• Title/Summary/Keyword: Practice-based

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COVID-19 vaccine-induced immune thrombotic thrombocytopenia: a review

  • Siti Nur Atikah Aishah Suhaimi;Izzati Abdul Halim Zaki;Zakiah Mohd Noordin;Nur Sabiha Md Hussin;Long Chiau Ming;Hanis Hanum Zulkifly
    • Clinical and Experimental Vaccine Research
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    • v.12 no.4
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    • pp.265-290
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    • 2023
  • Rare but serious thrombotic incidents in relation to thrombocytopenia, termed vaccine-induced immune thrombotic thrombocytopenia (VITT), have been observed since the vaccine rollout, particularly among replication-defective adenoviral vector-based severe acute respiratory syndrome coronavirus 2 vaccine recipients. Herein, we comprehensively reviewed and summarized reported studies of VITT following the coronavirus disease 2019 (COVID-19) vaccination to determine its prevalence, clinical characteristics, as well as its management. A literature search up to October 1, 2021 using PubMed and SCOPUS identified a combined total of 720 articles. Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guideline, after screening the titles and abstracts based on the eligibility criteria, the remaining 47 full-text articles were assessed for eligibility and 29 studies were included. Findings revealed that VITT cases are strongly related to viral vector-based vaccines, which are the AstraZeneca COVID-19 vaccine (95%) and the Janssen COVID-19 vaccine (4%), with much rarer reports involving messenger RNA-based vaccines such as the Moderna COVID-19 vaccine (0.2%) and the Pfizer COVID-19 vaccine (0.2%). The most severe manifestation of VITT is cerebral venous sinus thrombosis with 317 cases (70.4%) and the earliest primary symptom in the majority of cases is headache. Intravenous immunoglobulin and non-heparin anticoagulant are the main therapeutic options for managing immune responses and thrombosis, respectively. As there is emerging knowledge on and refinement of the published guidelines regarding VITT, this review may assist the medical communities in early VITT recognition, understanding the clinical presentations, diagnostic criteria as well as its management, offering a window of opportunity to VITT patients. Further larger sample size trials could further elucidate the link and safety profile.

A Study on the Cooperation between Medical Care and Law - Focusing on the discussion of the role of clinical practice guideline in Japan - (의료와 사법(司法)의 협력 -일본에서의 진료가이드라인의 역할에 대한 논의를 중심으로-)

  • Song, young-min
    • The Korean Society of Law and Medicine
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    • v.23 no.2
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    • pp.39-65
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    • 2022
  • There are two aspects of clinical practice guidelines that act as non-legal control before medical practice and as legal control standards after medical practice. The essential purpose of clinical practice guidelines is the former, but the latter action cannot be excluded. The clinical practice guidelines are a means of linking law and medical care. The negative perception of clinical practice guidelines that medical professionals' autonomy can be violated by the enactment of clinical practice guidelines is an excessive negative evaluation of clinical practice guidelines. Rather, judicial judgment based on clinical practice guidelines plays a role in respecting the autonomy of medical professionals. In other words, the clinical practice guidelines suppress legal regulations on medical care as much as possible and are based on doctors' professional ethics and self-discipline, and patient awareness and cooperation. In order to establish an ideal relationship of cooperation between doctors and patients, 'medical ethics' must be incorporated as a legal means. Clinical practice guidelines are the most appropriate means for incorporating such medical ethics into legal procedures. The lawyer solves the case with a legal syllogism that establishes a norm and applies facts to it to conclude. For the resolution of medical disputes, Clinical practice guidelines are used to establish norms that doctors should perform for specific diseases, and conclusions are drawn by applying the established norms to specific medical practices. When it is not easy to apply the established norms to specific medical practices, medical judgments by experts, such as emotions, expert testimony, and explanations by expert members, are used. As such, the Law respects the autonomy of medical care even in the establishment of norms and the application of norms. In particular, Clinical practice guidelines prepared independently by the medical community are referred to in establishing norms, which are the prerequisites for legal syllogism. This shows that doctors participate in the formation of precedents and contribute to the formation of norms. The use of clinical practice guidelines in trials is respect and consideration for the autonomy of medical care. Although there may be an aspect in which the autonomy of individual doctors is limited by clinical practice guidelines, it should be considered that the autonomy of doctors as a group is respected. In this way, the clinical practice guidelines play a role in protecting the autonomy of the "medical" group from the logic of the "law."

The Development of Nursing Education Program on Web-Based Instruction;Application to Nursing Management Practice (웹 기반(Web-Based Instruction) 간호관리학 실습교육 프로그램 개발)

  • Shim, Jun-Kyung;Kwon, Sung-Bok;Chi, Sung-Ai
    • Journal of Korean Academy of Nursing Administration
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    • v.9 no.2
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    • pp.283-295
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    • 2003
  • This study describes the development of nursing education program on web-based instruction for Nursing Management Practice of nursing school. The program has been developed based on five steps of the teaching-learning design model developed by Chung, In-Sung which is widely used in Web-Based Instruction(WBI). The objective of this study was to develop nursing education program on WEI and to evaluate its effectiveness. The subjects consisted of twenty-four senior nursing students taking the Nursing Management Practice course. Two sets of questionnaires were used for this study. They were asked to evaluate the program in terms of appropriateness of the teaching strategy, precision of the contents, easiness of use, easiness of approaching system, interface design, system management, enhancement of communication, and effectiveness of learning. The program was developed in five steps, analysis of the student, design of the contents, production of the system, implementation of the system, and evaluation of the effectiveness. It is concluded that this program was very useful in increasing the effectiveness of learning and motivation in the students. In addition to this, the web-based learning system would be one of the best qualified educational method for nursing students. Therefore, I would suggest that it can be used for other nursing courses which is available on the Web.

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A Correlation Study on the Relationship between Motivation for Achievement and Satisfaction on Clinical Practice in EMT students (응급구조과 학생의 성취동기와 임상실습 만족도와의 상관성 연구)

  • Park, Dae-Sung;Nam, Kun-Woo
    • The Korean Journal of Emergency Medical Services
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    • v.11 no.3
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    • pp.47-64
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    • 2007
  • Purpose : This study examines satisfaction of students at the department of Emergency Medical Technology with clinical practice and relationship between motivation of achievement and satisfaction with clinical practice and aims to provide basic materials contributing to the improvement of clinical practice education. Method : It selected 237 students in the second and third grade at the dept. of Emergency Medical and having experience in clinical practice as the subjects, collected data from Sept. 1 to 30, 2007 and analyzed 237 questionnaires collected with SPSS 12.0 program. Result : 1. Degree of motivation of achievement scored 3.46 of full marks of five points and they showed motivation of achievement over average score. Students who entered the dept. of Emergency medical after beginning social career(3.78) showed higher motivation of achievement in the period of entrance and group having will to be volunteer(3.66) showed the highest motivation of achievement in selecting this major. The better personal relationship they have, the greater hospital grade and the higher their transcript, the higher motivation of achievement they have. In the desired area of employment after graduation, first-aid staffs at the field of industry group(3.85) showed the highest motivation of achievement. 2. Degree of their satisfaction with clinical practice scored 3.53 of full marks of five and they showed satisfaction with it over average score. They showed the highest satisfaction in the contents of practice(3.64). 3. There was statistically significant positive correlation between motivation of achievement and satisfaction with clinical practice(r = .165, p < .05). Conclusion : There was statistically significant positive correlation between motivation of achievement and satisfaction with clinical practice. Repeated research through sampling based on probability to generalize relevance of motivation of achievement and satisfaction with clinical practice is needed and further researches on developing program to inspire motivation of achievement in theoretical learning as well as in clinical practice are required.

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Dental hygiene students self-efficacy and satisfaction with clinical practice (치위생과 학생의 자기효능감과 임상실습만족도)

  • Lee, Seong-Sook;Cho, Myung-Sook
    • Journal of Korean Dental Hygiene Science
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    • v.2 no.2
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    • pp.1-11
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    • 2019
  • Objectives: The purpose of this study was to examine the relationship between the self-efficacy of dental hygiene students and their satisfaction with clinical practice to provide information for developing programs aimed at instilling self-efficacy and boosting satisfaction with clinical practice. Methods: A self-reported survey was conducted with dental hygiene students in the metropolitan area. Of those surveys distributed, 243 questionnaires were analyzed. Results: The results of this study are as follows: 1. Regarding self-efficacy, the subjects had a mean result of 2.96(out of five points), and 3.09 points in satisfaction with clinical practice. 2. As for the subfactors of self-efficacy, the students who got higher grades, whose awareness of dental hygienists was better and whose awareness of dental hygienists after on-site clinical practice was better scored higher in terms of confidence and self-regulation. In task difficulty preference, the students who were more satisfied with majoring in dental hygiene and whose awareness of dental hygienists was better scored higher. In terms of motivation for choosing the dental hygiene department, the students scored higher when the department was their preferred option. 3. In satisfaction with clinical practice, the students who were aware of dental hygienists at the time of college entrance was better. Those whose awareness of dental hygienists after experiencing clinical practice was better and who were more satisfied with majoring in dental hygiene expressed more satisfaction with clinical practice. 4. Satisfaction with clinical practice was higher when self-efficacy was better. Conclusions: Based on the above results, it is thought that developing programs that can enhance self-efficacy and include on-site clinical practice would be beneficial as higher self-efficacy levels were related to higher clinical practice satisfaction.

Analysis on the current status of clinical practice and training in dental hygiene students (치위생학 임상실습교육 현황 분석)

  • Won, Bok-Yeon;Jang, Gye-Won;Hwang, Mi-Yeong;Jang, Jong-Hwa
    • Journal of Korean society of Dental Hygiene
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    • v.16 no.6
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    • pp.993-1007
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    • 2016
  • Objectives: The purpose of the study was to review the current status of clinical practice and training in dental hygiene in hospitals and clinics for the students. Methods: A self-reported questionnaire was completed by 80 dental hospitals and clinics from August 8 to September 12, 2016. Except incomplete answers, 211 copies were retrieved and analyzed. The questionnaire consisted of general characteristics of the subjects (6 items), present condition of clinical education (7 items), support policy and facilities (8 items), teaching personnel (6 items), improvement direction (3 items), and general considerations (3 items). Results: The annual practice time for students was 8.4 weeks. The average number of students per each practice institution was 5.95. The evaluation of the clinical practice period was rated as 'average' by 55.3% of the respondents, while 65.4% preferred the current duration of the practice. Meanwhile, 33.0% of the respondents wanted to increase the practice period. In clinical training education support, 62.3% of the hospitals had a person in charge, 79.2% of the hospitals and clinics had a operative procedure, appointed staff and a department for student practice. But 86.5% of the hospitals did not have standards for the budget for practice and instruction fee. In the personnel for clinical training, 52.6% said they were dental hygienists. In 87.1%, the practice instruction conducted by professors was done through communication with the hospital or clinic, while the man-to-man practice instruction was 8.6%. Conclusions: It is necessary to improve the process and operation method of dental hygiene clinical training. In order to make clinical training meet education goals, a standardized set of criteria is needed to support training education and guidelines for instructors and students.

Effects of clinical practice and major satisfaction of dental hygiene students on career preparation behavior (치위생(학)과 학생들의 임상실습과 전공만족도가 진로준비행동에 미치는 영향)

  • Kim, Soo-Kyung;Kang, Ri-U;Kim, Eun-Yong;Moon, Jung-Eun;Jang, Ji-Hee;Jung, Eun-Seo
    • Journal of Korean society of Dental Hygiene
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    • v.18 no.2
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    • pp.239-251
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    • 2018
  • Objectives: The purpose of this study was to investigate the effects of dental hygiene students' clinical practice stress, satisfaction and major satisfaction on career preparation behaviors. Methods:This study was conducted targeting the dental hygiene students who have clinical practice experience. The final 305 subjects were analyzed using SPSS 22.0 program. Results: The correlation between clinical practice stress and career satisfaction and career preparation behavior decreases with the higher degree of clinical practice and career preparation behavior. Analysis results about the affecting factors on the level of satisfaction with major satisfaction factors showed the highest factor of preparation behavior, followed by clinical practice and clinical practice stress in order. Analysis results about the affecting factors on the showed the highest factor of preparation behavior, followed by clinical practice and clinical practice stress in order. Conclusions: The results of this study showed that the higher the satisfaction of clinical practice and the higher the satisfaction of career, the more positive the career preparation behavior. Therefore, it's recommended to support continuous education programs to be coherent with dental hygiene student's career preparation behavior based on reinforcing individual competency by obtaining self-confidence and satisfaction from clinical practice.

An Analysis of Pharmacy Students' Perceptions and Evaluations after Community Pharmacy Practice Experiences (지역약국 실무실습 후 실습에 대한 약학대학 학생들의 인식과 평가에 대한 분석)

  • Yang, Young-Mo;Lee, Jieun;Lee, Ik-Soo;Choi, Eun Joo
    • YAKHAK HOEJI
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    • v.58 no.3
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    • pp.208-222
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    • 2014
  • Pharmacy practice experiences play a central role in improving the professional abilities and roles of student pharmacists in the changed '2+4'-year curricula of Korean pharmacy schools. For the first 3 years, the students usually learn theoretical areas, and for the last year, they apply learned knowledge to actual pharmacy practice environments. Especially, in order for community pharmacy practice experiences to become firmly established, it is important to evaluate students' feedbacks of community pharmacy practice experiences. However, there have been little studies regarding this area in Korea. This study was to analyze pharmacy students' perceptions and evaluations after community pharmacy practice experiences. The self-reported questionnaire using a 5-point Likert scale was utilized to collect data from the pharmacy students completing community pharmacy practice experiences. Total 62 students responded to the survey questionnaires. The average of students' evaluations of preceptors for overall evaluation items was 4.31 whereas that of student evaluations of practice sites for them was 4.03. The self-evaluations of students' expertises were mostly positive except for that of populations care. The evaluation item 'I believe this experience will help me be a better pharmacist' received the highest satisfaction. According to the results regarding open-ended questions, the students learned the needs for academic motivations and self-developments, and they thought that the curriculum should be standardized and systematized in order to improve contents for community pharmacy practice experiences. Furthermore, based on these results, the guidelines of community pharmacy practice experiences should be modified, and researches on the validation and evaluations of the modified guidelines should be implemented.

A Study on Dental Hygiene Students' Curriculum Regarding Clinical Practice (일부 치위생과 학생들의 임상실습 시 교과목 효용에 관한 연구)

  • Jang, Sung-Yeon
    • Journal of Korean Dental Hygiene Science
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    • v.4 no.1
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    • pp.11-18
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    • 2021
  • Background: The present study aimed to analyze which curriculum is the most relevant to dental hygiene students when they participate in clinical practice in order to provide a useful reference for preparing educational guidance in this field. Method: The survey utilized in the present study consisted of six questions about general characteristics, such as grade, satisfaction with major, amount of clinical practice, period of clinical practice, place of clinical practice, and the most interesting are during clinical practice. When evaluating curriculum relevancy, the following were ranked on a 5-point Likert scale, where 5 = very useful, 4 = comparatively useful, 3 = normal, 2 = comparatively unuseful, 1 = very unuseful: difference in requirements in the field of clinical practice, reason for this difference, and question about the utility of each curriculum. On this scale, higher points implied higher relevance. Result: The highest groups of curricula regarding curriculum utility were as follows: operative dentistry (59.6%), pre-clinical practice (55.2%), dental materials and clinical practice (54.4%), and prosthetic dentistry (49.6%). The lowest groups of curricula regarding curriculum utility were as follows: oral physiology (2.0%), oral histology and embryology (1.6%), and oral microbiology (1.2%). These results imply a lack of connection between the curriculum and tasks in clinical practice. Conclusion: Based on the results of the present study, it appears that both theory and practice courses of the clinical curriculum must be conducted systematically, and that there is a need to conduct education for the fundamental curricula, such as oral physiology, oral histology and embryology, and oral microbiology, regarding the relevance of tasks practiced in clinics.

Current status of dental hygiene curriculum related to clinical practice for dental hygienists in some universities (일부 대학 치위생학과의 치과임상실무 관련 교육과정 운영현황)

  • Lee, Hyo-Jin;Shin, Bo-Mi;Shin, Sun-Jung;Bae, Soo-Myoung
    • Journal of Korean society of Dental Hygiene
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    • v.21 no.6
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    • pp.793-803
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    • 2021
  • Objectives: The purpose of this study was to investigate the current status of dental hygiene curricula related to clinical practice in Korea. Methods: Clinical work included the categories 'history taking, infection control, oral prophylaxis, preventive treatment, education/counseling, radiography/reading, assisting/cooperation, impression/bite registration, anesthesia, etc.', and 66 works were finally selected based on the frequent tasks of dental hygienists. The subjects were made to answer nine questionnaires. Results: It was found that the theory and practice of the main works operated quite differently in lectures and practice in each school. All types of practice were applied to all schools in the case of 'scaling'. The evaluation of clinical practice was also found to be very different from school to school. Conclusions: For dental hygienists to establish expertise in clinical practice and promote quality improvement, it is necessary to develop a core curriculum focusing on clinical practice. The standardized curriculum should be improved to an efficient and competency-centered one defining clearly the role of dental hygienists considering the needs and importance of clinical practice.