• Title/Summary/Keyword: Medical practice

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The Need for a New Curriculum in Clinical Genetic Education (임상유전학 교육에서 새로운 교과과정 개발의 필요성)

  • Lee, Chang-Woo
    • Korean Medical Education Review
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    • v.16 no.1
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    • pp.50-54
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    • 2014
  • It is becoming increasingly important for medical doctors to have a thorough understanding of human genetics and the ethical, legal, and social implications of genetic testing, counseling, and treatment. As genetic engineering and technology evolves, medical doctors will find themselves called in to counsel patients about a rapidly increasing number of diseases for which genetic testing and treatments are available. Medical doctors will need to master a new set of principles and clinical skills. A lack of knowledge about these issues and problems may lead to serious, lifelong or even fatal negative effects on patients. Medical genetics has moved from the study of rare conditions to the illumination of disorders that impact the entire spectrum of medical practice. This study demonstrates several areas in which medical genetics is clearly an important tool in medical practice and the necessity of establishing new curriculum for clinical genetic education in Korea. Medical students nearing graduation may lack genetic knowledge that is essential for daily practice because genetics has little or no place in clinical teaching. Medical schools should make extensive curriculum changes to increase students' awareness of clinical genetics and its ethical implications. The medical school curriculum will need creative new approaches to keeping up with the rapid pace of evolution of clinical genetics.

Validation of the Korean Version of the Undergraduate Clinical Education Environment Measure (한국형 임상실습 교육환경 평가척도 타당화)

  • Chun, Kyunghee;Park, Young Soon;Oak, Ji Won
    • Korean Medical Education Review
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    • v.23 no.1
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    • pp.37-45
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    • 2021
  • In light of the need for a tool to evaluate the clinical practice education environment as perceived by medical and nursing students, this study is was conducted to develop and validate the Korean version of the Undergraduate Clinical Education Environment Measure (K-UCEEM) as a measurement tool for managing the clinical practice education climate and quality of education. For validation, the UCEEM consisting of 25 items developed by Pia Strand in 2013 was adapted according to standard translation procedures. The K-UCEEM questionnaire was administered to 73 medical students and 135 nursing students who participated in clinical practice at one medical institution. Exploratory factor analysis and confirmatory factor analysis were conducted to confirm the validity of the instrument's structure. In order to determine referential validity, the relationships among stresses in clinical practice were examined, and differences in factor scores were compared by gender and college. It was confirmed that the scale of 24 items and five factors showed a moderate model fitness index. The reliability of the factors ranged from 0.786 to 0.867. In addition, all five factors were found to have negative correlations with the clinical practice stress sub-factor, and there were statistically significant differences by gender and college. Through this study, the validity and reliability of the K-UCEEM were verified. In the future, it is expected that further verification of the scale, as well as evaluation and improvement of the clinical practice education environment based on this scale, will occur.

Progress in the Direct Application of Pharmacogenomics to Patient Care: Sustaining innovation

  • Burckart, Gilbert J.;Frueh, Felix W.;Lesko, Lawrence J.
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 2006.11a
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    • pp.23-39
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    • 2006
  • The application of the knowledge from the Human Genome Project to clinical medicine will be through both industrial drug development and the application of pharmacogenomics (PG) to patient care. The slow uptake of clinical innovations into clinical practice can be frustrating, but understanding the history of acceptance and sustaining medical innovation is critically important to position PG to succeed. This primarily means that PG tests must have legitimacy; they must be thoroughly validated, must be cost-effective, must be widely accepted by medical practitioners, must be supported by public policy, and must have a way of being easily incorporated into current medical practice. They must also lead to actionalble decisions by health care providers for their patients. Innovative PG assays should be tested in the best US laboratories, and reimbursement for testing must be accepted at the federal and state level. The companies providing these PG tests should be capable of supporting the interpretation and use of the test throughout medical practice. Advances such as the addition of PG information to drug labeling and the routine use of validated biomarkers to determine choice of cancer chemotherapy have been made. The PG research community must pay attention to the principles that have been previously described for acceptance and sustaining medical innovations in order for PG to be widely accepted in clinical medical practice.

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Progress in the Direct Application of Pharmacogenomics to Patient Care: Sustaining innovation

  • Frueh, Felix W.;Lesko, Lawrence J.;Burckart, Gilbert J.
    • Biomolecules & Therapeutics
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    • v.15 no.1
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    • pp.1-6
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    • 2007
  • The application of the knowledge from the Human Genome Project to clinical medicine will be through both industrial drug development and the application of pharmacogenomics (PG) to patient care. The slow uptake of clinical innovations into clinical practice can be frustrating, but understanding the history of acceptance and sustaining medical innovation is critically important to position PG to succeed. This primarily means that PG tests must have legitimacy; they must be thoroughly validated, must be cost-effective, must be widely accepted by medical practitioners, must be supported by public policy, and must have a way of being easily incorporated into current medical practice. They must also lead to actionalble decisions by health care providers for their patients. Innovative PG assays should be tested in the best US laboratories, and reimbursement for testing must be accepted at the federal and state level. The companies providing these PG tests should be capable of sup-porting the interpretation and use of the test throughout medical practice. Advances such as the addition of PG information to drug labeling and the routine use of validated biomarkers to determine choice of cancer chemotherapy have been made. The PG research community must pay attention to the principles that have been previously described for acceptance and sustaining medical innovations in order for PG to be widely accepted in clinical medical practice.

Progress in the Direct Application of Pharmacogenomics to Patient Care: Sustaining innovation

  • Burckart, Gilbert J.;Frueh, Felix W.;Lesko, Lawrence J.
    • 한국약용작물학회:학술대회논문집
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    • 2006.11a
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    • pp.23-39
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    • 2006
  • The application of the knowledge from the Human Genome Project to clinical medicine will be through both industrial drug development and the application of pharmacogenomics (PG) to patient care. The slow uptake of clinical innovations into clinical practice can be frustrating, but understanding the history of acceptance and sustaining medical innovation is critically important to position PG to succeed. This primarily means that PG tests must have legitimacy; they must be thoroughly validated, must be cost-effective, must be widely accepted by medical practitioners, must be supported by public policy, and must have a way of being easily incorporated into current medical practice. They must also lead to actionalble decisions by health care providers for their patients. Innovative PG assays should be tested in the best US laboratories, and reimbursement for testing must be accepted at the federal and state level. The companies providing these PG tests should be capable of supporting the interpretation and use of the test throughout medical practice. Advances such as the addition of PG information to drug labeling and the routine use of validated biomarkers to determine choice of cancer chemotherapy have been made. The PG research community must pay attention to the principles that have been previously described for acceptance and sustaining medical innovations in order for PG to be widely accepted in clinical medical practice.

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Adaptation of the Evidence-Based Nursing Practice Guideline: Prevention and Management of Moisture Associated Skin Damage (근거 기반 간호 실무지침 수용개작: 습기 관련 피부 손상의 예방과 관리)

  • Baek, Kyu Won;Park, Joo Hee;Kim, Min Kyung;Kim, Kyung Sun;Jeon, Kyoung Ok;Park, Su Hyun;Yang, Weon Ji;Hwang, Ji Won
    • Journal of Korean Clinical Nursing Research
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    • v.24 no.3
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    • pp.263-272
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    • 2018
  • Purpose: This study was done to develop an evidence-based nursing clinical practice guideline for Moisture associated skin damage (MASD) prevention and management for patients in Korea. Methods: The guideline adaptation process was used and conducted according to the guideline adaptation manual developed by the Korean Hospital Nurses Association. It consists of three main phases and 9 modules including a total of 24 steps. Results: The adapted MASD clinical practice guideline consisted of 4 sections, 8 domains and 28 recommendations. The number of recommendations in each section was: 7 on MASD assessment, 14 on MASD prevention and management, 4 on education, and 3 on organizational policy. Of the recommendations, 3.6% were marked as A grade, 28.6% as B grade, and 67.8% as C grade. Conclusion: This MASD clinical practice guideline is the first to be developed in Korea. The developed guideline will contribute to standardized and consistent MASD prevention and management. The guideline can be recommended for dissemination and utilization by nurses nationwide to improve the quality of MASD prevention and management. Regular revision is recommended.

The Change of Basic and Postgraduate Medical Education after Intern Training System Dismantling (인턴수련제도 폐지에 따른 기본의학교육-졸업 후 의학교육의 변화)

  • Kim, Byung Soo
    • Korean Medical Education Review
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    • v.15 no.2
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    • pp.69-74
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    • 2013
  • This study aimed to review the expected changes in the medical educational environment and to evaluate approaches to coping with the abolition of the postgraduate intern training system. It is expected that after the intern training system is dismantled, postgraduate medical students will be deprived of the opportunity to practice opportunity for clinical practice and to inquire into their medical specialization. Therefore, major improvements in the clinical education curriculum must be made so that students can do so through the clinical education program. Offering students the opportunity to perform clinical practice through the clinical education program might require a revision in the laws and regulations on clinical education as well as the standardization of the clinical education curriculum in line with international practices. Reform measures to provide students the opportunity to inquire their specializations might be the introduction of a medical curriculum containing diverse fields and the establishment of a matching program to assign medical students to their residency programs after medical school. Finally, the fact that the basic concern of postgraduate medical education is the cultivation of primary care physicians must not be forgotten even after the dismantling of the postgraduate intern training system.

Development of the Prevention Guideline of Deep Vein Thrombosis in Patients with Surgery according to the Guideline Adaptation Process (수술환자의 심부정맥혈전증 예방 지침 수용개작)

  • Yoon, Ji Hyun;Lee, Ihn Seon;Lee, Kyeong Yoon;Jang, Mi Ja;Lee, Jung Min;Nam, Min Sun;Park, Ji Hyeon;Hwang, Ji Won;Song, Hyun Ju;Cho, Yong Ae;Kwon, In Gak;Kim, Mi Young
    • Journal of Korean Clinical Nursing Research
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    • v.20 no.3
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    • pp.337-347
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    • 2014
  • Purpose: Deep Vein Thrombosis (DVT) is the cause of fatal diseases such as pulmonary embolism, due to a prolonged immobility, surgery, paralysis, and injuries. This study aimed to develop an evidence-based practice guideline for DVT prevention and apply it to patients with surgery in diverse nursing sites in South Korea. Methods: A 24-staged processes of adaptation was carried out on the basis of "adaptation of nursing practical guidelines" developed by Gu et al., in 2012. Results: Developed nursing guidelines of DVT prevention are composed of 79 recommendations in 8 domains. The extent and ratings of each recommendation with its evidence were addressed along with the background information. Conclusion: The developed DVT prevention guideline is necessary to be added to the evidence-based practice guidelines for the fundamentals of nursing practice. The developed guideline is needed to be disseminated to diverse nursing clinical settings in order to prevent DVT and enhance the quality nursing care.

Recent Trends in the Theory of Expectation Rights Violations in Japan (기대권침해론에 관한 일본의 최근 동향)

  • Song, Young Min
    • The Korean Society of Law and Medicine
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    • v.14 no.1
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    • pp.209-236
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    • 2013
  • The concept of expectation rights considers 'the expectation' that the patient should be given proper medical treatment as the benefit and protection of the law, so it would be the benefit and protection of the law due to personal rights different from 'the legal principle that has the possibility to a considerable extent' being in an extension of life and body. However, the problem how the patient's expectation of medical service sets up in order to make it the benefit and protection of the law would be still left in the vague concept of the patient's 'expectation', thus, in the first place, the medical practice following formed medical standard in every particular medical institutes should be the standard because these medical services are normally within a range of the patients' expectations. In addition, it should be naturally constituted as mental profit to get the subjective circumstances such as 'the patient's expectation' to be an object, and also, different from the profit and protection of the law such as life and body that should be absolutely protected, the origin of violation behavior should be regarded simultaneously to define the denotation of expectation rights. Therefore, the expectation rights violations would be problematic in case it fails to reach the medical standard that is expected for common doctors to practice properly. This is the concept of expectation rights that gets subjective matters such as the patient's expectation to be objectivity as medical practices that can be expected by generalized abstract doctors. This standard should be defined as the minimum standard that is naturally expected for doctors to practice, different from medical standard that decides the level of doctors.

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Social Cognitive Theory and Medical Education: How Social Interactions Can Inform Learning (사회인지이론과 의학교육: 어떻게 사회적 상호작용을 통해 학습이 일어나는가)

  • Kim, Hae Won
    • Korean Medical Education Review
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    • v.22 no.2
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    • pp.67-76
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    • 2020
  • The structures and processes of medical education have changed little since the publication of Flexner's report, which stressed the scientific orientation of medical education and the curricular structure of 2 years of formal knowledge education and 2 years of clinical experience. However, the previous perspectives on medical education are facing challenges, and these call for new pedagogy and theories on which to base medical education practice. Considering that social dimensions of learning have been emphasized in practice, perspectives that integrate these aspects are needed. Among the various learning theories, social cognitive theory refers to the theoretical framework which contends that learning occurs within interactions with others and environments. From a social cognitive standpoint, learning through observation is a critical component in human functioning. Indeed, observational learning has particular significance in medical education in that it provides the context for which the importance and meaning of role models can be understood. In addition, as theoretical constructs such as self-efficacy and outcome expectations allow us to establish an effective learning environment, exploring the concepts of the theory could be beneficial to medical education practice. In this context, the present review article aims to provide a glimpse of the fundamental assumptions and theoretical concepts of social cognitive theory and discusses the implications the theory has on teaching and learning. Further, a review of previous studies could help explain how the theory has informed medical education practice. Finally, the author will conclude with the implications and limitations of applying social cognitive theory in medical education.