• 한국경영과학회:학술대회논문집
• /
• 한국경영과학회/대한산업공학회 2003년도 춘계공동학술대회
• /
• pp.81-86
• /
• 2003

다수의 수련병원이 단일 병원군을 형성하려 전공의를 공동으로 모집선발하고, 또한 공동 책임에 수련시키는 전공의 통합수련프로그램인 "병원군별 전공의 총정원제"에서 인턴 순환근무 수련일정 계획은 순환교육과 임상경험을 위란 인턴의 일년간 수련일정을 수립하는 의사결정문제이다. 전공의의 순환배치와 관련하여 병원간의 갈등 또는 인턴의 불만 등이 발생할 수 있기에 병원군별 전공의 총정원제는 질적으로 우수하면 객관적인 인턴수련일정을 필요로 한다. 본 논문은 인턴일정계획의 수리모형을 제시하고, 면실의 데이터를 사용해 산출된 순환일정을 다각도로 분석한 결과를 제시한다. 작성된 수련일정은 9개병원이 참여한 CMC병원군에서 2003년 현재 263명 인턴의 일년수련 순환배지에 사용되고 있다.

• 정신신체의학
• /
• 제29권1호
• /
• pp.49-57
• /
• 2021

연구목적 전공의 공통역량으로서 의료커뮤니케이션의 중요성을 환기시키기 위하여 전공의를 대상으로 의료커뮤니케이션 능력을 조사하고 의료커뮤니케이션 능력, 진료수행 자기효능감 그리고 공감능력의 관련성을 분석하고자 하였다. 방 법 일 대학병원 소속 총 106명 전공의를 대상으로 자기평가 의료커뮤니케이션 능력, 수정된 진료수행 자기효능감 척도, 한국판 의사 공감 척도를 조사하였다. 성별, 나이, 전공과목(인턴, 내과계, 외과계), 연차(인턴, 1~2년차, 3~4년차)에 따른 의료커뮤니케이션 능력의 차이를 조사하였다. 상관분석으로 의료커뮤니케이션 능력, 수정된 진료수행 자기효능감, 공감능력의 상관계수를 구하였고 구조방정식 모형을 이용하여 의료커뮤니케이션 능력에 영향을 미치는 각 변수의 효과를 검증하였다. 결 과 인턴 31명(31.6%), 내과계 레지던트 45명(45.9%), 외과계 레지던트 22명(22.4%)으로 총 98명이 참가하였다. 성별, 나이, 전공과목, 연차에 따른 자기평가 의료커뮤니케이션 능력 점수는 통계적으로 유의한 차이가 없었다. 의료커뮤니케이션 능력은 수정된 진료수행 자기효능감(r=0.782, p<0.001) 및 공감능력(r=0.210, p=0.038)과 유의한 정적 상관관계가 있었다. 공감능력은 진료수행 자기효능감에 직접적으로 유의한 영향을 미쳤으며(β=0.30, p<0.01), 진료수행 자기효능감은 의료커뮤니케이션 능력에 직접적으로 유의한 영향을 보였다(β=0.80, p<0.001). 공감능력은 진료수행 자기효능감을 매개하여(β=0.26, p<0.05) 간접적으로 의료커뮤니케이션 능력에 영향을 미치고 있었다. 결 론 전공의 의료커뮤니케이션 능력은 성공적 진료를 위해 필요한 진료수행 자기효능감과 직접적 연관성이 있었으므로 전공의 공통교육과정의 하나로서 중요한 위치를 차치한다고 할 수 있다. 그리고 현재의 의료커뮤니케이션 모델은 공감 능력과는 구별해서 이해될 필요가 있음이 시사된다.

• 한국한의학연구원논문집
• /
• 제14권3호
• /
• pp.149-154
• /
• 2008

With sophisticated clinical skills and the effectiveness of Traditional Korean Medicine(TKM), many TKM doctors look forward to over seas expansion. About 450 TKM doctors had NCCAOM certificate, but only 40 TKM doctors arc in US now. Because The status of NCCAOM certificate in USA is not adequate enough for TKM doctors to perform medical treatments. In case of US, State medical boards depend to a large extent on the Educational Commission for Foreign Medical Graduates(ECFMG) for certification of international medical graduates (IMGs) seeking licensure in the United States. In addition to receiving certification that includes verification of education credentials, IMGs must pass Steps I and II of the USMLE. In order to obtain a license to practice in the United States, IMGs must successfully complete a residency in a program approved by the American Council of Graduate Medical Education(ACGME) and the complete Step III, the final step in the USMLE. TKM doctors, in the prospective of overseas expansion, applied to ECFMG and their applications have been rejected. This circumstance happened because Korea is unique country in the world with two different medical licensing system, Oriental and Western, both being physician workforce. Rejection by ECFMG occurred because of their minimal understanding of Korea's situation, while the responsibility to inform, propagate and protect TKM doctors own rights depend exclusively to Korean government, TKM doctor oneself and its related organizations, all the members should endeavor on it.

• Clinical and Experimental Emergency Medicine
• /
• 제5권4호
• /
• pp.240-248
• /
• 2018

Objective Determine differences between faculty, residents, and nurses regarding night shift preparation, performance, recovery, and perception of emotional and physical health effects. Methods Survey study performed at an urban university medical center emergency department with an accredited residency program in emergency medicine. Results Forty-seven faculty, 37 residents, and 90 nurses completed the survey. There was no difference in use of physical sleep aids between groups, except nurses utilized blackout curtains more (69%) than residents (60%) and faculty (45%). Bedroom temperature preference was similar. The routine use of pharmacologic sleep aids differed: nurses and residents (both 38%) compared to faculty (13%). Residents routinely used melatonin more (79%) than did faculty (33%) and nurses (38%). Faculty preferred not to eat (45%), whereas residents (24%) preferred a full meal. The majority (>72%) in all groups drank coffee before their night shift and reported feeling tired despite their routine, with 4:00 a.m. as median nadir. Faculty reported a higher rate (41%) of falling asleep while driving compared to residents (14%) and nurses (32%), but the accident rate (3% to 6%) did not differ significantly. All had similar opinions regarding night shift-associated health effects. However, faculty reported lower level of satisfaction working night shifts, whereas nurses agreed less than the other groups regarding increased risk of drug and alcohol dependence. Conclusion Faculty, residents, and nurses shared many characteristics. Faculty tended to not use pharmacologic sleep aids, not eat before their shift, fall asleep at a higher rate while driving home, and enjoy night shift work less.

• 여성건강간호학회지
• /
• 제21권1호
• /
• pp.32-42
• /
• 2015

Purpose: The purpose of this study was to investigate factors that influence married female immigrants' perceived health status. Methods: This study was a retrospective review of dataset from the 2012 National Multicultural Family Survey in Korea. Data were analyzed using descriptive statistics, t-tests, an analysis of variance (ANOVA), Pearson correlation analysis, and multiple regression with the data of 3,014 married female immigrants. Results: Multiple regression analysis showed that demographic factors (age, education level, nationality, period of residency in Korea, and residential area), socio-economical factors (monthly family income, employment, support from the government for basic living, and Medicaid), social support factors (marital conflict, satisfaction with family relationships, some one to talk about self or family matters, meeting with homeland friend, and participation in community meeting), and immigration factors (life satisfaction, experience of social discrimination, and difficulties with living and using medical care) were associated with perceived health status. Conclusion: It is important to pay closer attention to immigrant women who have low economic status, less social support, experience difficulties with living in Korea and using medical care. An effective support system for this population should be developed in order to help them successfully transition.

• Asian Pacific Journal of Cancer Prevention
• /
• 제17권3호
• /
• pp.1473-1478
• /
• 2016

Background: Cigarette smoking is as the leading cause of cancer mortality and other chronic diseases in males worldwide. The prevalence of cigarette smoking is different across and within countries by age, education level, occupation, and so on. This study aimed to determine the prevalence of cigarette smoking and its relationship with individuals' demographic factors and BMI in adolescent men living in Tehran, Iran. Materials and Methods: This study involved secondary analysis of the 'Urban Health Equity Assessment and Response Tool-2' survey conducted in Tehran, Iran, among men aged 20+, 2011-2012. Using a multistage sampling method, 45,990 men were included in the study. The cigarette smoking status, BMI and demographic factors measured through a self-administered questionnaire. Chi-square, t-test, and logistic regression model were used to examine the relationships between the independents variables and cigarette smoking behavior, using SPSS software version 21. Results: In the total of 45,990 men, the overall prevalence of cigarette smoking was 14.6% (CI 95%: 14.29-14.94). Age (OR=0.96; CI 95%:0.94-0.98), house ownership (OR=0.68; CI 95%: 0.64-0.72), job status (OR=0.60; CI 95%: 0.46-0.86), marital status (OR=0.42; CI 95%: 0.39-0.47) and educational levels (OR=0.50; CI95%: 0.45-0.54) were associated with the prevalence of cigarette smoking. However, associations with BMI, family size, residency years, and district were not statistically significant. Conclusions: Given the relatively high prevalence of cigarette smoking in the study population, policy interventions are required to address this major public health issue, with a focus on the population demographic influences.

• 생물정신의학
• /
• 제8권1호
• /
• pp.53-61
• /
• 2001

현재 국내 신경정신의학계가 당면하고 있는 학문과 진료 영역의 문제점들과 그 원인들을 살펴보고 정신과 의사들의 학문적인 성숙과 진료 영역의 확대를 위한 해결 방안을 모색해 보았다. 진료 영역이 축소된 이유로 의료계 내부에서는 최근에 이루어진 신경과학의 눈부신 발전, 신경정신과에서 신경과와 정신과로의 분리, 의료 제도의 변화, 정신과 의사들의 안이한 대처, 정신의학 교육의 왜곡 등을 생각할 수 있다. 의료계 외부의 조건들로는 정신의학과 정신과에 대한 사회적 편견, 의료에 대한 외부의 규제를 들 수 있다. 정신의학의 영역을 확대하기 위해서는 의과대학생 교육, 전공의 수련 과정, 전문의 연수 교육, 정신의학 교과서의 편찬 등을 통한 정신의학 교육의 개편 강화, 신경정신의학의 정체성 재확립, 그리고 신경과학과 신경학 교육의 강화 등을 적극적으로 추진해야 할 것이다. 아울러 정신과 의사들의 활동 분야를 확대하고 행동과학을 임상 진료 과목으로 개발하며 정신의학과 유관한 제 3 의 전문 진료 과목을 창출하고 정신과 의사의 기본적인 술기에 일차 진료 의사의 역할을 추가하는 방안들도 고려해 볼 필요가 있다.

• 의학교육논단
• /
• 제16권2호
• /
• pp.99-107
• /
• 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.

• Asian Pacific Journal of Cancer Prevention
• /
• 제17권sup3호
• /
• pp.93-99
• /
• 2016

Completeness is an important indicator of data quality in cancer registry programs. This study aimed to estimate the completeness of registered cases in a population based cancer registry program implemented in five provinces of Iran. Capture-recapture methods were used to estimate the number of cases that may have been missed and to estimate rates of completeness for different categories of age, year, and sex. The data used for this study were obtained from three sources: 1) National Pathology Database; 2) National Hospital Discharge Database; and 3) National Death Registry Database. The three sources were linked and duplicates were identified based on first name, last name, father's names, and date of birth, ICD code, and case's residency address using Microsoft Excel. Removing duplicates, the three sources reported a total of 35,643 cases from March 2008 to March 2011. Running many different multivariate models of capture-recapture and controlling for source dependencies revealed an overall under-reporting of 49% in all five registries combined. The estimated completeness differed based on age, sex, and year. The overall completeness was higher for males than females (71.2% for males and 59.9% for females). Younger age had lower rates of completeness compared to older age (38.1% for <40 years, 55.4% for 40-60 years, and 76.7 for >60 years). The results of this study indicated a moderate to severe (depending on the age, sex and year) degree of completeness in the population based cancer registration of Iran.

• Journal of Gastric Cancer
• /
• 제15권4호
• /
• pp.270-277
• /
• 2015

Purpose: Minimally invasive gastrectomy (MIG), including laparoscopic distal subtotal gastrectomy (LDG) and robotic distal subtotal gastrectomy (RDG), is performed for gastric cancer, and requires a learning period. However, there are few reports regarding MIG by a beginner surgeon trained in MIG for gastric cancer during surgical residency and fellowship. The aim of this study was to report our initial experience with MIG, LDG, and RDG by a trained beginner surgeon. Materials and Methods: Between January 2014 and February 2015, a total of 36 patients (20 LDGs and 16 RDGs) underwent MIG by a beginner surgeon during the learning period, and 13 underwent open distal subtotal gastrectomy (ODG) by an experienced surgeon in Bundang CHA Medical Center. Demographic characteristics, operative findings, and short-term outcomes were evaluated for the groups. Results: MIG was safely performed without open conversion in all patients and there was no mortality in either group. There was no significant difference between the groups in demographic factors except for body mass index. There were significant differences in extent of lymph node dissection (LND) (D2 LND: ODG 8.3% vs. MIG 55.6%, P=0.004) and mean operative time (ODG 178.8 minutes vs. MIG 254.7 minutes, P<0.001). The serial changes in postoperative hemoglobin level (P=0.464) and white blood cell count (P=0.644) did not show significant differences between the groups. There were no significant differences in morbidity. Conclusions: This study showed that the operative and short-term outcomes of MIG for gastric cancer by a trained beginner surgeon were comparable with those of ODG performed by an experienced surgeon.