need clinical competency, but also a wide range of abilities including professionalism, leadership, effective communication, cooperation, and attention to continuous professional development/continuing medical education activities. Each Korean association of specialties has its own educational goals and standardized education programs to help residents learn specific techniques and competencies related to medical care for patients, though the training environment of each residency is different within each trainee hospital. Although it is also important to evaluate residency education programs, currently there is only an examination of knowledge and assessment of skills based on mini-clinical evaluation exercises or direct observation of procedural skills. In order to develop an objective and estimable evaluation tool that can assess the overall achievement level within each training course, it is necessary to evaluate the knowledge, skills, and attitudes of residents. Residency education programs need further attention and reform.

• 의학교육논단
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• 제16권2호
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• pp.99-107
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• 2014

The purpose of this study was to establish a better operation plan for medical school student internship by gaining a deeper understanding of the student internship process. Toward this end, an investigation was carried out using in-depth interviews of students with experience as student internship at Catholic University of Daegu School of Medicine. Students who participated in the student internship program at Catholic University of Daegu School of Medicine took part in the clinic twice every two-week period for a total of four weeks as a member of the care team. The students performed several activities during their internships, including for example history taking, physical examinations, keeping medical records, simulation of writing prescriptions, clinical skills, patient education, night work, and rounds with the attending professor. In this study were analyzed the contents of a student internship, the difference in clerkship, the competence of the faculty, student participation attitudes and the overall effect of the internship on the students. It was found that the in-depth contents, passion of members including professors and students, especially the role of the professor, was more important component than the contents of the internship program or clinical training. The student-intern system was revealed to have the following positive characteristics: 1) education deeper than clerkship was performed through one-on-one faculty-student interaction, and 2) students' experience was broadened.

• Archives of Plastic Surgery
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• 제48권1호
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• pp.107-113
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• 2021

Background Applicants to integrated plastic and reconstructive surgery (PRS) residency in the United States spend exorbitant amounts of time and money throughout the interview process. Outside of first-hand experience through a visiting rotation, applicants utilize various resources in learning about a program. Today's applicants are "Millennials," the demographic cohort raised during the information age and proficient with digital technology. The authors evaluated whether programs have a presence on social media, and whether applicants are following these accounts. Methods An online survey was sent to applicants to a single integrated plastic surgery program evaluating basic demographics, social media utilization, and sources of information accessed throughout the residency application process. A manual search of popular social media platforms (Instagram, Facebook, and Twitter) was performed in October 2019. Accounts affiliated with integrated PRS programs were identified and analyzed. Results Eighty-four of 222 applicants (37.8%) completed the survey. Ninety-six percent of applicants were within the Millennial demographic. Ninety-six percent of applicants had some form of social media presence, with Facebook (90%) and Instagram (87%) being the most popular platforms. Seventy-three percent of applicants reported following a PRS residency social media account. As of October 2019, 59 integrated residency programs (73%) have active Instagram accounts. Conclusions Applicants still rely on the program website when researching potential residencies, but social media is being rapidly adopted by programs. Program social media accounts should be used as a dynamic form of communication to better inform applicants of program strengths and weaknesses.

• Archives of Plastic Surgery
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• 제43권5호
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• pp.451-456
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• 2016

Background Comprehensive aesthetic surgery training continues to be a challenge for residency programs. Our residency program developed a rhinoplasty-based objective structured clinical examination (OSCE) based upon validated methods as part of the residency education curriculum. We report our experience with the rhinoplasty-based OSCE and offer guidance to its incorporation within residency programs. Methods The encounter involved resident evaluation and operative planning for a standardized patient desiring a rhinoplasty procedure. Validated OSCE methods currently used at our medical school were implemented. Residents were evaluated on appropriate history taking, physical examination, and explanation to the patient of treatment options. Examination results were evaluated using analysis of variance (statistical significance P<0.05). Results Twelve residents completed the rhinoplasty OSCE. Medical knowledge assessment showed increasing performance with clinical year, 50% versus 84% for postgraduate year 3 and 6, respectively (P<0.005). Systems-based practice scores showed that all residents incorrectly submitted forms for billing and operative scheduling. All residents confirmed that the OSCE realistically represents an actual patient encounter. All faculty confirmed the utility of evaluating resident performance during the OSCE as a useful assessment tool for determining the Next Accreditation System Milestone level. Conclusions Aesthetic surgery training for residents will require innovative methods for education. Our examination showed a program-educational weakness in billing/coding, an area that will be improved upon by topic-specific lectures. A thoroughly developed OSCE can provide a realistic educational opportunity to improve residents' performance on the nonoperative aspects of rhinoplasty and should be considered as an adjunct to resident education.

• 의학교육논단
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• 제17권1호
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• pp.20-25
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• 2015

In light of changes in today's medical environment, whether to dismantle the 50-year-old internship training system in the Republic of Korea is under debate. Although the question remains open, discussions on such issues have drawn attention to the quality of the clinical clerkship and student career advisory programs in medical colleges. The purpose of this study is to analyze the experiential clerkship and career exploration issues. Ensuring excellence of the clerkship and career advisory sessions is an essential responsibility of educational institutions regardless of whether the intern training system is dismantled. Important objectives of the experimental clerkship include reinforcing prerequisites established by law, introducing a student practice license, developing a standardized clinical assessment and student portfolio requirement, and publishing a guidebook for clinical directors. For career exploration, it is necessary to broaden participants' experiences of specialties and to manage the variety of student career guidance programs. It is imperative for the Korean Association of Medical Colleges, in collaboration with medical colleges, to play a leading role in focusing more attention and effort on such issues.

• 대한간호학회지
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• 제54권3호
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• pp.358-371
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• 2024

Purpose: This study aimed to analyze the experiences of new nurses during their first year of hospital employment to gather data for the development of an evidence-based new nurse residency program focused on adaptability. Methods: This study was conducted at a tertiary hospital in Korea between March and August 2021 with 80 new nurses who wrote in critical reflective journals during their first year of work. NetMiner 4.5.0 was used to conduct a text network analysis of the critical reflective journals to uncover core keywords and topics across three periods. Results: In the journals, over time, degree centrality emerged as "study" and "patient understanding" for 1 to 3 months, "insufficient" and "stress" for 4 to 6 months, and "handover" and "preparation" for 7 to 12 months. Major sub-themes at 1 to 3 months were: "rounds," "intravenous-cannulation," "medical device," and "patient understanding"; at 4 to 6 months they were "admission," "discharge," "oxygen therapy," and "disease"; and at 7 to 12 months they were "burden," "independence," and "solution." Conclusion: These results provide valuable insights into the challenges and experiences encountered by new nurses during different stages of their field adaptation process. This information may highlight the best nurse leadership methods for improving institutional education and supporting new nurses' transitions to the hospital work environment.

• Archives of Plastic Surgery
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• 제45권5호
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• pp.395-402
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• 2018

Increased emphasis on competency-based learning modules and widespread departure from traditional models of Halstedian apprenticeship have made surgical simulation an increasingly appealing component of medical education. Surgical simulators are available in numerous modalities, including virtual, synthetic, animal, and non-living models. The ideal surgical simulator would facilitate the acquisition and refinement of surgical skills prior to clinical application, by mimicking the size, color, texture, recoil, and environment of the operating room. Simulation training has proven helpful for advancing specific surgical skills and techniques, aiding in early and late resident learning curves. In this review, the current applications and potential benefits of incorporating simulation-based surgical training into residency curriculum are explored in depth, specifically in the context of plastic surgery. Despite the prevalence of simulation-based training models, there is a paucity of research on integration into resident programs. Current curriculums emphasize the ability to identify anatomical landmarks and procedural steps through virtual simulation. Although transfer of these skills to the operating room is promising, careful attention must be paid to mastery versus memorization. In the authors' opinions, curriculums should involve step-wise employment of diverse models in different stages of training to assess milestones. To date, the simulation of tactile experience that is reminiscent of real-time clinical scenarios remains challenging, and a sophisticated model has yet to be established.

• Archives of Plastic Surgery
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• 제44권5호
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• pp.428-433
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• 2017

Background Candidate characteristics for hand surgery fellowship training remains unknown, as very little data is available in the literature. This study aims to provide information on the criteria that are employed to select candidates for the hand surgery fellowship match. Methods A 38-question survey was sent in April 2015 to all Accreditation Council for Graduate Medical Education recognized hand surgery fellowship program directors (n=81) involved in the U.S. match. The survey investigated factors used for the selection of applicants, including medical school, residency training, research experience, fellowship interview, and candidate characteristics. A 5-point Likert scale was used to grade 33 factors from "not at all important" (1) to "essential in making my decision" (5); or for five controversial factors from "very negative impact" (1) to "very positive impact in making my decision" (5). Results A total of 52% (42 out of 81) of responses were received from hand surgery fellowship program directors. The most important influential factors were interactions with faculty during interview and visit ($4.6{\pm}0.6$), interpersonal skills ($4.6{\pm}0.5$), overall interview performance in the selection process ($4.6{\pm}0.6$), professionalism and ethics ($4.6{\pm}0.7$), and letters of recommendation from hand surgeons ($4.5{\pm}0.7$). Factors that have a negative impact on the selection process include visa requirement ($2.1{\pm}1.2$), graduate of non-plastic surgery residency program ($2.4{\pm}1.3$), and graduate of a foreign medical school ($2.4{\pm}1.1$). Conclusions This study provides data on hand surgery fellowship directors' perception on the criteria important for fellowship applicant selection, and showed that interview-related criteria and letters of recommendation are the important factors.

• 의학교육논단
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• 제23권1호
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• pp.23-36
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• 2021

Residents serve as educators who teach patients, medical students, fellow residents, and other medical personnel while being trained as learners. The purpose of this study was to review the literature on the competencies, perceptions, and educational status of residents as teachers, and to suggest appropriate competencies and curricular components. A literature review was conducted and resident-related institutional homepages were searched. Many countries are developing the educational competencies of residents as teachers and implementing educational programs. Residents most often taught clinical knowledge and clinical skills to patients, medical students, fellow residents, and other medical professionals, and recognized the importance of education, the joy of teaching, and the role of teachers; however, the task of teaching was burdensome. Based on these findings, competencies and educational programs for the resident as teacher are proposed. The competencies consist of the five stages of ACCESS (active learner, clinical teacher, curriculum developer, educational scholar, social communicator, supervisor/leader), and specific teaching content, methods, and assessment methods are suggested to develop these competencies. Educating residents to develop their competencies as teachers is very important as a way to foster lifelong learning skills, help others, and assist in leadership roles.