• Korean journal of medical education
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• v.30 no.4
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• pp.347-357
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• 2018

Purpose: The purpose of this study was to apply alternative standard setting methods for the Korean Medical Licensing Examination (KMLE), a criterion-referenced written examination, and to compare them to the conventional cut score used on the KMLE. Methods: The process and results of criterion-referenced standard settings (i.e., the modified-Angoff and bookmark methods) were evaluated. The ratio of passing and failing examinees determined using these alternative standard setting methods was compared to the results of the conventional criteria. Additionally, the external, internal and procedural evaluation of these methods were reviewed. Results: The modified-Angoff method yielded the highest cut score, followed sequentially by the conventional method and the bookmark method. The classification agreement between the modified-Angoff and bookmark methods was 0.720 measured by Cohen's ${\kappa}$ coefficient. The intra-panelist classification consistency of modified-Angoff method was higher than bookmark method. However, the inter-panelist classification consistency was vice versa. The standard setting panelists' survey results showed that the procedures of both methods were satisfactory, but panelists had more confidence in the results of the modified-Angoff method. Conclusion: The modified-Angoff method showed results that were more similar to those of the conventional method. Both new methods showed very high concordance with the conventional method, as well as with each other. The modified-Angoff method was considered feasible for adoption on the KMLE. The standard setting panelists responded positively to the modified-Angoff method in terms of its practical applicability, despite certain advantages of the bookmark method.

• Journal of Korean society of Dental Hygiene
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• v.6 no.3
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• pp.243-261
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• 2006

Priority setting in national health insurances in major advanced countries and the nation was investigated to draw the criteria for priority setting and suggest the most rational criteria for dental insurance so as to help secure the efficiency of medicare financing and individual's health right and also elevate medical consumers' satisfaction with health insurance. 1. Priorities in national health insurance are different from country to country, depending on the medical security systems, priority introducing conditions, and social environment, but have many common factors. 2. The priority setting criteria for national health insurance in those countries include the following in common: the efficiency, equity, and cost effect of treatment, emergency of treatment, consumption of expense, efficacy of treatment, patient's receptiveness, patient's demand, severity of disease, and patient's responsibility for the disease. 3. In oral diseases, severe diseases including oral cavity cancer are low in rate, and in-hospital treatments are few. From the above findings, it is suggested that dental insurance should establish discriminative criteria for priority setting by reflecting the aspects of dental diseases and system difference between dental and other health insurances and taking account of efficiency of treatment through prevention, cost effect, prevalence and incidence of generalized diseases, and individual's financing burden.

• Korean Journal of Social Welfare
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• v.59 no.2
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• pp.223-249
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• 2007

In the health care setting which social work services are provided by interdisciplinary team approach, understanding the perception and expectation on the role of social workers worked with medical team is important for social workers to play their role effectively. This study is focused on the medical team members such as doctors, nurses, nutritionists and administrative staffs by researching the type of perception and each characteristics through using the Q methodology. It is concluded that perception on medical social workers is categorized into three types : psycho-social counselor, coordinator/developer of resources, multiple function player. Finding for this study suggest that the implications on social work practice in health care setting.

• Gut and Liver
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• v.12 no.6
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• pp.694-703
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• 2018

Background/Aims: Limited data exist comparing the safety and efficacy of direct-acting antivirals (DAAs) in hepatitis C virus (HCV) monoinfected and HCV/human immunodeficiency virus (HIV) coinfected patients in the real-world clinic practice setting. Methods: All HCV monoinfected and HCV/HIV coinfected patients treated with DAAs between January 2014 and October 2017 in community clinic settings were retrospectively analyzed. Pretreatment baseline patient characteristics, treatment efficacy, factors affecting sustained virologic response at 12 weeks (SVR12) after treatment, and adverse reactions were compared between the groups. Results: A total of 327 patients were included in the study, of which 253 were HCV monoinfected, and 74 were HCV/HIV coinfected. There was a statistically significant difference observed in SVR12 when comparing HCV monoinfection and HCV/HIV coinfection (94% and 84%, respectively, p=0.005). However, there were no significant factors identified as a predictor of a reduced response. The most common adverse effect was fatigue (27%). No significant drug interaction was observed between DAA and antiretroviral therapy. None of the patients discontinued the treatment due to adverse events. Conclusions: In a real-world setting, DAA regimens have lower SVR12 in HCV/HIV coinfection than in HCV monoinfection. Further studies involving a higher number of HCV/HIV coinfected patients are needed to identify real predictors of a reduced response.

• Korean Journal of Social Welfare
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• v.57 no.4
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• pp.343-370
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• 2005

This study is to find out factors that protect social workers in a medical setting from burnout. It is differentiated from the existing studies, which focused on factors or process causing burnout. The participants of the study were ten social workers, who have been working in a medical setting for at least seven years and were recognized as competent social workers by at least five other colleagues. The data were collected through intensive interviews. The contents of the interviews were analyzed by using Nvivo2, a computer software program for use qualitative study analysis. The result of this study categorized coping strategies that kept the social workers from burnout. Among such factors were their own admissions of having professional competency, feeling worthwhile and sense of accomplishment, having a firm belief system and value about their profession, teamwork, and their overall disposition. Additionally, they said that the support by their agency and the recognition and support by family contributed to their overall coping ability. Through this study, it was found that the social workers in medical setting were reducing risk factors related to burnout and overcoming them with various protective factors. These protective factors reflected the unique characteristics that social workers encounter in a medical setting. It was remarkable that 'developing and managing their professional competency' was emphasized most as a protective factor.

• Archives of Plastic Surgery
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• v.49 no.1
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• pp.132-136
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• 2022

• Journal of Korean Medical Science
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• v.33 no.49
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• pp.313.1-313.3
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• 2018

• Health Policy and Management
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• v.23 no.2
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• pp.103-111
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• 2013

Seven diagnosis-related groups (DRGs) prospective payment system is going to expand to all hospitals including university hospitals this year. However there are few studies on the change of practice pattern under prospective payment system in the university hospital setting. So This study was intended to predict the practice pattern change after the introduction of 7 DRGs prospective payment system in a university hospital setting. To predict the change of practice pattern, this study used simulation technique. Five hundred and nineteen patients classified as 5 DRGs in a university hospital were selected for simulation. The change of practice pattern were predicted based on clinicians' opinion. We also predicted payment change by service items. Major findings of this study are as follows. First, the total medical payment was reduced by 14.4%. The drug payment change (8.8%) took most of total payment reduction. The followings are the change of treatment material cost (3.2%), the change of laboratory tests cost (1.8%), the change of room charge (0.5%), and other payment change (0.1%), respectively. Second, most of the reduction in total medical payment resulted from the decreased amount of medical services themselves. The transfer of medical services to outpatient setting took up only 4.9% of the total payment reduction. The change of unit price or composition took up 5.5% of the total payment reduction. In this study we found that it is possible to reduce the inpatient services through practice pattern change in university hospital setting. However, it needs to be careful to adjust DRG payment after the reduction of provided services, because most of reduction was not due to service transfer but to service volume reduction. It is desirable to utilize the saving from practice pattern change as incentive to improve quality of care.

• Korean Medical Education Review
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• v.18 no.3
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• pp.125-131
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• 2016

Recent changes in educational paradigms that emphasize the performance or outcomes of education are redefining how learning objectives are being described as 'learning outcomes' in various academic disciplines. Medical education is not an exception to this trend. However, it has come to our attention that the key concepts and appropriate descriptions of learning outcomes have not been well understood among educators and that this lack of understanding has hindered our efforts to implement the practice in the field. This study aims to provide a direction to establish and describe learning outcomes by examining previous studies that have focused on setting learning objectives as well as learning outcomes. Setting and describing learning outcomes starts from reflection on the approach of behavioral learning objectives, which overemphasizes learner's acquired knowledge, skills, and attitude in each classroom rather than actual performance. On the other hand, the learning outcome approach focuses on what the learner is able to do as a result of a learning experience. This approach is more learner-friendly and encourages students to lead and be responsible for their learning process. Learning outcomes can best be described when the relevance of actual contexts and the hierarchy of learning objectives are considered. In addition, they should be in the form of context, task, performance, and level, as well as be planned with proper assessment and feedback procedures. When these conditions are met, the learning outcome approach is beneficial to students as it presents a curriculum that is more open to learners. Despite these advantages of the learning outcome approach, there is a possible concern that setting the learning outcomes and describing them can restrict evaluation to lower cognitive skills if the concept of learning outcome is narrowly interpreted or is set too low. To avoid such narrow applications, it is important for educators to understand the comprehensiveness of the learning outcome setting and to consider long-term outcomes embedded in an organizational vision rather than only short-term behavioral outcomes.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.8
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• pp.4169-4172
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• 2012

Background: The majority of women in rural India have poor or no access to cervical cancer screening services, although one.quarter of all cervical cancers in the world occur there. Several large trials have proven the efficacy of low-tech cervical cancer screening methods in the Indian context but none have documented the necessary components and processes of implementing this evidence in a low-resource setting. Methods: This paper discusses a feasible model of implementation of cervical cancer screening programme in low-resource settings developed through a pilot research project carried out in rural Tamilnadu, India. The programme used visual inspection of cervix after acetic acid application (VIA) as a screening tool, nurses in the primary care centres as the primary screeners and peer educators within Self-Help Women groups to raise community awareness. Results: The uptake of screening was initially low despite the access to a screening programme. However, the programme witnessed an incremental increase in the number of women accessing screening with increasing community awareness. Conclusions: The investigators recommend 4 key components to programme implementation in low-resource setting: 1) Evidence-based, cost-effective test and treatment available within the reach of the community; 2) Appropriate referral pathways; 3) Skilled health workers and necessary equipment; and 4) Optimisation of health literacy, beliefs, attitudes of the community.