• Korean Medical Education Review
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• v.14 no.1
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• pp.19-24
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• 2012

The purpose of this study was to observe how Ajou University School of Medicine runs its curriculum to cultivate professionalism. The paper also proposes a plan for the next step for the school. The Patient-Doctor-Society (PDS) course, begun in 2009, can be summarized by three characteristics. First, the PDS course is an integrated curriculum that is not a one-time program for a specific grade, but a continuous program open for all medical students. Second, the PDS course is designed following the philosophy and educational goals of the institution, and the curriculum assures maximum autonomy. Third, the PDS course is 'whole person education' that provides knowledge and teaches skills and an attitude. By analyzing the pros and cons of the program through annual evaluation, leaders of the program at Ajou will continue to consider what to teach and how to do so.

• Journal of Korean Academy of Nursing Administration
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• v.6 no.1
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• pp.5-18
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• 2000

This study was conducted to analyze the degree of department satisfaction and correlation accordng to nurses's clinical characteristics. Data fors tudy were selected August, 1999. The sample coisted of 512 nurses working in K university hosptal in Seoul. The collected materials have been alyzed by percentage, average, t-test, ANOVA, arson Correlation Coefficiency using SPSS window 8.0 program. The result were as the follows ; 1. Fifty-one percent answered to be satisfactory in current department of work, and nurses who had been experienced the transfer are fifty percent, and nurse specialist is eight point two percent. 2. The order of the degree of department duty satisfaction was mutual action, professinal position, autonomy, assignment desire, relation between the doctor and nurses, wage, administration. 3. The result of the degree of department duty satisfaction according to the age has shown significant differences in administration and assignment desire, and the result of the degree of department duty satisfaction according to the education and religion has shown significant differences in administration, and the result of the degree of department duty satisfaction according to marital status has shown significant differences in wage and administration. 4. The result of the degree of department duty satisfaction according La the position has shown significant differences in administration, assignment desire and the sum of duty satisfaction, and the result of the degree of department duty satisfaction according to the nurse specialist has shown no significant differences in total areas, and the result of the degree of department duty satisfaction according to the transfer has shown significant differences in relation between the doctor and nurses, administration, autonomy and the sum of duty satisfaction. 5. The result of the degree of department duty satisfaction according to the nursing career and present assignment career has shown no significant differences in total areas, and the result of degree of department duty satisfaction according to the present assignment has shown significant differences in relation between doctor and nurses, administration, assignment desire and the sum of duty satisfaction. 6. The result of the degree of department duty satisfaction according to the request and experiences of trasfer has shown significant differences in wage, administration, assignment desire and the sum of duty satisfaction 7. The result of the degree of department duty satisfaction according to the degree of satisfaction of present assignment has shown no significant difference in professional position 8. The result of relation of nurses'a clinical characteristics and the degree of department duty satisfaction and the sum of duty satisfaction has shown no significant differences in age, present assignment career, but the result of nursing career has shown significant differences in relation between doctor and nurse, administration, autonomy, assignment desire and the sum of duty satisfaction. and the satisfaction of present assignment which was very effective on duty satisfaction was as significant correlation with wage, professinal position, relation between doctor and nurses, administration, autonomy assignment desire, mutual action and the sum of duty satisfaction. The above result show us that the degree of wage is effected on marital status, experience of transfer, degree of satisfaction of present assignment, request of transfef and the relation between doctor and nurses is effected on experience of transfer, present assignment, degree of satisfaction of present assignment and the administration is effected on age, education, marital status position, experiences of transfer, request of transfer, degree of satisfaction of present assignment and the autonomy is effected on experience of transfer, degree of satisfaction of present assignment and the assignment desire is effected on position, pre sent assignment, degree of satisfaction of present assignment, request of transfer and the mutual action is effected on present assignment. and the sum of duty satisfaction is effected on marital status, position, experience of transfer, request of transfer, present assignment, degree of satisfaction of present assignment.

• Journal of Physiology & Pathology in Korean Medicine
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• v.22 no.5
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• pp.1132-1139
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• 2008

The structure of medical profession is composed of multiple relations among state, patients, and medical professions. There are conflicts between the nation and medical professions because the nation controls the monopoly of medical professions through medical policies. Patients make relations with medical profession as medical consumers. And medical professions compete each other in order to gain the control of the medical market. This paper attempts to review the dynamic relations between the nation and medical professions. The medical professions and the nation are in conflict about the control of the autonomy of medical professions. The medical professions want to exercise the monopoly rights in their own area and, on the other had, the nation wants to prevent problems that might result from the monopoly by regulations and to have the control over the national operation. Given this, the common view of medical sociology is that the nation and the medical professions are in constant conflict. The arguments that the present medical sociology has on the relationship between the nation and medical professions can be summarized like these: first, the nation is the authenticator of medical system; second, the nation is a medical provider and consumer; and, third, the nation is a mediator of regulations and conflicts. Based on the above mentioned relations between the nation and medical professions, this paper attempts to see how the nation, which is one component of the medical structure, make influences on Korean Oriental doctors and Traditional Chinese doctors. So as to do this, the changes in medical policies and promoting policies for Korean Oriental medicine and Traditional Chinese medicine are analyzed. Finally, the differences in national policies of Korean Oriental medicine and Traditional Chinese medicine are compared.

• Journal of Korean Academy of Nursing
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• v.31 no.2
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• pp.279-291
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• 2001

Rapid progress in modern medical technology has made it possible to sustain life and/or delay death using 'heroic' treatments. The availability of life-sustaining treatment brings several issues in end-of-life care such as 'dying with dignity' and an radical increase in health care costs. The use of Advance Directives(AD) have been widely heralded by health care providers, gerontologists, and advocacy groups as means of protecting patients' right to accept or refuse life-sustaining treatment in end-of-life care. The use of AD can not only improve patients' autonomy and quality of life but also bring efficiency in distributing health care resources. The proportion of older persons in Korean population has been increasing. Those 65 years of age or over were about 7 percent of the population. Death and dying is not limited to older persons, but it is more prevalent among them. In conjunction with an aging population and the increasing prevalence of death, the issues of death and dying will become crucial in near future in terms of 'dying with dignity', 'autonomy', and 'self-control'. This paper attempts to explode and establish the concept of advance directives (AD) based on literature review. Data sources are computer searches with the MEDLINE database. Due to the lack of prior study on AD for a Korean cases, studies abroad are reviewed. This paper suggests the need for future study on the possibility of the use of AD in Korea.

• The Korean Journal of Emergency Medical Services
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• v.16 no.1
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• pp.65-80
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• 2012

Purpose: The objective of this study was to assess the job satisfaction and turnover intention of the emergency medical technicians (EMT) in the private ambulance service, to examine their job satisfaction and turnover intention, and to provide the solution for the management of the private ambulance service. Methods: The survey was conducted with 121 EMTs (73 paramedics, 36 basic EMTs and 12 nurses) in the private ambulance service in Korea from September 15 to October 14, 2011. In the reliability of the questionnaire, Cronbach's ${\alpha}$ was 0.790 for job satisfaction and 0.796 for turnover intention. Using SPSS 18.0, we obtained Cronbach's ${\alpha}$, frequencies, percentages, means, and standard deviations, and performed independent t-tests, ANOVA, and Pearson's correlation analysis. Results: 1) The mean score with regard to job satisfaction was 2.94 and that of their turnover intention was 4.23. In the area of job satisfaction, the mean score of the job demand area was 4.23; 3.97 for the job itself; 3.07 for the area of interaction; 2.98 for the area of autonomy: 2.67 for the organizational demand area; 2.67 for working conditions area; and 1.73 for the wage area. 2) Statistically significant difference was observed in job satisfaction according to age (F=3.819, p=.006), wages (t=-4.640, p=.000), terms of incumbency (F=3.868, p=.011), and in turnover intention it was according to sex (t=-1.995 p=.048), age (F=9.611, p=.000), education levels (F=6.974, p=.002), marital status (t=4.393, p=.000), wages (t=5.515, p=.000), license types (F=8.481, p=.001), and terms of incumbency ( F=14.115, p=.000). 3) The job satisfaction and the turnover intention had a negative correlation to each other (r=-.56, p<.000) in general, and in the sub-7 areas of job satisfaction, the correlation with turnover intention was high in order of the wage area (r=-.61, p=.000), working conditions area (r=-.52, p=.000), the area of autonomy (r=-.49, p=.000), the area of interaction (r=-.45, p=.000), the organizational demand area (r=-.40, p=.000), the job itself (r=-.24, p=.007) and the job demand area (r=-.24, p=.009). Conclusion: The government must take the charge of lowering the turnover intention among paramedics in the private ambulance service by providing the advantage in wages and fringe benefits. Ultimately, this would bring an improvement in the quality of medical emergency services to hospitals especially in the area of patient transfer and transportation.

• The Korean Society of Law and Medicine
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• v.9 no.1
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• pp.413-459
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• 2008

The Law has intervened to define rare circumstances in which a person should choose continuing life in United States. On the one hand, the law has traditionally acted to preservelife and to respect the sanctity of life. On the other hand, one's control over one's own body, and the right to determine what kind of medical care one will receive, is equally well respected and historically grounded. The competent patients have the right to forgo life-sustaining treatment, courts in United States have left many unanswered questions about the nature of that right. The right to choose to forgo life-sustaining treatment is a manifestation of a patient's autonomy interest. In United States, The Karen Quilan case gave rise to legislative activity in the host of state capitals, and several states had adopted statutes that formally recognized some forms of written directives describing some circumstances in which certain kinds of medical care could be terminated. These statues were sometimes dominated 'living will' acts, sometimes 'right to die' acts and ocasionally 'natural death' acts. Today virtually every state has produced a living will statue. In Korea, courts do not permit a terminally ill person to withhold or withdraw life-sustaining treatment. Living wills apply in case of terminal illness owing to a defect in legislation. Now In Korea, these lively dispute of legal policy on the preconditions and concrete procedure of living will act and natural death act. Through the legislation of living will act and natural death act, we should prepare some circumstances to respect patient's autonomy on the right to die. We should frame the cultural standard to make a decision of forgoing life-sustainin1g treatment under the discreet procedure.

• Health Policy and Management
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• v.22 no.3
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• pp.365-382
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• 2012

Background : Public hospitals suffer worsening shortage of physicians and face great pressure of recruiting doctors. This study is aim to identify the factors associated with retention of physicians who are working in public hospitals. Methods : We conducted a cross-sectional and self-administered questionnaire survey in July, 2011. A total of 333 physicians responded from the 31 public hospitals. We analyzed the difference of job retention across the variables among doctors stratified as salaried and public health doctors. We used chi-square test and multiple logistic regression analysis. Results : To the salaried doctor, longer work period(OR=2.04 in 3rd quartile), professional autonomy(OR=2.69), and positive attitude toward public health(OR=2.39) affect to the higher job retention whereas complain of low income(OR=0.33) and complain of poor clinical environment(OR=0.26) affects to the lower job retention. To the public health doctors, community connections such as hometown(OR=6.27), spouse factors(OR=3.49), and positive attitude toward public health(OR=3.19) affect to the higher job retention. But longer work period(OR=0.17 in 3rd quartile) affects to the lower job retention. Conclusions : Associated factors of job retention vary across physician's status. Professional autonomy has major impact on the job retention to the salaried doctor. And familial factors as well as community relationship have greatest impact to the public health doctor. Positive attitude toward public health is associated with the higher job retention to the both of salaried and public health doctors.

• Journal of Home Health Care Nursing
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• v.7 no.1
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• pp.73-82
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• 2000

Twenty-first century coming of health care in our country is in a situation of much conflict because the relationship between nurses and doctors is seen in terms of a traditional and vertical structure. Accordingly. it is very difficult to find collaboration amongst individuals of these two professions. Now nursing is trying to find independence and autonomy by carrying out independent professional skills. This study on collaboration and the obstacles hindering its pursuit. The strategies of collaboration to give better health care quality are as follows; First, a program for professionals should be developed to enhance professional knowledge and technology and train nursing professionals so that nursing can be acknowledged as a profession with a power to carry out on independent job. Second, collaboration reduces expenses and results in satisfactory performances of duty, high productivity, low incidence of medical accident, and higher satisfaction of the patient. Therefore the leader in the higher position should take positive stance for collaboration and help create a cooperative situation through the development of practical orders for collaboration. opening cooperative wards, and meeting for collaboration. Third, a collaboration model should be introduced into the courses of the nursing and medical school curriculum, which would influence job atmosphere after graduation. Fourth, nurses should have pride in their jobs as professionals and have confidence in their professional skill, knowledge and ability. Nurses should make an effort to share responsibility and have independence and autonomy. Fifth, common people as well as doctors know little about professional practice and the role of nurses, so a publicity campaign is also required.

• Journal of Oral Medicine and Pain
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• v.31 no.4
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• pp.283-296
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• 2006

Along with the development of scientific technologies, health care has been growing remarkably, and as the social life quality improves with increasing interest in health, the demand for medical service is rapidly increasing. However, medical accident and medical dispute also are rapidly increasing due to various factors such as, increasing sense of people's right, lack of understanding in the nature of medical practice, over expectation on medical technique, commercialize medical supply system, moral degeneracy and unawareness of medical jurisprudence by doctors, widespread trend of mutual distrust, and lack of systematized device for solution of medical dispute. This study analysed 30 cases of civil suit in the year between 1994 to 2004, which were selected among the medical dispute cases in dental field with the judgement collected from organizations related to dentistry and department of oral medicine, Yonsei university dental hospital. The following results were drawn from the analyses: 1. The distribution of year showed rapid increase of medical dispute after the year 2000. 2. In the types of medical dispute, suit associated with tooth extraction took 36.7% of all. 3. As for the cause of medical dispute, uncomfortable feeling and dissatisfaction with the treatment showed 36.7%, death and permanent damage showed 16.7% each. 4. Winning the suit, compulsory mediation and recommendation for settlement took 60.0% of judgement result for the plaintiff. 5. For the type of medical organization in relation to medical dispute, 60.0% was found to be the private dental clinics, and 30.0% was university dental hospitals. 6. For the level of trial, dispute that progressed above 2 or 3 trials was of 30.0%. 7. For the amount of claim for damage, the claim amounting between 50 million to 100 million won was of 36.7%, and that of more than 100 million won was 13.3%, and in case of the judgement amount, the amount ranging from 10 million to 30 million won was of 40.0%, and that of more than 100 million won was of 6.7%. 8. For the number of dentist involved in the suit, 26.7% was of 2 or more dentists. 9. For the amount of time spent until the judgement, 46.7% took 11 to 20 months, and 36.7% took 21 to 30 months. 10. For medical malpractice, 46.7% was judged to be guilty, and 70% of the cases had undergone medical judgement or verification of the case by specialists during the process of the suit. 11. In the lost cases of doctors(18 cases), 72.2% was due to violence of carefulness in practice and 16.7% was due to missing of explanation to patient. Medical disputes occurring in the field of dentistry are usually of relatively less risky cases. Hence, the importance of explanation to patient is emphasized, and since the levels of patient satisfaction are subjective, improvement of the relationship between the patient and the dentist and recovery of autonomy within the group dentist are essential in addition to the reduction of technical malpractice. Moreover, management measure against the medical dispute should be set up through complement of the current doctors and hospitals medical malpractice insurance which is being conducted irrationally, and establishment of system in which education as well as consultation for medical disputes lead by the group of dental clinicians and academic scholars are accessible.

• Research in Community and Public Health Nursing
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• v.5 no.2
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• pp.130-146
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• 1994

Our medical care system is trying to diversify in order to meet the client's needs, and to adjust to a medical environment which is changing very rapidly. Because current nursing theory and practice focus on holistic care, health care management, education, and research, contrary to the traditional emphasis on only assisting a physician, more autonomy and specialization for the implementation of nursing are required. Considering these trends and actual needs, the category of clinical nurse specialist should be established as soon as possible. In order to develop strategies for implementing this new professional specialty, the authors conducted a field survey and literature review of the current system in Korea. As a result, various obstacles and constraints were discovered as follows : 1) There are few accredited educational programs for the training of CNS's. 2) Several hospitals already have staff designated as clinical nurse specialist (CNS) even though the term CNS is not yet standardized or adopted in nationwide. 3) The role of the CNS is not clearly understood by the medical societies, or even nursing societies. A nurse who works in specific nursing areas such as central supply, kidney dialysis, intensive care, coronary care, etc. for a long time, considers herself /himself a CNS. Based upon the above findings, the following alternatives are recommended. 1) The role of the CNS should be defined according to specified functions and authority : professional autonomy ; counselling and educating patients and their familes, nurses, and even other medical personnel ; research on improvement of nursing ; and management of the nursing environment including medical resources, information, and cases. 2) the qualification of CNS should be attained only by a nurse who has an RN license and clinical experience of more than 3 years in a specific nursing field: passes a qualifying examination; and contributes to the professional development of peers, colleagues, and others. A master's degree should only be optional, because of the insufficient of graduate programs which are well designed for the CNS. 3) The CNS should initially be a head nurse rather than line staff in order to deal with as wide an experience base as possible. 4) The nursing specialty could be divided into two areas such as a clinical field and a community field. The clinical field could then be categorized by the Styles' classification such as diseases and pathogenics, systems, ages, acuity, skills/techniques, and function/role ; the community field could be classified according to work site.