• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.14 no.2
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• pp.41-49
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• 2008

임상추론은 환자를 평가하고 관리하는데 사용되는 임상가의 필수적인 생각 또는 동적인 인지과정이라고 할 수 있다. 임상추론은 환자의 문제를 인식하고 식별하며 더 나은 환자관리가 이루어지도록 환자의 상태에 대처하며 정보를 해석하고 분석하는 것으로서 이를 위해 임상가는 적절한 지식을 가지고 있어야 하며 임상추론 기술과 관련된 폭넓은 이해가 요구된다. 임상추론은 치료사, 환자, 그리고 환경간의 상호관계를 가진 복잡한 과정으로 임상추론과정에서 치료사와 환자간에는 충분한 협조가 이루어져야 한다. 임상추론에서의 해석적 모델로는 진단적 추론, 상호작용의 추론, 이야기적 추론, 협조적 추론, 예언적 추론, 윤리적 추론, 추론의 교육 등이 제시된다. 임상추론 과정에서 필수적인 주요 요소는 충분한 지식, 인지와 초인지 기술을 포함하며 이들 요소는 치료사와 환자간의 관계에서 발달되어야 한다. 이들 기술 중에 어떠한 실수라도 임상추론의 오류를 초래할 수 있다. 추론에서 오류의 원인으로는 암시된 정보의 잘못된 인지, 임상페턴에 대한 지식부족, 특정 상태에 대해 알려진 사실을 잘못 적용하는 경우를 들 수 있다. 오류는 임상추론 과정의 어떤 단계에서도 일어날 수 있으므로 효과적인 학습전략을 통하여 이들 오류를 예방할 수 있을 것이다.

• Journal of Korean Physical Therapy Science
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• v.18 no.1
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• pp.33-49
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• 2011

The process of physical therapy uses a problem-solving approach to enhance a patients's functioning status. The International Classification of Functioning, Disability and Health(ICF) is the common concept for the functioning in the world. Physical therapists require the ability to identify problems, formulate hypothesis, and plan intervention strategies through clinical reasoning. In the clinical process, physical therapists need to use standard and common languages in speech and in documentation. The purpose of this study was to suggest the process of making strategy for efficient intervention, examining and evaluating the functional problem of the person with stroke using ICF tools. For the first step in this process model, therapists could list the information relating to functional problems used by the ICF Core set and then could identify the interaction among the problems using the ICF assessment sheet. For the next step, therapist is needed to make the hypothesis and hypothesis testing, and then set a primary functional goals and therapeutic goals in detail after prioritizing the problems to be managed based on the problem list. Finally, after setting the identified problems as the purpose of intervention through the hypothesis testing, therapist could do some intervention after making a plan to solve these problems, and find out the outcomes using the ICF evaluation display. This report illustrates how to apply the process based on ICF concept into physical therapy practice. Making a decision for the most efficient intervention requires that therapists use the clinical reasoning process based on ICF concept.

• Journal of Korean Academy of Nursing Administration
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• v.13 no.1
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• pp.53-64
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• 2007

Purpose: This study was aimed to develop and evaluate of a Problem-based Learning (PBL) in the course of Nursing Management and Ethics. Method: The design of the study was both methodological and one group only pre-post design. The sample included 61 senior students who are currently enrolled in Nursing management and Ethics course in college of nursing. Data regarding PBL evaluation were collected on the critical thinking and clinical reasoning using structured questionnaires during March to June, 2005. Data were analyzed using descriptives and paired t-test. Results: A total of three PBL packages was developed by the two faculty members and two teaching assistants who are majoring in nursing management. PBL packages that had been developed was applied to 61 senior students for three months. Critical thinking and clinical reasoning were measured twice pre and post the application of PBL packages. There were statistically significant differences in the critical thinking and clinical reasoning between the pre and post PBL application. Conclusion: PBL was considered to be effective in understanding the learning concepts in the Nursing Management and Ethics. Further research on the facilitative strategies and development model considering the characteristics of Nursing Management and Ethics course is needed.

• Journal of the Korean neurological association
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• v.36 no.4
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• pp.421-426
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• 2018

• Journal of the Korean neurological association
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• v.36 no.4
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• pp.427-431
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• 2018

• Journal of Information Technology Services
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• v.10 no.1
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• pp.135-149
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• 2011

In this paper, we propose the high-risk group detection model for patients with high blood pressure using case-based reasoning. The proposed model can be applied for public health maintenance organizations to effectively manage knowledge related to high blood pressure and efficiently allocate limited health care resources. Especially, the focus is on the development of the model that can handle constraints such as managing large volume of data, enabling the automatic learning to adapt to external environmental changes and operating the system on a real-time basis. Using real data collected from local public health centers, the optimal high-risk group detection model was derived incorporating optimal parameter sets. The results of the performance test for the model using test data show that the prediction accuracy of the proposed model is two times better than the natural risk of high blood pressure.

• Proceedings of the Korea Inteligent Information System Society Conference
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• 2005.11a
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• pp.258-263
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• 2005

Haplotype-based analysis using high-density SNP markers have gained a great attention in evaluating genes in gene analysis and various clinical situations. However, there has been no research on disease diagnostic modeling based on SNPs analysis to our knowledge. The purpose of this study is to explore how knowledge discovery techniques are applied in medical informatics area and proposes a Case Based Reasoning (CBR) technique for diagnosis of gastric caner using Single Nucleotide Polymorphism(SNP).

• Korean Medical Education Review
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• v.15 no.3
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• pp.120-124
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• 2013

The clinical clerkship focuses students on developing their ability to perform comprehensive diagnosis and management of patients with common undifferentiated problems by the integration of knowledge and clinical reasoning. Therefore, the clerkship evaluation system should assess their actual problem solving and professional behavior. However, concern remains that clerkship evaluations are imprecise and highly variable. This review is designed to provide faculty members with concepts, options, and a methodology to actively teach and evaluate the clinical clerkship, as well as offer encouragement and inspiration to medical students. We reviewed past and current clinical clerkship evaluations and discuss several tips to improve clinical excellence such as continuity, transparency of the evaluation process, a faculty development program, practical examination of clinical skills, implementation of a checklist for recording exposure and skills, providing prompt and constructive feedback to students, self-evaluation of professional performance, varying multi-faceted assessment combinations, being outpatient clinic-centered, and having dedicated faculty members who give students one-on-one contact with a preceptor.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.17 no.1
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• pp.35-44
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• 2011

Background: This study was to suggest the process of making strategy for effective intervention and evaluation on functional problems of the frozen shoulder patient applied International Classification of Functioning Disability and Health (ICF) Tools. Methods: The patient was 48years old woman with right shoulder adhesive capsulitis and calcific tendinitis. In first phase, therapists could list the information relating to functional problems used by the ICF Core set and then could confirm the interaction among the problems using the ICF assessment sheet. In second phase, therapist is needed to make the hypothesis and hypothesis testing and then set a primary functional goals and therapeutic goals in detail after prioritizing the problems to be managed based on the problem list. Lastly, after setting the confirmed problems as the purpose of intervention through the hypothesis testing, therapist could do some intervention after making a plan to solve these problems. Results: This report illustrates how to apply the process based on ICF concept into physical therapy practice. The decided hypothesis and goal that are to solve the problems the client faced were remarkably meaningful. Conclusions: Clinical decision making for the most effective intervention requires that therapists use the clinical reasoning process based on ICF concept.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.18 no.4
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• pp.701-705
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• 1996

There are many kind of diagnostic entities in submandibular or neck masses, and we can set up treatment plan and estimate treatment result, prognosis by accurate diagnosis. By reasoning medical and dental history, physical examination, anatomical consideration of masses in submandibular or neck area, location of masses, laboratory and radiographic studies, we can formulate a clinical diagnosis or differential diagnosis. Although a clinical diagnosis might suffice in some instances, a definitive(microscopic) diagnosis is frequently required for proper treatment. In order to get some information about making accurate diagnosis and setting up appropriate treatment plan, we did clinical study and histopathologic classification of 82 patients who visited and were operated for submandibular masses at Department of Oral and Maxillofacial Surgery in Seoul National University Hospital from 1988 to 1992. The result were as follows : 1. Submandibular masses occured most frequently in forties and fifties, and there was no sex predilection. 2. Chief complaints were in order of mass, swelling, pain and consistency were soft mass, mobile hard mass, firm mass, diffuse swelling in descending order. 3. Most frequent pathologic finding was lymphadenitis. 4. Site of submandibular masses were submandible, neck, submental, retromandible in descending order, and there was no predilection between left and right side. 5. Accuracy rate between clinical impression and result was 51.2%.