• 의학교육논단
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• 제19권2호
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• pp.83-89
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• 2017

The aim of this study is to examine the effect of recorded video monitoring on students' self-reflection after completing their clinical performance examination. Taking into account the particular cases involved in the examination, the present study utilized history-taking, physical examination, and patient education as bases for evaluating information-establishment ability, and asking, listening, understanding, explaining, and connectedness as the bases for evaluating patient-physician interaction ability. Student self-monitoring through recorded video feedback was carried out three days after completion of their clinical performance examination. Students self-evaluated their performance with a 10-point scale before and after self-monitoring. The results of this study show that students have a general tendency to lower their own self-evaluation scores after self-monitoring. Although there was not a statistically significant change of interrelationship in the information-establishment ability evaluation, there was a meaningful change of interrelationship in the patient-physician interaction ability evaluation after self-monitoring; specifically, in the case of acute lower abdominal pain, a high correlation was found (r=0.31, p=0.02) between the evaluation scores of standardized patients and students related to patient-physician interaction ability. This implies that self-monitoring enables the students to acquire a reflective viewpoint from which to evaluate their own performance. Therefore, it can be said that self-monitoring through recorded video feedback is a valuable method for students to use in reviewing their performance in patient-physician interactions.

• 의학교육논단
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• 제21권3호
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• pp.150-154
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• 2019

When standardized patients (SPs) are used for educational purposes, the authenticity of role play and the quality of feedback are essential requirements of SPs. This study was conducted to investigate medical students' assessment of SPs and to identify the components of SPs' performance that were most strongly correlated with patient-physician interaction score. One hundred and forty-two fourth-year medical students were asked to complete the Maastricht Assessment of Simulated Patients (MaSP) at the end of a clinical performance examination. SPs evaluated the patient-physician interactions using a 4-point Likert scale (1=poor to 4=excellent). Medical students' assessment of SPs using the MaSP was positively correlated with patient-physician interactions (r=0.325, p<0.01). Items addressing the authenticity of role play (e.g., "SPs appear authentic," "SPs might be real patients," and "SPs answer questions in a natural manner") were closely correlated with patient-physician interactions (p<0.001, p=0.027, and p=0.017, respectively). These results showed that the MaSP appears to be a useful instrument for evaluating SPs' performance and that the authenticity of SPs' performance was positively correlated with medical students' interactions. In order to improve patient-physician interactions, medical students should be given opportunities to practice their skills with SPs who have been trained to portray patients with a specific condition in a realistic way.

• Journal of Information Technology Applications and Management
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• 제21권2호
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• pp.31-48
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• 2014

The concept of Health Related Quality of Life and its determinants have evolved since the 1980s. Although many researchers have published articles of technology usage in hospitals and the installation of technology based healthcare system, the research about applying the information technology to improve the patients' perceived quality of healthcare services is still limited. In general, services are deeds, processes and performances that are essentially concerns of the consumer. The healthcare service quality depends on tangible factors, such as equipments, facilities, and the quality of hospital staff and also the intangible ones. The main purpose of this work is to establish new model and find out the contribution of information technology to enhance the patients' perceived quality of healthcare service. We attempted to examine the main information technology related factors in 3 aspects, namely quality of information, the technology accessibility and the community that can improve patients' perceived quality of healthcare services. Offline and online questionnaires were used to measure the patients' perceived quality and were distributed to 384 people in 2 countries, Laos and South Korea. A principle component analysis and multiple regressions were used to verify our model. Results show that the use of information technology has partial positive effect on patient-physician interaction in both countries. However, patient knowledge and patient autonomy which are the 2 dimensions of patient-physician interaction has significant positive effect on patients' perceived quality of healthcare service.

• 대한한의학회지
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• 제42권3호
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• pp.86-98
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• 2021

Objectives: This study aims to evaluate the impact of patient-physician communication curriculum on students of Korean medical school in terms of cognitive, affective, and psychomotor level of communication skills. Methods: A communication curriculum was developed considering COVID-19 pandemic situation. Lectures, peer role-play, open interview with standardized patient (SP), discussion and feedback were conducted by online, and face-to-face 1:1 SP-interview was performed. Scores of written test, peer role-play of medical communication, SP-interview, self-evaluation on one's interview with real patients in clinical clerkship, and questionnaire of importance were collected and analyzed. Results: Converted to 100 point scale, the mean score of written test (cognitive level) was 91.2 while that of importance questionnaire (affective level) was 77.5. The mean scores of psychomotor level were 72.5, 77.5, and 62.5 for peer role-play, SP-interview, and real patient interview in clerkship, respectively. Conclusions: Students' performance is lower in higher level of competence. Curriculums should provide more opportunities of practices to students, and include evaluation focusing on performance skills.

• Journal of Yeungnam Medical Science
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• 제41권2호
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• pp.74-79
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• 2024

Patient-physician interaction (PPI) is an important area in medical education, but in-depth discussions on the content of the outcome of patient-doctor education are rare. Therefore, in this study, we will systematically analyze the research on PPI education in Korea. In this study, papers searched with keywords related to PPI education from Korea's academic journal service were targeted according to a systematic literature analysis method. The scope of the study was to include papers published in academic journals that are candidates for Korea Citation Index registration, excluding dissertations, research reports, posters, conference presentations, books, and internet materials. The content included papers targeting medical education and medical school students was set as the range. As a result of the analysis, although communication between PPI has many positive effects in the PPI in medical education at medical schools, obstacles do occur, and various ways to overcome them were suggested. Therefore, although medical interview training between patients and doctors in medical schools is necessary, it was analyzed as being based on overseas research or lacking in specific content. The core of PPI education appears to be medical interviews, and it seems necessary to discuss whether empathy or patient-centered medical care are appropriate as the main principles of PPI education in Korea. Therefore, education on the patient-doctor relationship is an important element in medical humanities and medical humanities education, and it is expected that research and education on this will progress more actively.

• Journal of Yeungnam Medical Science
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• 제38권2호
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• pp.118-126
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• 2021

Background: This study is an analysis of evaluator factors affecting physician-patient interaction (PPI) scores in clinical performance examination (CPX). The purpose of this study was to investigate possible ways to increase the reliability of the CPX evaluation. Methods: The six-item Yeungnam University Scale (YUS), four-item analytic global rating scale (AGRS), and one-item holistic rating scale (HRS) were used to evaluate student performance in PPI. A total of 72 fourth-year students from Yeungnam University College of Medicine in Korea participated in the evaluation with 32 faculty and 16 standardized patient (SP) raters. The study then examined the differences in scores between types of scale, raters (SP vs. faculty), faculty specialty, evaluation experience, and level of fatigue as time passes. Results: There were significant differences between faculty and SP scores in all three scales and a significant correlation among raters' scores. Scores given by raters on items related to their specialty were lower than those given by raters on items out of their specialty. On the YUS and AGRS, there were significant differences based on the faculty's evaluation experience; scores by raters who had three to ten previous evaluation experiences were lower than others' scores. There were also significant differences among SP raters on all scales. The correlation between the YUS and AGRS/HRS declined significantly according to the length of evaluation time. Conclusion: In CPX, PPI score reliability was found to be significantly affected by the evaluator factors as well as the type of scale.

• 한국의료질향상학회지
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• 제4권2호
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• pp.210-221
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• 1997

Background : Willingness to satisfy patients(WSP) among nurses is essential to promoting patient satisfaction which is a critical component in the quality of health care and its outcomes. This study was carried out to empirically find out the affecting factors of WSP among nurses in hospital settings. Methods : The model contains seven job relating determinants and two intervening variables as follows: i) job relating variables of professional status, task requirements, pay, physician-nurse interaction, nurse-nurse interaction, organizational policies, and autonomy, ii) intervening variables of job satisfaction and organizational commitment. Data were collected from 205 nurses in two general hospitals owned by one foundation located in Pusan, Korea, using a structured and self-administered questionnaire. Results : The major results were as follows: First, the results of ANOVA on WPS by personal characteristics showed a statistically significant relationships between WPS and hierarchical orders(p<.01) ana tenure(p<.10). Comparing with the lower orders and shorter tenure, the higher orders and the longer tenure showed better WPS. Second, the results of simple correlation analysis between WPS and determinants and intervening variables showed the following variables, in order of importance, were statistically significant(p<.01): work satisfaction(+), organizational commitment(+), task requirements(+), nurse-interaction(+), professional status(+), physician-nurse interaction(+). Third, the results of path analysis showed that two intervening variables of job satisfaction and organizational commitment, and three determinants of task requirements, professional status, and nurse-nurse interaction had a positively significant direct effect to WPS. Conclusion : The results suggest that nurses who are more satisfied with task requirements, status, nurse-nurse interaction, overall job satisfaction, and organizational commitment, will behave in ways that patients find more satisfied.

• 간호행정학회지
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• 제3권2호
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• pp.123-136
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• 1997

The purpose of this study was to confirm the classification of nursing activity and to analyze the time of nursing workload in a new open hospital. The data were collected from 20 nurses working in 6 general nursing units by 4 trained observers. The tools used for this study were an observation recording sheet and a classification sheet of nursing activity. The classification sheet was constructed to be adaptable to each hospital system based on the instrument described in the literature. The results of the study are as follows : The direct nursing activities consisted of 6 sections, 33 subsections and the indirect nursing activities consisted of 14 sections, 53 subsections. The direct nursing activities included medication, measuring and observation, care of therapies, care of physical comfort, laboratory and treatment. The indirect nursing activities included preparation of medical utensils, collection of information and assessment, recording, phone communication, professional interaction related to patients, personal time, assigning work to staff, patient eaucation and training, interaction with lab, transfer of administration of utensils, checking physician's order, dietary service, management of pollution and contagion, guide direction. Nurses spent 127.6min for direct nursing activity during day duty. It was 24.5% of total nursing activity. Within that activity medication had the highest percentage of time(40.09%), followed by communication and education with patient(24.76%), measuring and observation (16.93%), laboratory and treatment (12.85%), care of therapies(3.21%) and care of physical comfort (2.16%). The time breakdown for indirect nursing activities is as follows ; the preparation of medical utensils 22.3%, collection of information and assessment 20.29%, recording 20.27%, phone communication 8.14%, professional interaction related to patients 7.33%, personal time 7.24%, with the remaining timeshared by staffing, patient education and training, interaction with lab, transfer of administration of utensils, checking physician's order, dietary service, management of pollution and contagion, guide direction. In the analysis of the relationships between the working time and the work allocation characters of the nurses(including nurse's experiences. nurse-patients ratio, nurse-rooms ratio, and character of nursing unit) ; There were no significant differences in direct-indirect nursing times between nurse's career years. There was significant difference in direct nursing time between assigned patient numbers. The nurses assigned larger number of patients spent significantly more time in direct nursing care than that of the smaller. On the other hand, there was no significant difference in indirect nursing workload between the assigned patient numbers. There were no significant differences in direct-indirect nursing time between an allocated patient's room numbers. There was significant difference in working time between working places. The nurse in the medical unit spent more time in direct nursing care than her counterpart in the surgical unit. However there was no difference in direct nursing time between two groups. The study results indicate that nurses spent less time in the direct nursing care than in the previous studies even though the hospital system has been modernized. On the other hand they spent much more time for the coordinating role within the interdisciplinary team and for the overlapping paperwork. Therefore it is recommended that patient oriented job description and more efficient usage of modernized utilities be made.

• 동의생리병리학회지
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• 제29권2호
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• pp.152-159
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• 2015

As for medical education, not only acquirement of knowledge but also practical clinical competence is important because it is needed on primary medicine. Under this trend, Clinical Performance Examination(CPX) is already being practiced in medical college. But in spite of its importance, CPX is not yet practiced in Korean medical college. So, by contemplating necessity and outcome of CPX, We try to offer basic data for future imposition and improvement of CPX in Korean medical education. 49 students of grade 3 in a Daejeon Korean Medical College were targets of investigation. After educated about CPX in advance, They treated simulated patient and answered questionnaire about CPX. Then, their treatment was scored by Professor and simulated patients. Total 49 members responded to the survey and the results of the analysis were as follows. The answer that CPX is useful(Mean=4.12) and essential for acquiring professionalism of treatment(Mean=4.02) was got high scores. But many respondents replied about necessity of better CPX environment and felt difficulty about PPI(45%). Meanwhile, Professor group(Mean=9.24) tended to give more high score than Simulated patient group(Mean=7.94). This study can be very useful for composing basic data of CPX in Korean medical College and improving practical clinical competence of students. But this study has also some limits like area, respondent selection, group module etc. So, more detailed and comprehensive survey is needed. This work was supported by the Daejeon University Research Grant.

• 보건행정학회지
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• 제13권3호
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• pp.21-34
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• 2003

Patient revisit to used hospital is a key factor in determining a health care organization's competitive advantage and survival. This article examines the relationship between customer's satisfaction and his/her revisit associated with three different methods which are the Chi Square Automatic Interaction Detection(CHAID) for segmenting the outpatient group, logistic regression and neural networks for addressing the outpatient's revisit. The main findings indicate that the important factors on outpatient's revisit are physician's kindness, nurse's skill, overall level of satisfaction, hospital reputation, recommendation, level of diagnoses and outpatient's age. Among these ones, physician's kindness is the most important factor as guidelines for decision of their revisit. The decision maker of hospital should select the strategy containing the variable amount of the level of revisit and size of outpatient's group under the constraint on the hospital's time, budget and manpower given. Finally, this study shows that neural networks, as non-parametric technique, appear to more correctly predict revisit than does logistic regression as a parametric estimation technique.