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Lee YM, Kim S, Lee YH, Kim HS, Seo SW, Kim H, Kim KJ. Defining Medical AI Competencies for Medical School Graduates: Outcomes of a Delphi Survey and Medical Student/Educator Questionnaire of South Korean Medical Schools. Acad Med 2024; 99:524-533. [PMID: 38207056 DOI: 10.1097/acm.0000000000005618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Abstract
PURPOSE Given the increasing significance and potential impact of artificial intelligence (AI) technology on health care delivery, there is an increasing demand to integrate AI into medical school curricula. This study aimed to define medical AI competencies and identify the essential competencies for medical graduates in South Korea. METHOD An initial Delphi survey conducted in 2022 involving 4 groups of medical AI experts (n = 28) yielded 42 competency items. Subsequently, an online questionnaire survey was carried out with 1,955 participants (1,174 students and 781 professors) from medical schools across South Korea, utilizing the list of 42 competencies developed from the first Delphi round. A subsequent Delphi survey was conducted with 33 medical educators from 21 medical schools to differentiate the essential AI competencies from the optional ones. RESULTS The study identified 6 domains encompassing 36 AI competencies essential for medical graduates: (1) understanding digital health and changes driven by AI; (2) fundamental knowledge and skills in medical AI; (3) ethics and legal aspects in the use of medical AI; (4) medical AI application in clinical practice; (5) processing, analyzing, and evaluating medical data; and (6) research and development of medical AI, as well as subcompetencies within each domain. While numerous competencies within the first 4 domains were deemed essential, a higher percentage of experts indicated responses in the last 2 domains, data science and medical AI research and development, were optional. CONCLUSIONS This medical AI framework of 6 competencies and their subcompetencies for medical graduates exhibits promising potential for guiding the integration of AI into medical curricula. Further studies conducted in diverse contexts and countries are necessary to validate and confirm the applicability of these findings. Additional research is imperative for developing specific and feasible educational models to integrate these proposed competencies into pre-existing curricula.
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Shim S, Kim H, Lee YM. Scoping review: exploring residents' views of supervisor entrustment and its effect on learning and professional development. Korean J Med Educ 2024; 36:81-98. [PMID: 38462244 PMCID: PMC10925806 DOI: 10.3946/kjme.2024.286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 11/21/2023] [Accepted: 11/27/2023] [Indexed: 03/12/2024]
Abstract
This scoping review aimed to systematically explore the complex and nuanced perceptions of residents entrusted with significant responsibilities by their supervisors in the clinical context. We conducted a comprehensive search strategy targeting six major electronic databases. Data were extracted using the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist and a scoping review protocol. Resident perceptions regarding entrustment and its impact on learning and professional development were categorized. This review elucidated the role of supervisor entrustment in shaping residents' clinical performance, notably influencing autonomy, self-confidence, responsibility for patients, learning needs and goals, uncertainty management, and professional identity formation. Residents identified factors that promote and hinder performance and entrustment development resulting from supervisor entrustment and distinguished between appropriate supervision and over- or under-supervision. Our review suggests that residents' perceptions of supervisor entrustment, as bestowed by supervisors, serves as a catalyst for enhancing autonomy, thereby exerting a significant influence on clinical performance, and fostering the development of a professional identity. However, residents' views on appropriate supervision differ in some ways from supervisors' perspectives. Further research is needed to bridge the gap between residents' expectations of autonomy and what they are given, and to explore the intricate relationship between autonomy and entrustment.
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Affiliation(s)
- Sunhee Shim
- Department of Medical Education, Korea University College of Medicine, Seoul, Korea
| | | | - Young-Mee Lee
- Department of Medical Education, Korea University College of Medicine, Seoul, Korea
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Lee S, Yuh C, Shin YB, Lee HJ, Lee YM, Lee J, Cho CH. Effects of a Rice-Farming Simulation Video Game on Nature Relatedness, Nutritional Status, and Psychological State in Urban-Dwelling Adults During the COVID-19 Pandemic: Randomized Waitlist Controlled Trial. J Med Internet Res 2024; 26:e51596. [PMID: 38252464 PMCID: PMC10845032 DOI: 10.2196/51596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 11/23/2023] [Accepted: 11/30/2023] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND During the COVID-19 pandemic, urban inhabitants faced significant challenges in maintaining connections with nature, adhering to nutritional guidelines, and managing mental well-being. OBJECTIVE Recognizing the urgent need for innovative approaches, this study was designed to explore the potential benefits of a specific digital intervention, the rice-farming simulation game Sakuna: Of Rice and Ruin, for nature relatedness, nutritional behaviors, and psychological well-being. METHODS A total of 66 adults without any prior major psychiatric disorders residing in an urban area were recruited for the study. They were randomly assigned to 2 groups through block randomization: the immediate intervention group (IIG; 34/66, 52%) and the waitlist group (32/66, 48%). Participants in the IIG were instructed to play the game for at least 4 days per week for 3 weeks, with each session lasting from 30 minutes to 3 hours. Assessments were performed at baseline, week 1, and week 3. The Nature Relatedness Scale (NR) and Nutrition Quotient Scale were used to evaluate nature relatedness and nutritional state, respectively. Furthermore, psychological state was assessed using the World Health Organization Quality of Life-Brief Version (WHOQOL-BREF), Brief Fear of Negative Evaluation Scale, Social Avoidance and Distress Scale, Toronto Alexithymia Scale, State-Trait Anxiety Inventory, Center for Epidemiologic Studies Depression Scale Revised, and Korean Resilience Quotient. RESULTS This study's results revealed significant time interactions between the IIG and waitlist group for both the total NR score (P=.001) and the score of the self subdomain of NR (P<.001), indicating an impact of the game on nature relatedness. No group×time interactions were found for the total Nutrition Quotient Scale and subdomain scores, although both groups showed increases from baseline. For psychological state, a significant group×time interaction was observed in the total WHOQOL-BREF score (P=.049), suggesting an impact of the game on quality of life. The psychological (P=.01), social (P=.003), and environmental (P=.04) subdomains of the WHOQOL-BREF showed only a significant time effect. Other psychological scales did not display any significant changes (all P>.05). CONCLUSIONS Our findings suggest that the rice-farming game intervention might have positive effects on nature relatedness, nature-friendly dietary behaviors, quality of life, anxiety, depression, interpersonal relationships, and resilience among urban adults during the COVID-19 pandemic. The impact of pronature games in confined urban environments provides valuable evidence of how digital technologies can be used to enhance urban residents' affinity for nature and psychological well-being. This understanding can be extended in the future to other digital platforms, such as metaverses. TRIAL REGISTRATION Clinical Research Information Service (CRIS) KCT0007657; http://tinyurl.com/yck7zxp7.
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Affiliation(s)
- Seulki Lee
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea
| | - Chisung Yuh
- Department of Medical Education, Korea University College of Medicine, Seoul, Republic of Korea
| | - Yu-Bin Shin
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea
| | - Heon-Jeong Lee
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea
| | - Young-Mee Lee
- Department of Medical Education, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jungsil Lee
- Department of Environmental Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Chul-Hyun Cho
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea
- Department of Biomedical Informatics, Korea University College of Medicine, Seoul, Republic of Korea
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Kim SH, Lee YM. Physician empathy in Korean clinical contexts: developing a conceptual framework and exploring influencing factors. Korean J Med Educ 2023; 35:9-20. [PMID: 36858373 PMCID: PMC10020059 DOI: 10.3946/kjme.2023.245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 01/04/2023] [Accepted: 01/26/2023] [Indexed: 06/18/2023]
Abstract
PURPOSE Despite its well-known clinical importance, physician empathy (PE) has been variably defined and its concepts among cultures are yet to be studied. This study aimed to develop a conceptual framework of PE and explore influencing factors on physicians' empathetic behavior in the Korean clinical context. METHODS Forty-two faculty members and 67 residents participated in the two-round Delphi survey to arrive at a consensus regarding the conceptual framework of PE in 2019. To explore individual and external factors affecting physicians' empathetic behavior, a Likert scale questionnaire based on an initial free-text response was administered to the same participants. RESULTS The conceptual framework of PE among Korean doctors consisted of basic communication skills and attitudes, cognitively understanding of patients' thoughts and emotions, and communicating the doctors' understandings to patients. Individual attributes and system- and patient-factors were revealed as influencing factors for PE in real practice. The former included communication ability, self-awareness and management, humanism, clinical competence, and good personality traits. Excessive workload, time constraints, aggressive attitudes, and negative preconceptions towards doctors were perceived as inhibiting or hindering empathy in patient care. CONCLUSION PE in the Korean clinical context comprised behavioral and cognitive components. Individual attributes, as well as external factors including system- and patient-factors were identified to affect PE in clinical settings. Further studies are needed to enhance the conceptual clarity of PE and identify how to promote doctors' empathetic practice even in less favorable healthcare environments.
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Affiliation(s)
- Su Hyun Kim
- Pukyong National University Industry-University Cooperation Foundation, Busan,
Korea
| | - Young-Mee Lee
- Department of Medical Education, Korea University College of Medicine, Seoul,
Korea
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Lee HK, Yang YS, Kim SK, Vongxay V, Lee YM. Early adolescents’ sexual and reproductive health literacy in Lao PDR. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac130.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Sexual and reproductive health literacy (SRHL) refers to the ability to access, understand, appraise, and apply information for decision-making related to sexual and reproductive health. The low level of SRHL in adolescents increases their sexually risky behaviors and endangers sexual health. Although early adolescence is a critical development period for forming initial views on sexuality and is often a time for attempting risky behaviors, studies on SRHL for early adolescents are fairly limited in Las PDR. As an initial step for the development of a global health project between Lao PDR and South Korea, this study assessed the level of SRHL and the differences in gender among early adolescents in Lao PDR.
Methods
Participants were 235 students conveniently recruited from one junior high school each in two provinces in Lao PDR. SRHL was measured using the 39-item Teen Pregnancy Health Literacy scale consisting of 4 subscales of finding, understanding, appraisal, and application. The scores were classified into inadequate, problematic, sufficient, and excellent using the SRHL index formula. The mean differences in gender were compared using t-test.
Results
The mean of the SRHL scores of the participants was 19.07 (±10.57). The mean score was significantly lower for girls, at 17.67 (±11.22) than for boys, at 21.37 (±9.05) (p = .006). Significant differences were further identified in all four sub-domains of SRHL: finding (p = .025), understanding (p = .005), appraisal (p = .041), and application (p = .029). The majority of participants (91.7%) were categorized as having an ‘inadequate’ or ‘problematic’ level of SRHL.
Conclusions
The level of SRHL among most early adolescents was found to be inadequate. The level of SRHL among girls was much lower than that among boys. The findings suggest a gender-specific approach to developing health education programs to improve SRHL among early adolescents and prevent future sexually risky behaviors in Lao PDR.
Key messages
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Affiliation(s)
- HK Lee
- Nursing, Yonsei University, Seoul , South Korea
| | - YS Yang
- Regional Office, Korea International Cooperation Agency , Vientiane, Laos
| | - SK Kim
- Nursing, Soonchunhyang, Cheonan , South Korea
| | - V Vongxay
- Public Health, University of Health Sciences , Vientiane, Laos
| | - YM Lee
- Nursing, DePaul University , Chicago, USA
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Heisen C, Wychera C, Park H, Lee YM. Tight and loose culture in medical education. Korean J Med Educ 2022; 34:239-241. [PMID: 36070994 PMCID: PMC9452372 DOI: 10.3946/kjme.2022.234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 07/25/2022] [Accepted: 07/27/2022] [Indexed: 06/15/2023]
Affiliation(s)
- Christine Heisen
- Ludwig-Maximilian University, Faculty of Medicine, Munich,
Germany
| | - Chiara Wychera
- Ludwig-Maximilian University, Faculty of Medicine, Munich,
Germany
| | - Hyunmi Park
- Department of Medical Education, Korea University College of Medicine, Seoul,
Korea
| | - Young-Mee Lee
- Department of Medical Education, Korea University College of Medicine, Seoul,
Korea
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Lee YM, Park H, Shin HS, Huh S. Validation of a modified version of Interpersonal Reactivity Index for medical students using Rasch analysis. Teach Learn Med 2022:1-10. [PMID: 35465796 DOI: 10.1080/10401334.2022.2042815] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 01/23/2022] [Accepted: 02/07/2022] [Indexed: 06/14/2023]
Abstract
Construct: Empathy has been accepted to interweave both cognitive aspects (the ability to put oneself in another person's place), and affective (or emotional) aspects, indicating an emotional reaction or response to another person's emotional state. Literature supports the positive influences of empathy on doctor-patient relationship, patient satisfaction, and positive clinical outcomes. Background: Many studies have dealt with the development of empathy measurement tools for physicians and medical students. A frequently used empathy measuring instrument for medical students is the "Interpersonal Reactivity Index" (IRI) which was designed to measure the multi-dimensional aspects of empathy in the general adult population. Most previous literature which validated IRI for medical students has used factor analysis, whilst studies applying Rasch models have been limited. Our study aimed to investigate the psychometric properties of a modified version of IRI for medical students using Rasch analysis. Approach: Medical students (1,293) from 15 medical schools in South Korea participated in an online questionnaire consisting of 28 items of the Korean translated version of IRI. We applied exploratory factor analysis (EFA) using polychoric correlation matrix to determine the optimal number of factors followed by Rasch analysis and McDonald's Omega calculation. Findings: The adapted IRI-MS (IRI for medical students) consisted of 17 items in four dimensions: empathic concern (5), fictitious situation (4), perspective taking (4), and personal distress (4). The overall fit of IRI-MS revealed an acceptable goodness-of-fit for all 17 items and a positive point measure correlation for all items. Reliability indices from the Rasch modeling and McDonald's Omega values of all four dimensions were satisfactory for research. We found the Wright-Andrich maps and category probability curves of the IRI's four dimensions to be less than optimal in measuring empathy levels with adequate precision. Conclusions: Rasch analysis of IRI-MS fell short from being able to prove satisfactory validity in measuring the multidimensional nature of empathy in medical students. However, our study applying Rasch analysis may serve as groundwork for future studies, to further develop from the shortcomings of our findings.
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Affiliation(s)
- Young-Mee Lee
- Department of Medical Education, College of Medicine, Korea University, Seoul, South Korea
| | - Hyunmi Park
- Department of Medical Education, College of Medicine, Korea University, Seoul, South Korea
| | - Hyoung Seok Shin
- Department of Medical Humanities, School of Dentistry, Pusan National University, Yangsan, South Korea
| | - Sun Huh
- Department of Parasitology and Institute of Medical Education, College of Medicine, Hallym University, Chuncheon, South Korea
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Seo JH, Bae HO, Kim BJ, Huh S, Ahn YJ, Jung SS, Kim C, Im S, Kim JB, Cho SJ, Han HC, Lee YM. Burnout of Faculty Members of Medical Schools in Korea. J Korean Med Sci 2022; 37:e74. [PMID: 35257529 PMCID: PMC8901883 DOI: 10.3346/jkms.2022.37.e74] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 02/07/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND There is no national survey on medical school faculty members' burnout in Korea. This study aimed to investigate burnout levels and explore possible factors related to burnout among faculty members of Korean medical schools. METHODS An anonymous online questionnaire was distributed to 40 Korean medical schools from October 2020 to December 2020. Burnout was measured by a modified and revalidated version of the Maslach Burnout Inventory-Human Service Survey. RESULTS A total of 996 faculty members participated in the survey. Of them, 855 answered the burnout questions, and 829 completed all the questions in the questionnaire. A significant number of faculty members showed a high level of burnout in each sub-dimension: 34% in emotional exhaustion, 66.3% in depersonalization, and 92.4% in reduced personal accomplishment. A total of 31.5% of faculty members revealed a high level of burnout in two sub-dimensions, while 30.5% revealed a high level of burnout in all three sub-dimensions. Woman faculty members or those younger than 40 reported significantly higher emotional exhaustion and depersonalization. Long working hours (≥ 80 hours/week) showed the highest reduced personal accomplishment scores (F = 4.023, P = 0.018). The most significant stressor or burnout source was "excessive regulation by the government or university." The research was the most exasperating task, but the education was the least stressful. CONCLUSION This first nationwide study alerts that a significant number of faculty members in Korean medical schools seem to suffer from a high level of burnout. Further studies are necessary for identifying the burnout rate, related factors, and strategies to overcome physician burnout.
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Affiliation(s)
- Ji-Hyun Seo
- Department of Pediatrics and Medical Education, Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Gyeongsang Institute of Health Sciences, Jinju, Korea
| | - Hwa-Ok Bae
- Department of Social Welfare, Gyeongsang National University College of Social Sciences, Jinju, Korea
| | - Bong Jo Kim
- Department of Psychiatry, Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Gyeongsang Institute of Health Sciences, Jinju, Korea
| | - Sun Huh
- Department of Parasitology, Hallym University College of Medicine, Chuncheon, Korea
| | - Young Joon Ahn
- Department of Medical Education, Chosun University School of Medicine, Gwangju, Korea
| | - Sung Soo Jung
- Department of Medical Education, Chungnam National University School of Medicine, Daejeon, Korea
| | - Chanwoong Kim
- Department of Emergency Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Sunju Im
- Department of Medical Education, Pusan National University School of Medicine, Yangsan, Korea
| | - Jae-Bum Kim
- Department of Thoracic and Cardiovascular Surgery, Keimyung University School of Medicine, Daegu, Korea
| | - Seong-Joon Cho
- Department of Thoracic and Cardiovascular Surgery, Kangwon National University Medical School, Chuncheon, Korea
| | - Hee Chul Han
- Korea Association of Medical Colleges, Department of Physiology, Korea University College of Medicine, Seoul, Korea
| | - Young-Mee Lee
- Department of Medical Education, Korea University College of Medicine, Seoul, Korea.
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Monrouxe LV, Chandratilake M, Chen J, Chhabra S, Zheng L, Costa PS, Lee YM, Karnieli-Miller O, Nishigori H, Ogden K, Pawlikowska T, Riquelme A, Sethi A, Soemantri D, Wearn A, Wolvaardt L, Yusoff MSB, Yau SY. Medical Students' and Trainees' Country-By-Gender Profiles: Hofstede's Cultural Dimensions Across Sixteen Diverse Countries. Front Med (Lausanne) 2022; 8:746288. [PMID: 35211478 PMCID: PMC8862177 DOI: 10.3389/fmed.2021.746288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 12/17/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose The global mobility of medical student and trainee populations has drawn researchers' attention to consider internationalization in medical education. Recently, researchers have focused on cultural diversity, predominately drawing on Hofstede's cross-cultural analysis of cultural dimensions from general population data to explain their findings. However, to date no research has been specifically undertaken to examine cultural dimensions within a medical student or trainee population. This is problematic as within-country differences between gender and professional groups have been identified within these dimensions. We address this gap by drawing on the theoretical concept of national context effects: specifically Hofstede's six-dimensional perspective. In doing so we examine medical students' and trainees' country profiles across dimensions, country-by-gender clustering, and differences between our data and Hofstede's general population data. Methods We undertook a cross-cultural online questionnaire study (eight languages) containing Hofstede's 2013 Values Survey. Our questionnaire was live between 1st March to 19th Aug 2018, and December 2018 to mitigate country holiday periods. We recruited undergraduate medical students and trainees with at least 6-months' clinical training using school-specific methods including emails, announcements, and snowballing. Results We received 2,529 responses. Sixteen countries were retained for analyses (n = 2,307, 91%): Australia, Chile, China, Hong Kong, India, Indonesia, Ireland, Israel, Japan, Malaysia, New Zealand, Pakistan, South Africa, South Korea, Sri-Lanka, Taiwan. Power distance and masculinity are homogenous across countries. Uncertainty avoidance shows the greatest diversity. We identified four country clusters. Masculinity and uncertainty are uncorrelated with Hofstede's general population data. Conclusions Our medical student and trainee data provides medical education researchers with more appropriate cultural dimension profiles than those from general population data. Country cluster profiles stimulate useful hypotheses for further research, especially as patterning between clusters cuts across traditional Eastern-Western divides with national culture being stronger than gendered influences. The Uncertainty dimension with its complex pattern across clusters is a particularly fruitful avenue for further investigation.
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Affiliation(s)
- Lynn V Monrouxe
- Faculty of Medicine and Health, The University of Sydney, NSW, Australia.,Chang Gung Medical Education Research Centre, Chang Gung Memorial Hospital, Linkou, Taiwan
| | | | - Julie Chen
- Department of Family Medicine and Primary Care, Bau Institute of Medical and Health Sciences Education, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Shakuntala Chhabra
- Department of Obstetrics and Gynaecology, Mahatma Gandhi Institute of Medical Sciences, Wardha, India
| | - Lingbing Zheng
- Department of Education, Peking University Health Science Center, Beijing, China
| | - Patrício S Costa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Largo do Paço, Portugal.,Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
| | - Young-Mee Lee
- Department of Medical Education, Korea University College of Medicine, Seoul, South Korea
| | - Orit Karnieli-Miller
- Department of Medical Education, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Hiroshi Nishigori
- Center for Medical Education, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kathryn Ogden
- Tasmanian School of Medicine, University of Tasmania, Hobart, Tasmania, TAS, Australia
| | - Teresa Pawlikowska
- Health Professions Education Centre, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Arnoldo Riquelme
- Department of Gastroenterology, Centre for Medical Education and Health Sciences, Department of Health Sciences, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Ahsan Sethi
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Diantha Soemantri
- Department of Medical Education, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.,Medical Education Center, Faculty of Medicine, Indonesian Medical Education and Research Institute, Jakarta, Indonesia
| | - Andy Wearn
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Liz Wolvaardt
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | | | - Sze-Yuen Yau
- Chang Gung Medical Education Research Centre, Chang Gung Memorial Hospital, Linkou, Taiwan
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Shin HS, Park H, Lee YM. The relationship between medical students' empathy and burnout levels by gender and study years. Patient Educ Couns 2022; 105:432-439. [PMID: 34127334 DOI: 10.1016/j.pec.2021.05.036] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 05/14/2021] [Accepted: 05/22/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To investigate the multifaceted factors affecting empathy in medical students. METHODS 1293 medical students from 15 South Korean medical schools participated in an online survey. Affective empathy was measured with the 'empathy concern' and 'personal distress' dimensions from the Interpersonal Reactivity Index for Medical Students (IRI-MS). Cognitive empathy was assessed with IRI-MS' 'perspective taking' and Jefferson Scales for Physician Empathy for Student (JSPE-S). Maslach Burnout Inventory for Medical Students (MBI-MS) assessed the burnout levels of the participants. RESULTS A significant gender difference in affective and cognitive empathy was found using JSPE-S. Different patterns were seen in the empathy dimensions between the study years and genders. Burnout scores showed no gender differences, while exhaustion and cynicism increased, and academic efficacy decreased with seniority. Academic efficacy was a consistently influential factor for both affective and cognitive empathy in both genders, all study years and the three domains of burnout. CONCLUSION Academic efficacy was a significant factor influencing both affective and cognitive empathy. PRACTICAL IMPLICATIONS The comprehensive nature of empathy in medical students may be better investigated by applying multi-dimensional empathy measurement tools and by analyzing multiple factors such as gender, study year and burnout.
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Affiliation(s)
- Hyoung Seok Shin
- Department of Medical Education, Korea University College of Medicine, Seoul, Republic of Korea
| | - Hyunmi Park
- Department of Brain Convergence Research Center, Korea University College of Medicine, Seoul, Republic of Korea
| | - Young-Mee Lee
- Department of Medical Education, Korea University College of Medicine, Seoul, Republic of Korea.
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11
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Park H, Shim S, Lee YM. A scoping review on adaptations of clinical education for medical students during COVID-19. Prim Care Diabetes 2021; 15:958-976. [PMID: 34736876 PMCID: PMC8426188 DOI: 10.1016/j.pcd.2021.09.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 08/30/2021] [Accepted: 09/06/2021] [Indexed: 02/07/2023]
Abstract
Rapid advances in clinical education in response to the COVID-19 pandemic are taking place globally. This scoping review updated the educational strategies which could be applied by clinical educators in their practice to effectively maintain clinical attachment programs for medical students amidst public health crises. Almost all elements of clinical teaching were deliverable, whether it was online, onsite, virtual or blended, their educational effectiveness should be further examined. Increase in the number of telemedicine related publications were remarkable, and they could serve as a scalable model for future educational programs to be incorporated into the medical student curricula.
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Affiliation(s)
- Hyunmi Park
- Department of Medical Education, Korea University College of Medicine, Seoul, Republic of Korea; Department of Brain Convergence Research Center, Korea University College of Medicine, Seoul, Republic of Korea
| | - Sunhee Shim
- Department of Medical Education, Korea University College of Medicine, Seoul, Republic of Korea
| | - Young-Mee Lee
- Department of Medical Education, Korea University College of Medicine, Seoul, Republic of Korea.
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Abstract
Creation of guidelines and education on digital professionalism have been sluggish despite the ever-increasing use of social media by digitally native medical students, who are at risk of blurring the line between their professional and personal lives online. A qualitative thematic analysis was applied on 79 videos extracted from 70,154 YouTube videos uploaded by Korean medical students between March and April 2020. We found 20% contained at least one concerning behavior themed under 'failure to engage,' 'disrespectful behaviors,' or 'poor self-awareness.' Professional lapses identified were classified into seriousness levels. Mostly were "controversial' or 'concerning' but some 'highly concerning' contents were also found. This is the first study on digital professionalism behavior on medical students' YouTube videos. The potential negative impact on the medical profession of the easily accessible public online videos cannot be ignored and thus we suggest the need for them to be taken more seriously.
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Affiliation(s)
- Young-Mee Lee
- Department of Medical Education, Korea University College of Medicine, Seoul, Korea
| | - Jungmin Lee
- Korea University Guro Hospital, Korea University Medicine, Seoul, Korea
| | - Hye Chang Rhim
- Harvard University School of Public Health, Boston, MA, USA
| | - Hyunmi Park
- Department of Brain Convergence Research Center, Korea University College of Medicine, Seoul, Korea.
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13
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Kim SA, Lee YM, Hamann S, Kim SH. Differences in empathy toward patients between medical and nonmedical students: an fMRI study. Adv Health Sci Educ Theory Pract 2021; 26:1207-1227. [PMID: 33877486 PMCID: PMC8056797 DOI: 10.1007/s10459-021-10045-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 03/07/2021] [Indexed: 05/27/2023]
Abstract
There is growing concern about a potential decline in empathy among medical students over time. Despite the importance of empathy toward patients in medicine, it remains unclear the nature of the changes in empathy among medical students. Thus, we systematically investigated affective and cognitive empathy for patients among medical students using neuroscientific approach. Nineteen medical students who completed their fifth-year medical curriculum and 23 age- and sex-matched nonmedical students participated in a functional magnetic resonance imaging study. Inside a brain scanner, all participants read empathy-eliciting scenarios while adopting either the patient or doctor perspective. Brain activation and self-reported ratings during the experience of empathy were obtained. Behavioral results indicated that all participants reported greater emotional negativity and empathic concern in association with the patient perspective condition than with the doctor perspective condition. Functional brain imaging results indicated that neural activity in the posterior superior temporal region implicated in goal-relevant attention reorienting was overall increased under the patient perspective than the doctor perspective condition. Relative to nonmedical students, medical students showed decreased activity in the temporoparietal region implicated in mentalizing under the patient perspective versus doctor perspective condition. Notably, this same region showed increased activity under the doctor versus patient condition in medical students relative to nonmedical students. This study is among the first to investigate the neural mechanisms of empathy among medical students and the current findings point to the cognitive empathy system as the locus of the primary brain differences associated with empathy toward patients.
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Affiliation(s)
- Shin Ah Kim
- Department of Brain and Cognitive Engineering, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, 02841, South Korea
| | - Young-Mee Lee
- Department of Medical Education, Korea University College of Medicine, Seoul, South Korea
| | - Stephan Hamann
- Department of Psychology, Emory University, Atlanta, GA, USA
| | - Sang Hee Kim
- Department of Brain and Cognitive Engineering, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, 02841, South Korea.
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Park H, Lee YM, Ho MJ, Han HC. How the coronavirus disease 2019 pandemic changed medical education and deans' perspectives in Korean medical schools. Korean J Med Educ 2021; 33:65-74. [PMID: 33957729 PMCID: PMC8169373 DOI: 10.3946/kjme.2021.187] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 04/02/2021] [Accepted: 04/04/2021] [Indexed: 05/20/2023]
Abstract
PURPOSE This study explored how the Korean Medical Colleges responded to the coronavirus disease 2019 (COVID-19) pandemic and the medical deans' perspectives on what and how these adaptions influence the present and the future of medical education. METHODS An email survey combining short and open-ended questions was distributed to all 40 Korean school deans in May 2020. Thirty-seven deans out of 40 medical schools in Korea (92.5%) participated. RESULTS Most lectures moved online but students' assessments were delayed and later held onsite. Clinical rotations continued except for an average of 3-week suspension during the first COVID-19 wave. The deans' remarks on the positive influences far outweighed the negative impact of COVID-19 on medical education. Although technological adaptations caused initial hardship, the experience gained through the use of various online learning systems led to attitudinal changes on the importance of adopting new technology and a tailored and student centric curriculum in medical education. CONCLUSION The deans' perspective changes has shown the possibility of the deans' generation aligning more closely with the current Generation Z medical students. They projected further innovations in teaching and learning methods, especially applying flipped learning and highlighted the need to invest in faculty development so medical educators can be equipped and competent in diverse ICT (information and communications technology) learning platforms. Also, the need for advance preparations in medical education for future similar public health crises were stressed. Unprecedented changes brought by COVID-19 positively impacted Korean medical education in parts and the Korean deans envisioned further innovations using the experiences gained during this crisis.
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Affiliation(s)
- Hyunmi Park
- Brain Convergence Research Center, Korea University College of Medicine, Seoul, Korea
| | - Young-Mee Lee
- Department of Medical Education, Korea University College of Medicine, Seoul, Korea
| | - Ming-Jung Ho
- Center for Innovation and Leadership in Education, Georgetown University Medical Center, Washington, DC, USA
| | - Hee-Chul Han
- Department of Physiology, Korea University College of Medicine, Seoul, Korea
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15
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Chen YF, Li D, Lee YM, Lee CC, Huang HY, Tsou CH, Liang HC. Highly efficient solid-state Raman yellow-orange lasers created by enhancing the cavity reflectivity. Opt Lett 2021; 46:797-800. [PMID: 33577517 DOI: 10.1364/ol.415437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 01/08/2021] [Indexed: 06/12/2023]
Abstract
A new, to the best of our knowledge, output coupler (OC) with enhancement of the cavity reflectivity is proposed to remarkably elevate the output powers and efficiencies of diode-pumped Nd:GdVO4/KGW Raman yellow-orange lasers. The cavity reflectivity is effectively increased by using the double-sided dichroic coating on the OC. In comparison with the conventional single-sided coating, the conversion efficiency can be boosted from 15% to 26.3% in the experiment of a yellow laser at 578.8 nm, and the maximum output power can be increased from 5.7 to 10.5 W in the quasi-continuous-wave mode with 50% duty cycle and frequency of 500 Hz. Furthermore, in the operation of an orange laser at 588 nm, the maximum output power can be improved from 5.6 to 7.0 W by replacing the conventional OC with the new one.
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Park J, Park H, Lim JE, Rhim HC, Lee YM. Medical students' perspectives on recommencing clinical rotations during coronavirus disease 2019 at one institution in South Korea. Korean J Med Educ 2020; 32:223-229. [PMID: 32894923 PMCID: PMC7481053 DOI: 10.3946/kjme.2020.170] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 07/21/2020] [Accepted: 08/04/2020] [Indexed: 05/20/2023]
Abstract
PURPOSE Clinical rotations of medical students across the world have inevitably been affected due to the coronavirus disease 2019 (COVID-19) pandemic. The aims of this study were to explore medical students' perception on the school's response and management of clinical rotation during the COVID-19 pandemic and on how it had affected the quality of their education. METHODS An online questionnaire was distributed to third year medical students at one institution whose clinical rotations re-started during the pandemic. The questions asked about the students' satisfaction with the school's policy and feelings of safety, and the impact of COVID-19 on clinical learning. RESULTS The students' perception on the school's response to the pandemic was mixed. Re-commencement of the clinical rotations and procurement of personal protective equipment was positive but a third of students still felt unsafe. The decreased number of hospital patients did not seem to have impacted their overall clinical education with praise on the role of the supervising physicians. Seventy-six-point seven percent of students conferred the positive educational opportunities on medical professionalism presented to them only as the clinical rotation during the ongoing pandemic. CONCLUSION Our observations on the re-commencement of clerkship during this pandemic may help equip medical institutions on future public health crisis.
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Affiliation(s)
- Jewel Park
- Korea University College of Medicine, Seoul, Korea
| | - Hyunmi Park
- Department of Medical Education, Korea University College of Medicine, Seoul, Korea
| | - Ji-Eun Lim
- Korea University College of Medicine, Seoul, Korea
| | - Hye Chang Rhim
- Harvard T.H Chan School of Public Health, Boston, MA, USA
| | - Young-Mee Lee
- Department of Medical Education, Korea University College of Medicine, Seoul, Korea
- Corresponding Author: Young-Mee Lee (https://orcid.org/0000-0002-4685-9465) Department of Medical Education, Korea University College of Medicine, 73 Goryeodae-ro, Seongbuk-gu, Seoul 02841, Korea Tel: +82.2.2286.1098
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Lee YM, Park H, Pyun SB, Yoon YW. Enforced format change to medical education webinar during the coronavirus disease 2019 pandemic. Korean J Med Educ 2020; 32:101-102. [PMID: 32486619 PMCID: PMC7272379 DOI: 10.3946/kjme.2020.158] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 05/18/2020] [Indexed: 05/16/2023]
Affiliation(s)
- Young-Mee Lee
- Department of Medical Education, Korea University College of Medicine, Seoul, Korea
- Corresponding Author: Young-Mee Lee (https://orcid.org/0000-0002-4685-9465) Department of Medical Education, Korea University College of Medicine, 73 Goryeodae-ro, Seongbuk-gu, Seoul 02841, Korea Tel: +82.2.2286.1098
| | - Hyunmi Park
- Department of Surgery, Korea University College of Medicine, Seoul, Korea
| | - Sung-Bom Pyun
- Department of Physical Medicine and Rehabilitation, Korea University College of Medicine, Seoul, Korea
| | - Young Wook Yoon
- Department of Physiology, Korea University College of Medicine, Seoul, Korea
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18
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Affiliation(s)
- Young-Mee Lee
- Department of Medical Education, Korea University College of Medicine, Seoul, Korea
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19
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Samarasekera DD, Lee SS, Findyartini A, Mustika R, Nishigori H, Kimura S, Lee YM. Faculty development in medical education: an environmental scan in countries within the Asia pacific region. Korean J Med Educ 2020; 32:119-130. [PMID: 32486621 PMCID: PMC7272377 DOI: 10.3946/kjme.2020.160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 05/05/2020] [Accepted: 05/06/2020] [Indexed: 06/11/2023]
Abstract
PURPOSE In recent years, faculty development (FD) research is more noticeable within an inter-professional context and in allied health education. However, there is a paucity of published literature on FD medical education programs in Asia. With the formation of the Asia Pacific Medical Education Network (APME-Net) in 2015, a scoping review of an environmental scan of FD medical education programs in main institutions in South East Asia and Australia in 2018 was conducted. METHODS A survey was developed to collect data on FD in medical education after several rounds of discussion with APME-Net members. The representatives from nine countries in Asia and Australia were invited to partner in this research project. They sent the questionnaire to the Dean of all different medical schools after ethical clearance. The data collected was analyzed using descriptive statistics. RESULTS Only institutions in four countries responded to the questionnaire. The medical/health professions education center/department/unit has been established in most educational institutions in these countries. These centers/departments/units mostly carry out FD programs to improve the teaching and learning skills of trained participants, particularly clinical teachers via workshops and seminars. Staffing issues and participant buy-in are the current key priorities of the center/department/unit in terms of FD. Lastly, research related FD program has not been well-supported in these countries, hence, the lack of publication in this area. CONCLUSION Collaboration between countries to address key areas of interest and develop more standardized and productive FD medical education is required especially in research.
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Affiliation(s)
- Dujeepa D. Samarasekera
- Centre for Medical Education, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Shuh Shing Lee
- Centre for Medical Education, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ardi Findyartini
- Department of Medical Education, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Rita Mustika
- Department of Medical Education, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Hiroshi Nishigori
- Center for Medical Education, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | | | - Young-Mee Lee
- Department of Medical Education, Korea University College of Medicine, Seoul, Korea
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Kim K, Kim SH, Yoon H, Shin HS, Lee YM. Correction to: Assessing the effects of an empathy education program using psychometric instruments and brain fMRI. Adv Health Sci Educ Theory Pract 2020; 25:297. [PMID: 31620964 DOI: 10.1007/s10459-019-09929-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Due to an unfortunate turn of events, the funding note was omitted from the original publication. The correct funding note is published here and should be treated as definitive.
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Affiliation(s)
- Kangmoon Kim
- Department of Medical Education, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul, 02841, Korea
| | - Sang Hee Kim
- Department of Brain and Cognitive Engineering, Korea University, Seoul, Korea
| | - HeungSik Yoon
- Department of Brain and Cognitive Engineering, Korea University, Seoul, Korea
| | - Hyoung Seok Shin
- Department of Medical Education, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul, 02841, Korea
| | - Young-Mee Lee
- Department of Medical Education, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul, 02841, Korea.
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21
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Kim K, Kim SH, Yoon H, Shin HS, Lee YM. Assessing the effects of an empathy education program using psychometric instruments and brain fMRI. Adv Health Sci Educ Theory Pract 2020; 25:283-295. [PMID: 31559561 DOI: 10.1007/s10459-019-09918-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 09/13/2019] [Indexed: 06/10/2023]
Abstract
This study aimed to (1) evaluate the effects of an empathy education program, and (2) explore functional magnetic resonance imaging (fMRI) as a potential empathy assessment tool. An empathy enhancement program for premedical students was developed. The Korean version of the Jefferson Scale of Empathy-Student version (JSE-S) and Interpersonal Reactivity Index (K-IRI) were used to measure self-assessed changes in empathy. Clinical vignettes demonstrating empathy tasks were presented to participants undergoing fMRI, to assess regional changes in the brain. Self-reported empathy scores and brain activity signals using fMRI from before and after the program were compared. The JSE-S total and perspective taking scores significantly increased after the program. Data from the fMRI revealed noticeable differences in cognitive regions associated with empathy, namely the right superior medial frontal gyrus and left precentral gyrus. This study results support the prior evidence of positive impact of empathy education. In addition, the authors suggest that brain fMRI might be used in measuring the effectiveness of empathy education.
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Affiliation(s)
- Kangmoon Kim
- Department of Medical Education, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul, 02841, Korea
| | - Sang Hee Kim
- Department of Brain and Cognitive Engineering, Korea University, Seoul, Korea
| | - HeungSik Yoon
- Department of Brain and Cognitive Engineering, Korea University, Seoul, Korea
| | - Hyoung Seok Shin
- Department of Medical Education, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul, 02841, Korea
| | - Young-Mee Lee
- Department of Medical Education, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul, 02841, Korea.
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22
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Chung EK, Lee YM, Chae SJ, Yoon TY, Kim SY, Park SY, Park JY, Park CS. Korean medical students' attitudes toward academic misconduct: a cross-sectional multicenter study. Korean J Med Educ 2019; 31:309-317. [PMID: 31813197 PMCID: PMC6900343 DOI: 10.3946/kjme.2019.141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 10/24/2019] [Accepted: 10/24/2019] [Indexed: 06/10/2023]
Abstract
PURPOSE This study investigated medical students' attitudes toward academic misconduct that occurs in the learning environment during the pre-clinical and clinical periods. METHODS Third-year medical students from seven medical schools were invited to participate in this study. A total of 337 of the 557 (60.5%) students completed an inventory assessing their attitudes toward academic misconduct. The inventory covered seven factors: scientific misconduct (eight items), irresponsibility in class (six items), disrespectful behavior in patient care (five items), dishonesty in clerkship tasks (four items), free riding on group assignments (four items), irresponsibility during clerkship (two items), and cheating on examinations (one item). RESULTS Medical students showed a strict attitude toward academic misconduct such as cheating on examinations and disrespectful behavior in patient care, but they showed a less rigorous attitude toward dishonesty in clerkship tasks and irresponsibility in class. There was no difference in students' attitudes toward unprofessional behaviors by gender. The graduate medical school students showed a stricter attitude toward some factors of academic misconduct than the medical college students. This difference was significant for irresponsibility in class, disrespectful behavior in patient care, and free riding on group assignments. CONCLUSION This study indicates a critical vulnerability in medical students' professionalism toward academic integrity and responsibility. Further study evidence is needed to confirm whether this professionalism lapse is confined only to this population or is pervasive in other medical schools as well.
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Affiliation(s)
- Eun Kyung Chung
- Department of Medical Education, Chonnam National University Medical School, Gwangju, Korea
| | - Young-Mee Lee
- Department of Medical Education, Korea University College of Medicine, Seoul, Korea
| | - Su Jin Chae
- Department of Medical Education, Catholic Kwandong University College of Medicine, Incheon, Korea
| | - Tai Young Yoon
- Department of Medical Education and Medical Humanities, Kyung Hee University School of Medicine, Seoul, Korea
| | - Seok Yong Kim
- Department of Medical Education, Chungbuk National University Medical School, Cheongju, Korea
| | - So Youn Park
- Department of Medical Education and Medical Humanities, Kyung Hee University School of Medicine, Seoul, Korea
| | - Ji-Young Park
- Department of Pathology, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Chang-Shin Park
- Department of Pharmacology, Inha University School of Medicine, Incheon, Korea
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23
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Ellepola K, Truong T, Liu Y, Lin Q, Lim TK, Lee YM, Cao T, Koo H, Seneviratne CJ. Multi-omics Analyses Reveal Synergistic Carbohydrate Metabolism in Streptococcus mutans-Candida albicans Mixed-Species Biofilms. Infect Immun 2019; 87:e00339-19. [PMID: 31383746 PMCID: PMC6759298 DOI: 10.1128/iai.00339-19] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 07/26/2019] [Indexed: 12/25/2022] Open
Abstract
Candida albicans, a major opportunistic fungal pathogen, is frequently found together with Streptococcus mutans in dental biofilms associated with severe childhood caries (tooth decay), a prevalent pediatric oral disease. However, the impact of this cross-kingdom relationship on C. albicans remains largely uncharacterized. Here, we employed a novel quantitative proteomics approach in conjunction with transcriptomic profiling to unravel molecular pathways of C. albicans when cocultured with S. mutans in mixed biofilms. RNA sequencing and iTRAQ (isobaric tags for relative and absolute quantitation)-based quantitative proteomics revealed that C. albicans genes and proteins associated with carbohydrate metabolism were significantly enhanced, including sugar transport, aerobic respiration, pyruvate breakdown, and the glyoxylate cycle. Other C. albicans genes and proteins directly and indirectly related to cell morphogenesis and cell wall components such as mannan and glucan were also upregulated, indicating enhanced fungal activity in mixed-species biofilm. Further analyses revealed that S. mutans-derived exoenzyme glucosyltransferase B (GtfB), which binds to the fungal cell surface to promote coadhesion, can break down sucrose into glucose and fructose that can be readily metabolized by C. albicans, enhancing growth and acid production. Altogether, we identified key pathways used by C. albicans in the mixed biofilm, indicating an active fungal role in the sugar metabolism and environmental acidification (key virulence traits associated with caries onset) when interacting with S. mutans, and a new cross-feeding mechanism mediated by GtfB that enhances C. albicans carbohydrate utilization. In addition, we demonstrate that comprehensive transcriptomics and quantitative proteomics can be powerful tools to study microbial contributions which remain underexplored in cross-kingdom biofilms.
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Affiliation(s)
- K Ellepola
- Oral Sciences, Faculty of Dentistry, National University of Singapore, Singapore
- Center of Oral and Craniofacial Biology, School of Dentistry, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
| | - T Truong
- Oral Sciences, Faculty of Dentistry, National University of Singapore, Singapore
| | - Y Liu
- Biofilm Research Labs, Levy Center for Oral Health, Department of Orthodontics and Divisions of Pediatric Dentistry & Community Oral Health, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Q Lin
- Protein and Proteomic Centre, Department of Biological Sciences, National University of Singapore, Singapore
| | - T K Lim
- Protein and Proteomic Centre, Department of Biological Sciences, National University of Singapore, Singapore
| | - Y M Lee
- Protein and Proteomic Centre, Department of Biological Sciences, National University of Singapore, Singapore
| | - T Cao
- Oral Sciences, Faculty of Dentistry, National University of Singapore, Singapore
| | - H Koo
- Biofilm Research Labs, Levy Center for Oral Health, Department of Orthodontics and Divisions of Pediatric Dentistry & Community Oral Health, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - C J Seneviratne
- National Dental Centre Singapore, Oral Health ACP, SingHealth Duke NUS, Singapore
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Sohn S, Lee YM, Jung J, Cha ES, Chun BC. The flipped classroom model for an undergraduate epidemiology course. Korean J Med Educ 2019; 31:103-113. [PMID: 31230433 PMCID: PMC6589615 DOI: 10.3946/kjme.2019.122] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 04/01/2019] [Accepted: 05/07/2019] [Indexed: 06/09/2023]
Abstract
PURPOSE The flipped classroom has been suggested as a method for efficient teaching in medical education. However, its feasibility and effectiveness in the educational environment are often overlooked. The authors redesigned an epidemiology course applying the flipped classroom method under a traditional curriculum consisting of heavily scheduled classroom hours and explored its feasibility and effectiveness. METHODS In the fall semester of 2017, we flipped the 'practice of epidemiology' course for third-year medical students at Korea University College of Medicine. We provided online lectures and assigned readings as pre-class materials, and substituted group discussions and communicative activities for traditional lectures. We conducted pre- and post-course surveys to review students' perceptions. We also analyzed the pre-test results and final exam scores for quantitative comparison. RESULTS Ninety-seven students out of 120 completed the course. Most students made use of the online lectures, but not the reading materials. Lack of time was the most frequently cited reason for under-preparedness. We observed improvements in preparedness, participation, and effectiveness at the end of the course, while changes in satisfaction were unclear. Students' perceptions of course relevance and difficulty were predictive of pre-test outcomes, but the effects of preparedness and length of materials were insignificant. The authors found no evidence of differing test scores before and after the course. CONCLUSION This study supports the feasibility of the flipped classroom model even under a traditional, heavily scheduled medical curriculum. To encourage self-directed learning and achieve better learning outcomes, restructuring pre-existing curricular components should also be considered in parallel with new instructional methods.
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Affiliation(s)
- Sangho Sohn
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
| | - Young-Mee Lee
- Department of Medical Humanities, Korea University College of Medicine, Seoul, Korea
| | - Jaehun Jung
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
| | - Eun Shil Cha
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
| | - Byung Chul Chun
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
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Lee YM. It is time to reconsider the unnecessary division of premedical and medical studies. Korean J Med Educ 2018; 30:279-281. [PMID: 30522256 PMCID: PMC6288618 DOI: 10.3946/kjme.2018.102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 11/23/2018] [Accepted: 11/23/2018] [Indexed: 05/28/2023]
Affiliation(s)
- Young-Mee Lee
- Department of Medical Education, Korea University College of Medicine, Seoul, Korea
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26
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Chang HJ, Kim HJ, Rhyu IJ, Lee YM, Uhm CS. Emotional experiences of medical students during cadaver dissection and the role of memorial ceremonies: a qualitative study. BMC Med Educ 2018; 18:255. [PMID: 30419880 PMCID: PMC6233563 DOI: 10.1186/s12909-018-1358-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 10/22/2018] [Indexed: 05/09/2023]
Abstract
BACKGROUND It has been well reported that the emotional experiences of medical students in the gross anatomy laboratory could have significant impacts on their professional identity formation. This qualitative study aimed to investigate students' emotions towards cadaver dissection and the educational role of memorial ceremonies. METHODS A total of 37 students from eight teams were recruited in the team-based dissection course during two consecutive academic years (2016 and 2017) at one medical school. In focus group interviews, students were encouraged to express and discuss their emotions regarding cadaver dissection and memorial ceremonies. RESULTS The participants described their apprehension and anxiety during their first encounter with cadavers that diminished through gradual exposure. Unfortunately, their positive emotions such as gratitude and responsibility also tended to decline under the pressure of excessive workloads and frequent examinations. Memorial ceremonies, including not only large-scale events but also daily rituals, had educational effects that they prevented the decline of students' responsibility and respect during the dissection course. CONCLUSION Educators should assist medical students in overcoming their initial distress and maintaining respectful attitudes throughout the dissection course. Memorial ceremonies can be effective educational tools for fostering appropriate attitudes and ethical practice in the gross anatomy laboratory.
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Affiliation(s)
- Hyung-Joo Chang
- Department of Medical Education, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul, 02841 South Korea
| | - Hyun Jung Kim
- Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology, 291 Daehak-ro, Yuseong-gu, Daejeon, 34141 South Korea
| | - Im Joo Rhyu
- Department of Anatomy, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul, 02841 South Korea
| | - Young-Mee Lee
- Department of Medical Education, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul, 02841 South Korea
| | - Chang-Sub Uhm
- Department of Anatomy, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul, 02841 South Korea
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Kim K, Lee YM. Understanding uncertainty in medicine: concepts and implications in medical education. Korean J Med Educ 2018; 30:181-188. [PMID: 30180505 PMCID: PMC6127608 DOI: 10.3946/kjme.2018.92] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 06/27/2018] [Accepted: 07/05/2018] [Indexed: 05/30/2023]
Abstract
In an era of high technology and low trust, acknowledging and coping with uncertainty is more crucial than ever. Medical uncertainty has been considered an innate feature of medicine and medical practice. An intolerance to uncertainty increases physicians' stress and the effects of burnout and may be a potential threat to patient safety. Understanding medical uncertainty and acquiring proper coping strategies has been regarded to be a core clinical competency for medical graduates and trainees. Integrating intuition and logic and creating a culture that acknowledges medical uncertainty could be suggested ways to teach medical uncertainty. In this article, the authors describe the concepts of medical uncertainty, its influences on physicians and on medical students toward medical decision making, the role of tolerance/intolerance to uncertainty, and proposed strategies to improve coping with medical uncertainty.
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Affiliation(s)
- Kangmoon Kim
- Department of Medical Education, Korea University College of Medicine, Seoul, Korea
| | - Young-Mee Lee
- Department of Medical Education, Korea University College of Medicine, Seoul, Korea
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Yun WJ, Kim YG, Lee YM, Lim JY, Kim HJ, Khan MUK, Chang S, Park HS, Kyung CM. Depth extraction with offset pixels. Opt Express 2018; 26:15825-15841. [PMID: 30114838 DOI: 10.1364/oe.26.015825] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 05/27/2018] [Indexed: 06/08/2023]
Abstract
Numerous depth extraction techniques have been proposed in the past. However, the utility of these techniques is limited as they typically require multiple imaging units, bulky platforms for computation, cannot achieve high speed and are computationally expensive. To counter the above challenges, a sensor with Offset Pixel Apertures (OPA) has been recently proposed. However, a working system for depth extraction with the OPA sensor has not been discussed. In this paper, we propose the first such system for depth extraction using the OPA sensor. We also propose a dedicated hardware implementation for the proposed system, named as the Depth Map Processor (DMP). The DMP can provide depth at 30 frames per second at 1920 × 1080 resolution with 31 disparity levels. Furthermore, the proposed DMP has low power consumption as for the aforementioned speed and resolution it only requires 290.76 mW. The proposed system makes it an ideal choice for depth extraction systems in constrained environments.
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Kim MJ, Lee YM, Han JJ, Choi SJ, Hwang TY, Kwon MJ, Kwon HS, Lim MS, Hwang WM, Joo MC, Lee JT, Yang EB. Developing the Korean Association of Medical Colleges graduate outcomes of basic medical education based on "the role of Korean doctor, 2014". Korean J Med Educ 2018; 30:79-89. [PMID: 29860774 PMCID: PMC5990894 DOI: 10.3946/kjme.2018.83] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 05/08/2018] [Accepted: 05/08/2018] [Indexed: 06/08/2023]
Abstract
The Korean Association of Medical Colleges (KAMC) developed graduate outcomes based on "The role of Korean doctor, 2014" to serve as guidelines regarding outcome-based education in Korea. The working group in this study analyzed 65 competencies proposed in "The role of Korean doctor, 2014" according to the developmental principle that certain outcomes should be demonstrated at the point of entry into the graduate medical education. We established 34 competencies as "preliminary graduate outcomes" (PGOs). The advisory committee consisted of 11 professors, who reviewed the validity of PGOs. Ultimately, a total of 19 "revised graduate outcomes" (RGOs) were selected. We modified the RGOs based on opinions from medical schools and a public hearing. In November 2017, the KAMC announced the "graduate outcomes for basic medical education," which serves as a guide for basic medical education for the 40 medical schools throughout Korea. Medical schools can expand the graduate outcomes according to their educational goals and modify them according to their own context. We believe that graduate outcomes can be a starting point for connecting basic medical education to graduate medical education.
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Affiliation(s)
- Min Jeong Kim
- Department of Medical Education and Neurology, Kosin University College of Medicine, Busan, Korea
| | - Young-Mee Lee
- Department of Medical Education, Korea University College of Medicine, Seoul, Korea
| | - Jae Jin Han
- Department of Medical Education, Ewha Womans University School of Medicine, Seoul, Korea
| | - Seok Jin Choi
- Department of Radiology, Inje University College of Medicine, Busan, Korea
| | - Tae-Yoon Hwang
- Department of Preventive Medicine & Public Health, Yeungnam University College of Medicine, Daegu, Korea
| | - Min Jeong Kwon
- Department of Internal Medicine, Inje University College of Medicine, Busan, Korea
| | - Hyouk-Soo Kwon
- Department of Allergy and Clinical Immunology, University of Ulsan College of Medicine, Seoul, Korea
| | - Man-Sup Lim
- Department of Medical Education, Hallym University College of Medicine, Chuncheon, Korea
| | - Won Min Hwang
- Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Korea
| | - Min Cheol Joo
- Department of Rehabilitation Medicine, Wonkwang University School of Medicine, Iksan, Korea
| | - Jong-Tae Lee
- Department of Preventive Medicine, Inje University College of Medicine, Busan, Korea
| | - Eunbae B. Yang
- Department of Medical Education, Yonsei University College of Medicine, Seoul, Korea
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Kim DS, Son E, Lee YS, Lee YM, Park YH, Kim DH, Lee KW. Herbal Complex DKB114 for Hyperuricemia and Gout. Am J Transl Res 2018. [DOI: 10.1055/s-0038-1644979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- DS Kim
- Korean Herbal Medicine Research Division, Korea Institute of Oriental Medicine, 1672 Yuseong-daero, Yuseong-gu, Dajeon 34054, Republic of Korea
| | - E Son
- Korean Herbal Medicine Research Division, Korea Institute of Oriental Medicine, 1672 Yuseong-daero, Yuseong-gu, Dajeon 34054, Republic of Korea
| | - YS Lee
- Korean Herbal Medicine Research Division, Korea Institute of Oriental Medicine, 1672 Yuseong-daero, Yuseong-gu, Dajeon 34054, Republic of Korea
| | - YM Lee
- Korean Herbal Medicine Research Division, Korea Institute of Oriental Medicine, 1672 Yuseong-daero, Yuseong-gu, Dajeon 34054, Republic of Korea
| | - YH Park
- Dongkook Pharmaceutical Co., LTD, Gyeonggi Bio-Center, 147, Gwanggyo-ro, Yeongtong-gu, Suwon-city, Gyeonggi-do, Republic of Korea
| | - DH Kim
- Dongkook Pharmaceutical Co., LTD, Gyeonggi Bio-Center, 147, Gwanggyo-ro, Yeongtong-gu, Suwon-city, Gyeonggi-do, Republic of Korea
| | - KW Lee
- Dongkook Pharmaceutical Co., LTD, Gyeonggi Bio-Center, 147, Gwanggyo-ro, Yeongtong-gu, Suwon-city, Gyeonggi-do, Republic of Korea
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Ha KH, Kim SA, Lee YM, Kim DJ, Lee DH. Can persistent organic pollutants distinguish between two opposite metabolic phenotypes in lean Koreans? Diabetes Metab 2018; 44:168-171. [PMID: 29395811 DOI: 10.1016/j.diabet.2017.12.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 12/02/2017] [Accepted: 12/19/2017] [Indexed: 10/18/2022]
Abstract
AIMS This study investigated the association of persistent organic pollutants (POPs), an emerging new risk factor for type 2 diabetes and the metabolic syndrome, with the presence of opposite phenotypes of glucose and lipid metabolism among normal-weight Koreans of similar body composition. METHODS Fifty subjects, randomly selected from an ongoing community-based cohort study, from two opposite phenotype groups - metabolically unhealthy normal weight (MUHNW) and metabolically healthy normal weight (MHNW) - were matched for waist circumference, visceral fat mass and demographic variables, then compared for serum concentrations of POPs. RESULTS Most POPs (10 out of 13 compounds) were present in higher serum concentrations in the MUHNW than in the MHNW. In particular, serum concentrations of all compounds of the organochlorine pesticide class were 2.2 to 4.7 times higher in cases than in controls. Compared with the lowest tertile of summary measures of POPs, Odds ratios (95% confidence interval) for the second and third tertiles were 7.4 (1.9-29.4) and 10.4 (2.6-41.2), respectively. Adjusting for possible confounders did not change the results. CONCLUSION Taken altogether, these findings from the present and previous studies suggest that increased serum POP concentrations may play an important role in the development of unhealthy metabolic phenotypes in lean people.
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Affiliation(s)
- K H Ha
- Department of Endocrinology and Metabolism, Ajou University, School of Medicine, Suwon, Republic of Korea; Cardiovascular and Metabolic Disease Etiology Research Center, Ajou University School of Medicine, Suwon, Republic of Korea
| | - S A Kim
- Department of Biomedical Science, Kyungpook National University, Daegu, Republic of Korea; BK21 Plus KNU Biomedical Convergence Program, Department of Biomedical Science, Kyungpook National University, Daegu, Republic of Korea
| | - Y M Lee
- Department of Preventive Medicine, School of Medicine, Kyungpook National University, 680, Gukchaebosang-ro Jung-gu, Daegu 41944, Republic of Korea
| | - D J Kim
- Department of Endocrinology and Metabolism, Ajou University, School of Medicine, Suwon, Republic of Korea; Cardiovascular and Metabolic Disease Etiology Research Center, Ajou University School of Medicine, Suwon, Republic of Korea.
| | - D H Lee
- Department of Biomedical Science, Kyungpook National University, Daegu, Republic of Korea; BK21 Plus KNU Biomedical Convergence Program, Department of Biomedical Science, Kyungpook National University, Daegu, Republic of Korea; Department of Preventive Medicine, School of Medicine, Kyungpook National University, 680, Gukchaebosang-ro Jung-gu, Daegu 41944, Republic of Korea.
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Kim DW, Kim CS, Kim HJ, Lee YM, Kim HJ, Kwon KB. The Effect of Germanium Treatment on Rain Shelter House Cultivation of Korean Ginseng (Panax ginseng C. A. Meyer). Am J Transl Res 2017. [DOI: 10.1055/s-0037-1608510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- DW Kim
- Jeollabukdo ARES Medicinal Resource Research Institute, Jinan, Korea, Republic of (South)
| | - CS Kim
- Jeollabukdo ARES Medicinal Resource Research Institute, Jinan, Korea, Republic of (South)
| | - HJ Kim
- Jeollabukdo ARES Medicinal Resource Research Institute, Jinan, Korea, Republic of (South)
| | - YM Lee
- Jeollabukdo ARES Medicinal Resource Research Institute, Jinan, Korea, Republic of (South)
| | - HJ Kim
- Jeollabukdo ARES Medicinal Resource Research Institute, Jinan, Korea, Republic of (South)
| | - KB Kwon
- National Institute of Horticultural & Herbal science, RDA, Eumseong, Korea, Republic of (South)
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Kwon HJ, Lee YM, Lee YH, Chang HJ. Development an instrument assessing residents' attitude towards professionalism lapses in training. Korean J Med Educ 2017; 29:81-91. [PMID: 28597871 PMCID: PMC5465436 DOI: 10.3946/kjme.2017.55] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 03/08/2017] [Accepted: 04/12/2017] [Indexed: 05/28/2023]
Abstract
PURPOSE Medical professionalism is a fundamental competency for all physicians and continuous development of professionalism during residency training is crucial. The purpose of this study was to develop an instrument assessing residents' attitudes toward unprofessional behaviors. METHODS A questionnaire survey was conducted in cooperation with the Korea Resident Association from May to July 2013. A total of 317 residents from seven university-affiliated hospitals in South Korea participated in the survey. RESULTS In the exploratory factor analysis, seven factors were extracted from the data; factor loadings of the 44 items ranged between 0.40 and 0.89. Through iterative discussion, three items below 0.45 were deleted and one additional item was removed due to its irrelevance. Twelve items included in Factor 1 were divided into two different categories. A final version of the questionnaire containing 40 items in eight categories was assessed using confirmatory factor analysis. It was deemed to have a good fit; the root mean square error of approximation and comparative fit index were 0.07 and 0.9, respectively. The reliability (Cronbach's α) of the inventory was 0.97. CONCLUSION The items of this instrument encompass a broad range of residents' behaviors in clinical practice, research, and publication. In addition, it includes some types of misconduct that can be considered unique features of the authors' cultural backgrounds. We recommend this instrument as an assessment tool to diagnose residents' perceptions and attitudes towards professionalism lapses and to provide insight regarding potential improvement in professionalism education.
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Affiliation(s)
| | - Young-Mee Lee
- Corresponding Author: Young-Mee Lee (http://orcid.org/0000-0002-4685-9465) Department of Medical Humanities, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul 02841, Korea Tel: +82.2.920.6098 Fax: +82.2.928.1647
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Chang HJ, Lee YM, Lee YH, Kwon HJ. Causes of resident lapses in professional conduct during the training: A qualitative study on the perspectives of residents. Med Teach 2017; 39:278-284. [PMID: 28019136 DOI: 10.1080/0142159x.2017.1270432] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND The residency is a critical period for doctors to establish their professional identity and ethical standards, and yet during this time, residents are susceptible to engage in a diverse range of unprofessional behaviors. To prevent the misconduct of residents, it is critical to have a thorough understanding of the contributing factors or circumstances. METHODS We conducted a qualitative study on 20 residents at one Korean university-affiliated tertiary hospital. During in-depth interviews, residents were asked to reveal their experiences or observations of misconduct, and describe their perceptions on the attributes of professional lapses. RESULTS Diverse unethical and unprofessional behaviors were extracted from the transcripts and reported in a previous paper. In the current paper, the attributes that residents regarded as the causes of their unprofessional behaviors were identified within four categories: (1) inadequate systems within training hospitals; (2) lack of professionalism education; (3) strong hierarchical structure; and (4) poor character of individuals. The residents tended to perceive their misconduct as situation-sensitive, and emphasized the importance of systematic and cultural changes. CONCLUSIONS To enhance medical professionalism among residents, the results of this study suggest the need of systematic and structured training programs, adequate professionalism education with clear codes of conduct, and active monitoring and feedback systems.
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Affiliation(s)
- Hyung-Joo Chang
- a Department of Medical Humanities , Korea University College of Medicine , Seoul , Korea
| | - Young-Mee Lee
- a Department of Medical Humanities , Korea University College of Medicine , Seoul , Korea
| | - Young-Hee Lee
- a Department of Medical Humanities , Korea University College of Medicine , Seoul , Korea
| | - Hyo-Jin Kwon
- a Department of Medical Humanities , Korea University College of Medicine , Seoul , Korea
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Lee YM. Connect medical education practices and research in Asia with the rest of world. Korean J Med Educ 2017; 29:3-5. [PMID: 28264548 PMCID: PMC5339443 DOI: 10.3946/kjme.2017.47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Revised: 02/17/2016] [Accepted: 02/17/2016] [Indexed: 06/06/2023]
Affiliation(s)
- Young-Mee Lee
- Corresponding Author: Young-Mee Lee (http://orcid.org/0000-0002-4685-9465) Medical Education, Department of Medical Humanities, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul 02841, Korea Tel: +82.2.2286.1098 Fax: +82.2.928.1647
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Kim S, Bochatay N, Relyea-Chew A, Buttrick E, Amdahl C, Kim L, Frans E, Mossanen M, Khandekar A, Fehr R, Lee YM. Individual, interpersonal, and organisational factors of healthcare conflict: A scoping review. J Interprof Care 2017; 31:282-290. [PMID: 28276847 DOI: 10.1080/13561820.2016.1272558] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Unresolved conflicts among healthcare professionals can lead to difficult patient care consequences. This scoping review examines the current healthcare literature that reported sources and consequences of conflict associated with individual, interpersonal, and organisational factors. We identified 99 articles published between 2001 and 2015 from PubMed, Cumulative Index to Nursing and Allied Health Literature, and Excerpta Medical Database. Most reviewed studies relied on healthcare professionals' perceptions and beliefs associated with conflict sources and consequences, with few studies reporting behavioural or organisational change outcomes. Individual conflict sources included personal traits, such as self-focus, self-esteem, or worldview, as well as individuals' conflict management styles. These conflicts posed threats to one's physical, mental, and emotional health and to one's ability to perform at work. Interpersonal dynamics were hampered by colleagues' uncivil behaviours, such as low degree of support, to more destructive behaviours including bullying or humiliation. Perceptions of disrespectful working environment and weakened team collaboration were the main interpersonal conflict consequences. Organisational conflict sources included ambiguity in professional roles, scope of practice, reporting structure, or workflows, negatively affecting healthcare professionals' job satisfactions and intent to stay. Future inquiries into healthcare conflict research may target the following: shifting from research involving single professions to multiple professions; dissemination of studies via journals that promote interprofessional research; inquiries into the roles of unconscious or implicit bias, or psychological capital (i.e., resilience) in healthcare conflict; and diversification of data sources to include hospital or clinic data with implications for conflict sources.
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Affiliation(s)
- Sara Kim
- a Department of Surgery , University of Washington , Seattle , Washington , USA
| | - Naike Bochatay
- b Unit of Development and Research in Medical Education, Faculty of Medicine , University of Geneva , Geneva , Switzerland
| | | | - Elizabeth Buttrick
- a Department of Surgery , University of Washington , Seattle , Washington , USA
| | - Chris Amdahl
- d University of Washington , Seattle , Washington , USA
| | - Laura Kim
- e Compensation & Pension , Loma Linda VA Healthcare System , Loma Linda , California , USA
| | - Elise Frans
- f Wound and Ostomy , University of Washington Medical Center , Seattle , Washington , USA
| | - Matthew Mossanen
- g Department of Urology , University of Washington , Seattle , Washington , USA
| | | | - Ryan Fehr
- h Foster School of Business , University of Washington , Seattle , Washington , USA
| | - Young-Mee Lee
- i Department of Medical Humanities , Korea University College of Medicine , Seoul , South Korea
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Lee YM, Lee SY, Sasaki T, Kim K, Ahn D, Jung MC. Two different phase-change origins with chemical- and structural-phase-changes in C doped (1.5 wt.%) In 3Sb 1Te 2. Sci Rep 2016; 6:38663. [PMID: 27929133 PMCID: PMC5144130 DOI: 10.1038/srep38663] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 11/14/2016] [Indexed: 11/09/2022] Open
Abstract
We fabricated C-doped (1.5 wt.%) In3Sb1Te2 (CIST) thin films with amorphous phase (a-CIST) using a sputter method. Two electrical-phase-changes at 250 and 275 °C were observed in the sheet resistance measurement. In order to understand the origin of these electrical-phase-changes, all samples were characterized by XRD, TEM, and HRXPS with synchrotron radiation. In a-CIST, only weak Sb-C bonding was observed. In the first electrical-phase-change at 250 °C, strong Sb-C bonding occurred without an accompanying structural/phase change (still amorphous). On the other hand, the second electrical-phase-change at 275 °C was due to the structural/phase change from amorphous to crystalline without a chemical state change.
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Affiliation(s)
- Y M Lee
- Beamline Department, Pohang Accelerator Laboratory (PAL), Pohang, 37673, Republic of Korea
| | - S Y Lee
- Beamline Department, Pohang Accelerator Laboratory (PAL), Pohang, 37673, Republic of Korea
| | - T Sasaki
- Biology Resources Section, Research Support Division, Okinawa Institute of Science and Technology Graduate University, Okinawa, 904-0495, Japan
| | - K Kim
- AE Center, Samsung Advanced Institute of Technology, P. O. Box 111, Suwon, 440-600, Korea
| | - D Ahn
- Beamline Department, Pohang Accelerator Laboratory (PAL), Pohang, 37673, Republic of Korea
| | - M-C Jung
- Laboratroy for Organic Electronics, Graduate School of Materials Science, Nara Institute of Science and Technology, Nara, 630-0192, Japan
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Chang HJ, Kang J, Ham BJ, Lee YM. A functional neuroimaging study of the clinical reasoning of medical students. Adv Health Sci Educ Theory Pract 2016; 21:969-982. [PMID: 27230543 DOI: 10.1007/s10459-016-9685-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Accepted: 05/09/2016] [Indexed: 06/05/2023]
Abstract
As clinical reasoning is a fundamental competence of physicians for good clinical practices, medical academics have endeavored to teach reasoning skills to undergraduate students. However, our current understanding of student-level clinical reasoning is limited, mainly because of the lack of evaluation tools for this internal cognitive process. This functional magnetic resonance imaging (fMRI) study aimed to examine the clinical reasoning processes of medical students in response to problem-solving questions. We recruited 24 2nd-year medical students who had completed their preclinical curriculum. They answered 40 clinical vignette-based multiple-choice questions during fMRI scanning. We compared the imaging data for 20 problem-solving questions (reasoning task) and 20 recall questions (recall task). Compared to the recall task, the reasoning task resulted in significantly greater activation in nine brain regions, including the dorsolateral prefrontal cortex and inferior parietal cortex, which are known to be associated with executive function and deductive reasoning. During the recall task, significant activation was observed in the brain regions that are related to memory and emotions, including the amygdala and ventromedial prefrontal cortex. Our results support that medical students mainly solve clinical questions with deductive reasoning involving prior knowledge structures and executive functions. The problem-solving questions induced the students to utilize higher cognitive functions compared with the recall questions. Interestingly, the results suggested that the students experienced some emotional distress while they were solving the recall questions. In addition, these results suggest that fMRI is a promising research tool for investigating students' cognitive processes.
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Affiliation(s)
- Hyung-Joo Chang
- Department of Medical Humanities, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul, 136-705, South Korea
| | - June Kang
- Department of Biomedical Sciences, Korea University College of Medicine, Seoul, South Korea
| | - Byung-Joo Ham
- Department of Psychiatry, Korea University College of Medicine, Seoul, South Korea
| | - Young-Mee Lee
- Department of Medical Humanities, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul, 136-705, South Korea.
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Ahn E, Ahn D, Lee YM. Learners' perspective: where and when pre-residency trainees learn more to achieve their core clinical competencies. Korean J Med Educ 2016; 28:355-371. [PMID: 27907982 PMCID: PMC5138571 DOI: 10.3946/kjme.2016.41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 09/12/2016] [Accepted: 09/22/2016] [Indexed: 06/06/2023]
Abstract
PURPOSE While it is known that effective clinical education requires active involvement of its participants, regular feedback, communication skills and interprofessional training, limited studies have been conducted in Korea that demonstrate how pre-residency trainees acquire their core clinical skills. This is a cross-sectional study of interns and students across a third-tier university hospital in Korea to examine where and when they acquire core clinical skills. METHODS A total of 74 students and 91 interns were asked to participate in a closed-ended questionnaire, and 50 participants (20 students and 30 interns) were involved in semistructured individual interviews. The questionnaire was based on the Accreditation Council for Graduate Medical Education core competencies. RESULTS The majority of core clinical skills were acquired during their rotations in emergency medicine, general surgery, and cardiothoracic surgery. The semistructured interviews revealed that these departments required their trainees to be highly involved and analytical, and participate in clinical discourse. CONCLUSION The common factor among the three departments is an environment in which trainees are highly involved in clinical duties, and are expected to make first-contact patient encounters, participate in clinical discourse, interpret investigative results and arrive at their own conclusions. Work-based learning appear to be key to the trends observed, and further study is warranted to determine whether these findings are indicative of true acquisition of clinical competence.
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Affiliation(s)
- Eusang Ahn
- Department of Medical Humanities, Korea University College of Medicine, Korea University Medical Center, Seoul, Korea
- Department of Emergency Medicine, Korea University Medical Center, Seoul, Korea
| | - Ducksun Ahn
- Department of Medical Humanities, Korea University College of Medicine, Korea University Medical Center, Seoul, Korea
| | - Young-Mee Lee
- Department of Medical Humanities, Korea University College of Medicine, Korea University Medical Center, Seoul, Korea
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Abstract
This study aimed to investigate the role of PIN1 on the hepatic differentiation of human dental pulp stem cells (hDPSCs) and its signaling pathway, as well as the potential therapeutic effects of hDPSC transplantation and PIN1 inhibition on CCl4 (carbon tetrachloride)-induced liver fibrosis in mice. The in vitro results showed that hepatic differentiation was suppressed by infection with adenovirus-PIN1 and promoted by PIN1 inhibitor juglone via the downregulation of Wnt3a and β-catenin. Compared with treatment with either hDPSC transplantation or juglone alone, the combination of hDPSCs and juglone into CCl4-injured mice significantly suppressed liver fibrosis and restored serum levels of alanine transaminase, aspartate transaminase, and ammonia. Collectively, the present study shows for the first time that PIN1 inhibition promotes hepatic differentiation of hDPSCs through the Wnt/β-catenin pathway. Furthermore, juglone in combination with hDPSC transplantation effectively treats liver fibrosis, suggesting that hDPSC transplantation with PIN1 inhibition may be a novel therapeutic candidate for the treatment of liver injury.
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Affiliation(s)
- H J Kim
- 1 Department of Oral Physiology, BK21 PLUS Project, and Institute of Translational Dental Sciences, School of Dentistry, Pusan National University, Yangsan, Republic of Korea
| | - Y A Cho
- 2 Department of Oral and Maxillofacial Pathology, Research Center for Tooth and Periodontal Regeneration, and School of Dentistry, Kyung Hee University, Seoul, Republic of Korea
| | - Y M Lee
- 2 Department of Oral and Maxillofacial Pathology, Research Center for Tooth and Periodontal Regeneration, and School of Dentistry, Kyung Hee University, Seoul, Republic of Korea
| | - S Y Lee
- 2 Department of Oral and Maxillofacial Pathology, Research Center for Tooth and Periodontal Regeneration, and School of Dentistry, Kyung Hee University, Seoul, Republic of Korea
| | - W J Bae
- 2 Department of Oral and Maxillofacial Pathology, Research Center for Tooth and Periodontal Regeneration, and School of Dentistry, Kyung Hee University, Seoul, Republic of Korea
| | - E C Kim
- 2 Department of Oral and Maxillofacial Pathology, Research Center for Tooth and Periodontal Regeneration, and School of Dentistry, Kyung Hee University, Seoul, Republic of Korea
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Park HM, Doster AR, Tashbaeva RE, Lee YM, Lyoo YS, Lee SJ, Kim HJ, Sur JH. Clinical, Histopathological and Immunohistochemical Findings in a Case of Megakaryoblastic Leukemia in a Dog. J Vet Diagn Invest 2016; 18:287-91. [PMID: 16789720 DOI: 10.1177/104063870601800311] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The clinical, hematological, and histopathologic features of megakaryoblastic leukemia (M7) were investigated in a 10-year-old female Shih-Tzu dog. Megakaryoblastic leukemia was diagnosed using anti-human platelet glycoprotein (GP IIIa) and anti-human von Willebrand factor (vWF) antibodies. The expression of CD antigen on megakaryoblasts was also assessed using a CD79a monoclonal antibody. Immunological markers allowed visualization of neoplastic megakaryocytes. Antibodies against platelet GP IIIa were demonstrated to be the most useful for the diagnosis of megakaryoblastic leukemia of paraffin-embedded canine tissues. Hematological and histological data coupled with immunohistochemical reactivity for platelet GP IIIa, vWF, and CD79a antigen in blast cells confirmed a diagnosis of M7 megakaryoblastic leukemia.
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Affiliation(s)
- Hee-Myung Park
- Department of Veterinary Pathology, Small Animal Tumor Diagnostic Center, College of Veterinary Medicine, Konkuk University, Seoul, KwangJin-Ku 143-701, Korea
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Hussain S, Kenigsberg BB, Danahey K, Lee YM, Galecki PM, Ratain MJ, O'Donnell PH. Disease-drug database for pharmacogenomic-based prescribing. Clin Pharmacol Ther 2016; 100:179-90. [PMID: 26940584 DOI: 10.1002/cpt.364] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Revised: 02/04/2016] [Accepted: 02/28/2016] [Indexed: 01/04/2023]
Abstract
Providers have expressed a strong desire to have additional clinical decision-support tools to help with interpretation of pharmacogenomic results. We developed and tested a novel disease-drug association tool that enables pharmacogenomic-based prescribing to treat common diseases. First, 324 drugs were mapped to 484 distinct diseases (mean number of drugs treating each disease was 4.9; range 1-37). Then the disease-drug association tool was pharmacogenomically annotated, with an average of 1.8 pharmacogenomically annotated drugs associated/disease. Applying this tool to a prospectively enrolled >1,000 patient cohort from a tertiary medical center showed that 90% of the top ∼20 diseases in this population and ≥93% of patients could appropriately be treated with ≥1 medication with actionable pharmacogenomic information. When combined with clinical patient genotypes, this tool permits delivery of patient-specific pharmacogenomically informed disease treatment recommendations to inform the treatment of many medical conditions of the US population, a key initial step towards implementation of precision medicine.
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Affiliation(s)
- S Hussain
- Center for Personalized Therapeutics, University of Chicago, Chicago, Illinois, USA
| | - B B Kenigsberg
- Internal Medicine Residency Program, University of Chicago Medical Center, Chicago, Illinois, USA
| | - K Danahey
- Center for Personalized Therapeutics, University of Chicago, Chicago, Illinois, USA.,Center for Research Informatics, University of Chicago, Chicago, Illinois, USA
| | - Y M Lee
- Committee on Clinical Pharmacology and Pharmacogenomics, University of Chicago, Chicago, Illinois, USA
| | - P M Galecki
- Center for Personalized Therapeutics, University of Chicago, Chicago, Illinois, USA
| | - M J Ratain
- Center for Personalized Therapeutics, University of Chicago, Chicago, Illinois, USA.,Committee on Clinical Pharmacology and Pharmacogenomics, University of Chicago, Chicago, Illinois, USA.,Department of Medicine, University of Chicago, Chicago, Illinois, USA
| | - P H O'Donnell
- Center for Personalized Therapeutics, University of Chicago, Chicago, Illinois, USA.,Committee on Clinical Pharmacology and Pharmacogenomics, University of Chicago, Chicago, Illinois, USA.,Department of Medicine, University of Chicago, Chicago, Illinois, USA
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Lee YM, Sung TY, Kim WB, Chung KW, Yoon JH, Hong SJ. Risk factors for recurrence in patients with papillary thyroid carcinoma undergoing modified radical neck dissection. Br J Surg 2016; 103:1020-5. [PMID: 27121346 DOI: 10.1002/bjs.10144] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 11/09/2015] [Accepted: 02/05/2016] [Indexed: 11/08/2022]
Abstract
BACKGROUND This study evaluated the impact of lymph node-related factors on the risk of and site of recurrence in patients who had papillary thyroid carcinoma with lymph node metastasis in the lateral compartment (classified as pN1b). METHODS Patients underwent total thyroidectomy with unilateral modified radical neck dissection for classical papillary thyroid carcinoma. Risk factors for recurrence were evaluated according to the pattern of recurrence. RESULTS A total of 324 patients were included in the study. The median follow-up was 63 (range 14-181) months. Recurrence was detected in 47 patients (14·5 per cent). In the multivariable analysis, a maximum diameter of metastatic lymph nodes larger than 2·0 cm (hazard ratio (HR) 1·15, 95 per cent c.i. 1·06 to 1·25; P = 0·033) and a central compartment metastatic lymph node ratio of more than 0·42 (HR 3·35, 1·65 to 6·79; P < 0·001) were identified as independent risk factors for locoregional recurrence. Age 45 years or older (HR 5·69, 1·24 to 26·12; P = 0·025) and extranodal extension of metastasis (HR 12·71, 1·64 to 98·25; P = 0·015) were risk factors for distant metastasis. In subgroup analysis of locoregional recurrence, several lymph node-related factors affected the risk of recurrence according to the specific site of metastasis. CONCLUSION Lymph node-related factors are of importance for the risk of recurrence in patients with classical papillary thyroid carcinoma classified as pN1b.
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Affiliation(s)
- Y M Lee
- Departments of Surgery, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, Korea
| | - T Y Sung
- Departments of Surgery, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, Korea
| | - W B Kim
- Departments of Internal Medicine, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, Korea
| | - K W Chung
- Departments of Surgery, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, Korea
| | - J H Yoon
- Departments of Surgery, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, Korea
| | - S J Hong
- Departments of Surgery, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, Korea
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Moon BC, Kim WJ, Ji Y, Lee YM, Kang YM, Choi G. Molecular identification of the traditional herbal medicines, Arisaematis Rhizoma and Pinelliae Tuber, and common adulterants via universal DNA barcode sequences. Genet Mol Res 2016; 15:gmr7064. [PMID: 26909979 DOI: 10.4238/gmr.15017064] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Methods to identify Pinelliae Tuber and Arisaematis Rhizoma are required because of frequent reciprocal substitution between these two herbal medicines and the existence of several closely related plant materials. As a result of the morphological similarity of dried tubers, correct discrimination of authentic herbal medicines is difficult by conventional methods. Therefore, we analyzed DNA barcode sequences to identify each herbal medicine and the common adulterants at a species level. To verify the identity of these herbal medicines, we collected five authentic species (Pinellia ternata for Pinelliae Tuber, and Arisaema amurense, A. amurense var. serratum, A. erubescens, and A. heterophyllum for Arisaematis Rhizoma) and six common adulterant plant species. Maturase K (matK) and ribulose-1,5-bisphosphate carboxylase/oxygenase large subunit (rbcL) genes were then amplified using universal primers. In comparative analyses of two DNA barcode sequences, we obtained 45 species-specific nucleotides sufficient to identify each species (except A. erubescens with matK) and 28 marker nucleotides for each species (except P. pedatisecta with rbcL). Sequence differences at corresponding positions of the two combined DNA barcodes provided genetic marker nucleotides that could be used to identify specimens of the correct species among the analyzed medicinal plants. Furthermore, we generated a phylogenetic tree showing nine distinct groups depending on the species. These results can be used to authenticate Pinelliae Tuber and Arisaematis Rhizoma from their adulterants and to identify each species. Thus, comparative analyses of plant DNA barcode sequences identified useful genetic markers for the authentication of Pinelliae Tuber and Arisaematis Rhizoma from several adulterant herbal materials.
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Affiliation(s)
- B C Moon
- K-herb Research Center, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - W J Kim
- K-herb Research Center, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Y Ji
- K-herb Research Center, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Y M Lee
- K-herb Research Center, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Y M Kang
- K-herb Research Center, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - G Choi
- K-herb Research Center, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
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Kwon HJ, Lee YM, Chang HJ, Kim AR. [Needs assessment of a core curriculum for residency training]. Korean J Med Educ 2015; 27:201-212. [PMID: 26330071 PMCID: PMC8813425 DOI: 10.3946/kjme.2015.27.3.201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 07/23/2015] [Accepted: 07/27/2015] [Indexed: 06/05/2023]
Abstract
PURPOSE The core curriculum in graduate medical education (GME) is an educational program that covers the minimum body of knowledge and skills that is required of all residents, regardless of their specialty. This study examined the opinions of stakeholders in GME regarding the core curriculum. METHODS A questionnaire was administered at three tertiary hospitals that were affiliated with one university; 192 residents and 61 faculty members and attending physicians participated in the survey. The questionnaire comprised six items on physician competency and the needs for a core curriculum. Questions on subjects or topics and adequate training years for each topics were asked only to residents. RESULTS Most residents (78.6%) and faculty members (86.9%) chose "medical expertise" as the "doctor's role in the 21st century." In contrast, communicator, manager, and collaborator were recognized by less than 30% of all participants. Most residents (74.1%) responded that a core curriculum is "necessary but not feasible," whereas 68.3% of faculty members answered that it is "absolutely needed." Regarding subjects that should be included in the core curriculum, residents and faculty members had disparate preferences- residents preferred more "management of a private clinic" and "financial management," whereas faculty members desired "medical ethics" and "communication skills." CONCLUSION Residents and faculty members agree that residents should develop a wide range of competencies in their training. However, the perception of the feasibility and opinions on the contents of the core curriculum differed between groups. Further studies with larger samples should be conducted to define the roles and professional competencies of physicians and the needs for a core curriculum in GME.
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Affiliation(s)
| | - Young-Mee Lee
- Corresponding Author: Young-Mee Lee (http://orcid.org/0000-0002-4685-9465) Department of Medical Humanities, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul 136-705, Korea Tel: +82.2.2286.6098 Fax: +82.2.928.1647
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Choi HJ, Lee JC, Lee YM. Hourglass epidermoid inclusion cyst of the hand. J Hand Surg Eur Vol 2015; 40:749-50. [PMID: 24212414 DOI: 10.1177/1753193413511576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- H J Choi
- Department of Plastic and Reconstructive Surgery, College of Medicine, Soonchunhyang University, Cheonan, Korea
| | - J C Lee
- Department of Plastic and Reconstructive Surgery, College of Medicine, Soonchunhyang University, Cheonan, Korea
| | - Y M Lee
- Department of Plastic and Reconstructive Surgery, College of Medicine, Soonchunhyang University, Cheonan, Korea
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Fong SSM, Wong JYH, Chung LMY, Yam TTT, Chung JWY, Lee YM, Chow LPY, Luk WS, Ng SSM. Changes in heart-rate variability of survivors of nasopharyngeal cancer during Tai Chi Qigong practice. J Phys Ther Sci 2015; 27:1577-9. [PMID: 26157266 PMCID: PMC4483444 DOI: 10.1589/jpts.27.1577] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 01/31/2015] [Indexed: 01/08/2023] Open
Abstract
[Purpose] To explore the changes in heart-rate variability (HRV) of survivors of nasopharyngeal cancer (NPC) before, during, and after a Tai Chi (TC) Qigong exercise. [Subjects and Methods] Eleven survivors of NPC participated voluntarily in the study. The heart rate of each participant was measured continuously for 1 minute before the TC Qigong intervention, during the 5-minute TC Qigong intervention, and for 1 minute after the intervention, using a Polar heart-rate monitor. Spectral HRV was expressed in terms of normalised low frequency (LF) power, normalised high frequency (HF) power, and the low frequency/high frequency (LF/HF) power ratio. [Results] Both the LF-power and the HF-power components had significant time effects. However, the time effect of the LF/HF power ratio was not significant. Post hoc contrast analysis revealed a significant decrease in LF power and a concomitant increase in HF power during the 4th minute and 5th minute of the TC Qigong exercise. [Conclusion] Five minutes of TC Qigong exercise was found to improve HRV by increasing HF power and decreasing LF power, but these effects were transient. TC Qigong might be an appropriate exercise for improving the ANS function and psychological and cardiac health of survivors of NPC.
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Affiliation(s)
- Shirley S M Fong
- Institute of Human Performance, The University of Hong Kong: Pokfulam, Hong Kong
| | - Janet Y H Wong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Louisa M Y Chung
- Department of Health and Physical Education, Hong Kong Institute of Education, Hong Kong
| | - Timothy T T Yam
- Department of Physiotherapy, David Trench Rehabilitation Centre, Hong Kong
| | - Joanne W Y Chung
- Department of Health and Physical Education, Hong Kong Institute of Education, Hong Kong
| | | | - Lina P Y Chow
- Department of Health and Physical Education, Hong Kong Institute of Education, Hong Kong
| | - W S Luk
- The Association of Licentiates of the Medical Council of Hong Kong, Hong Kong
| | - Shamay S M Ng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
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Abstract
UNLABELLED PHENOMENON: Medical ethics and professionalism are fundamental competencies for all physicians, and resident physicians have to develop these competencies during their training. Although Korea has a reputation for having the highest quality medical practice in East Asia, improvements in the technological aspects of care have outpaced the developments in institutional systems and education needed to fulfill social responsibility. Enhancing professionalism education during postgraduate training requires thorough exposition of this situation. APPROACH Twenty residents from 17 clinical departments at 1 Korean tertiary university-affiliated hospital were recruited, and in-depth interviews were conducted in person by an interviewer who was a fellow resident with participants. Interviewees recalled and described personal experiences or observations of misbehaviors that had occurred during their residency training. Researchers recorded and transcribed all interviews, and 4 researchers conducted a thematic analysis. FINDINGS Authors extracted 48 descriptors representing 8 categories of unethical and unprofessional behaviors from the transcripts: (a) substandard practice, (b) violation of work ethics, (c) misconduct related to conflict of interest, (d) dishonesty with patients, (e) violation of patient confidentiality, (f) lack of respect for patients, (g) lack of respect for colleagues, and (h) misconduct in research. Each of the interviewees mentioned between 3 and 18 descriptors. "Not fulfilling basic duties for patient care" was the most frequently mentioned misconduct, followed by "fabricating patient medical status or test results to meet preoperative criteria for anesthesia" and "verbal or physical abuse of junior doctors." INSIGHTS: Residents reported a diverse variety of unethical and unprofessional behaviors throughout their training and described the ethical distress they suffered in the real clinical situations. The results of this study support the notion that reinforcing ethics and professionalism education during postgraduate medical training in a practical and authentic way will help trainees manage the ethical conflicts or dilemmas they will inevitably encounter.
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Affiliation(s)
- Hyung-Joo Chang
- a Department of Medical Humanities , Korea University College of Medicine , Seoul , Korea
| | - Young-Mee Lee
- a Department of Medical Humanities , Korea University College of Medicine , Seoul , Korea
| | - Young-Hee Lee
- a Department of Medical Humanities , Korea University College of Medicine , Seoul , Korea
| | - Hyo-Jin Kwon
- a Department of Medical Humanities , Korea University College of Medicine , Seoul , Korea
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Lee YH, Lee YM, Kwon HJ. [Development of a code of professional conduct for medical students and residents]. Korean J Med Educ 2014; 26:321-333. [PMID: 25800239 PMCID: PMC8813438 DOI: 10.3946/kjme.2014.26.4.321] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Revised: 09/24/2014] [Accepted: 09/27/2014] [Indexed: 06/04/2023]
Abstract
PURPOSE The purpose of this study was to describe the development of a code of professional conduct that should be practiced by medical students and residents. METHODS The content of a draft version of a code of professional conduct was generated through extensive literature reviews and the results of surveys that were administered to students and residents. The content validity for the draft version was reviewed by an expert panel: five experts in medical ethics and eight specialists in medical education. The survey was distributed as an email questionnaire and included closed-ended items and open comments. SPSS for Windows version 12.0 (SPSS Inc.) was used for the analysis. RESULTS After analyzing the experts' reviews and holding a reiterative discussion, we developed the final version of a code of conduct for professional behavior. It consists of nine categories and 44 items for students and 44 items for residents. The nine categories were academic integrity, responsibility during clerkship or hospital work, endeavor to improve clinical competency, respect for patients and keeping confidentiality, honesty in patient care, boundary issues and conflicts of interests, impaired physician behaviors, respect for others, and research ethics. CONCLUSION Because our code of conduct for professional behaviors cannot extensively include all aspects of medical professionalism, we focused on behaviors that can be used to monitor and prevent misconduct by medical learners. Further studies and discourse among stakeholders should be performed to develop a national consensus statement or code of conduct to reinforce professionalism for learners in medicine.
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Affiliation(s)
| | - Young-Mee Lee
- Corresponding Author: Young-Mee Lee (http://orcid.org/0000-0002-4685-9465) Department of Medical Humanities, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul 136-705, Korea Tel: +82.2.2286.1098 Fax: +82.2.2286.1104
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Hwang CY, Lee I, Cho Y, Lee YM, Baek K, Jung YJ, Yang YY, Lee T, Rhee TS, Lee HK. Rhodococcus aerolatus sp. nov., isolated from subarctic rainwater. Int J Syst Evol Microbiol 2014; 65:465-471. [PMID: 25385992 DOI: 10.1099/ijs.0.070086-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
A Gram-stain-positive, rod-shaped and non-motile strain, designated PAMC 27367(T), was isolated from rainwater collected on the Bering Sea. Analysis of the 16S rRNA gene sequence of the strain showed an affiliation with the genus Rhodococcus. Phylogenetic analyses revealed that strain PAMC 27367(T) formed a robust clade with the type strains of Rhodococcus rhodnii, Rhodococcus aetherivorans and Rhodococcus ruber with 16S rRNA gene sequence similarities of 96.3 %, 95.8 % and 95.5 %, respectively. Cells of the strain grew optimally at 25 °C and at pH 6.5-7.0 in the presence of 0-2 % (w/v) sea salts. The major polar lipids were diphosphatidylglycerol, phosphatidylglycerol, phosphatidylethanolamine, phosphatidylinositol, phosphatidylinositol mannoside and three unknown phospholipids. The major cellular fatty acids (>10 %) were iso-C16 : 0, C17 : 1ω8c and 10-methyl C17 : 0. Cell wall analysis showed that strain PAMC 27367(T) contained meso-diaminopimelic acid. The genomic DNA G+C content was 77.1 mol%. Based on the phylogenetic, chemotaxonomic and phenotypic data presented here, we propose a novel species with the name Rhodococcus aerolatus sp. nov., with PAMC 27367(T) ( = KCTC 29240(T) = JCM 19485(T)) as the type strain.
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Affiliation(s)
- C Y Hwang
- Division of Polar Life Sciences, Korea Polar Research Institute, 26 Songdomirae-ro, Yeonsu-gu, Incheon 406-840, Republic of Korea
| | - I Lee
- Division of Polar Life Sciences, Korea Polar Research Institute, 26 Songdomirae-ro, Yeonsu-gu, Incheon 406-840, Republic of Korea
| | - Y Cho
- Division of Polar Life Sciences, Korea Polar Research Institute, 26 Songdomirae-ro, Yeonsu-gu, Incheon 406-840, Republic of Korea
| | - Y M Lee
- Division of Polar Life Sciences, Korea Polar Research Institute, 26 Songdomirae-ro, Yeonsu-gu, Incheon 406-840, Republic of Korea
| | - K Baek
- Division of Polar Life Sciences, Korea Polar Research Institute, 26 Songdomirae-ro, Yeonsu-gu, Incheon 406-840, Republic of Korea
| | - Y-J Jung
- Division of Polar Life Sciences, Korea Polar Research Institute, 26 Songdomirae-ro, Yeonsu-gu, Incheon 406-840, Republic of Korea
| | - Y Y Yang
- Division of Polar Life Sciences, Korea Polar Research Institute, 26 Songdomirae-ro, Yeonsu-gu, Incheon 406-840, Republic of Korea
| | - T Lee
- Department of Environmental Science, Hankuk University of Foreign Studies, 81 Oedae-ro, Yongin-si, Gyeonggi-do 449-791, Republic of Korea
| | - T S Rhee
- Division of Polar Ocean Environment, Korea Polar Research Institute, 26 Songdomirae-ro, Yeonsu-gu, Incheon 406-840, Republic of Korea
| | - H K Lee
- Division of Polar Life Sciences, Korea Polar Research Institute, 26 Songdomirae-ro, Yeonsu-gu, Incheon 406-840, Republic of Korea
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