Educational implications of assessing learning outcomes with multiple choice questions and short essay questions

PURPOSE

This study investigates the characteristics of different item types to assess learning outcomes and explore the educational implications that can be obtained from the results of learning outcome assessments.

METHODS

Forty-five second-year premedical students participated in this study. Multiple choice question (MCQ) and short essay question (SEQ) scores and pass rates for 10 learning outcomes were analyzed. Descriptive statistics and correlation analysis were used to analyze the data.

RESULTS

The correlation analysis indicated that there was a significant correlation between SEQs and pass rate but there was no significant correlation between MCQs and pass rate. Some students with identical scores on the MCQs had different scores on the SEQs or on the learning outcomes.

CONCLUSION

This study showed that students' achievement of learning outcomes can be assessed using various types of questions in outcome-based education.

Accreditation standards items of post-2nd cycle related to the decision of accreditation of medical schools by the Korean Institute of Medical Education and Evaluation

PURPOSE

The purpose of this study is to analyze the accreditation standards items related to the decision of accreditation of medical schools by the Korea Institute of Medical Education and Evaluation (KIMEE).

METHODS

The subjects are medical schools in Korea that have received post-2nd cycle accreditation from the KIMEE between 2012 and 2016. Analyses were conducted for differences in accreditation decisions according to the characteristics of medical schools, sufficient ratios of basic standards items, and correlation between standards items related to accreditation decisions.

RESULTS

After examining differences in accreditation decisions by the medical school's characteristics, there were no significant correlations between accreditation standard items and accreditation decisions. Second, according to the number of schools that sufficiently or insufficiently met each standard item, from the total of 97 standard items, 20 (20.6%) were sufficiently fulfilled by all medical schools. Standard item 2-5-2 demonstrated the highest insufficiency ratio. Third, with respect to the standard item that had an effect on accreditation decisions, standard item 1-5-1 showed the highest correlation with the sufficiency rate.

CONCLUSION

The validity of accreditation standards items was assured as this study evaluated the post-2nd cycle accreditation standards items regardless of each medical school's characteristics. The accreditation standards items were found to have a meaningful impact on the development of medical schools and qualitative improvement in medical education. The findings are expected to contribute to guaranteeing the validity and reliability of accreditation decisions and raising the quality of accreditation.

Medical students' satisfaction on online flipped learning by learning styles

PURPOSE

The purpose of this study was to examine the differences in the medical students' satisfaction on online flipped learning by the learning style.

METHODS

A total of 42 second-year medical students were participated in this study. As study tools, Felder and Soloman's Index of Learning Styles and the Korean Educational Development Institute's National Assessment of Student Engagement in Learning were utilized. Data analysis was conducted with the Kruskal-Wallis test, a nonparametric statistical method.

RESULTS

Results showed that there were statistically significant differences within active-reflective types and sensing-intuitive types. The active-reflective type has been shown to have statistically significant differences for the three effects of learning, such as problem solving and understanding, active participation, and self-directed learning attitudes. For sensing-intuitive type, active participation showed a significant difference from other effects of learning.

CONCLUSION

The learning style is an important concept in understanding the diverse ways in which students process and absorb new information. Hence research is needed to conduct successful small group activities through online. In the future, it is necessary to find the factors that can lead to successful online classes in medical schools.

Exploring the strategies for successfully building e-portfolios in medical schools

PURPOSE

The purpose of this study is to examine the characteristics of resistance among medical students toward e-portfolios and find the strategies for them to successfully prepare e-portfolios.

METHODS

Participants were a group of 258 medical students. The questionnaire comprised 13 items developed based on the innovation resistance theory. The data were analyzed using descriptive analysis and Spearman's correlation analysis using PASW SPSS version 18.0 (SPSS Inc., Chicago, USA).

RESULTS

Students perceived that e-portfolios have a high degree of relative advantage, trialability, and complexity as their innovation resistance characteristics. Regarding perceived risk, they did not want others to see their information, but they had a high degree of demand for communication with their professors.

CONCLUSION

The successful use of portfolios can serve as a tool for student management and assessment that can reflect their introspection, personal development, and academic performance. This study proposed the strategies to promote the use of e-portfolios by strengthening education on the need for them, specific feedback of instructors, and students' autonomy.

Outbreak associated with Rotavirus G11,P[25] in Korea in 2018

We here report the first outbreak caused by rotavirus G11,P[25] in Korea in 2018, representing a case of re-assortment with pig-derived rotavirus. The genotype constellation was identical to the virus identified in Korea in 2012 as G11-P[25]-I12-R1-C1-M1-A1-N1-T1-E1-H1. The infection source was not known exactly but it must be considered infection from swine.

An Outbreak Associated with Sapovirus GI.3 in an Elementary School in Gyeonggi-do, Korea

On October 4, 2018, an outbreak of gastroenteritis associated with sapovirus occurred among elementary school students in Gyeonggi-do, Korea. Epidemiologic studies were conducted in a retrospective cohort approach. Using self-administered questionnaires, we collected information on symptoms and food items consumed. Of the 999 subjects, 17 developed patients that met the case definition. The main symptom was vomiting (100%), and the symptomatic age was 6-12 years. Positive samples were identified by conventional reverse transcription polymerase chain reaction for sequencing. They were classified into genotype GI.3 by phylogenetic analysis. This is the first report of an outbreak associated with sapovirus GI.3 in Korea.

Korean medical students' attitudes toward academic misconduct: a cross-sectional multicenter study

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.

Medical students' satisfaction with clinical clerkship and its relationship with professional self-concept

PURPOSE

Medical students construct their identity as a student physician through clinical clerkship. However, there is a lack of research on the effect of clinical clerkship on professional self-concept formation. The aim of this study is to analyze and ascertain the relationship between medical students' satisfaction with clinical clerkship and professional self-concept.

METHODS

This investigation studied 84 third- and fourth-year medical students enrolled in the Ajou University School of Medicine and Graduate School of Medicine. Study measures tools included satisfaction with clinical clerkship and professional self-concept measurement. For data analyses, a descriptive analysis of the research variable characteristics was applied, gender differences in variables by years of medical school were analyzed with t-tests, and correlation analysis was used to check for relationships between variables.

RESULTS

We found no statistically significant differences between satisfaction with clinical clerkship with respect to medical school year and gender. While professional self-concept did not show significant differences by year of medical school, we observed statistically significant differences by gender with respect to the subscales of professional practice and communication factor. In addition, satisfaction with clinical clerkship and professional self-concept demonstrated statistically significant positive correlation. The present research was able to confirm that there exists a correlation between medical students' clinical clerkship experience and professional self-concept formation.

CONCLUSION

Our study outcomes shows that provision of positive assistance as a measure to enhance satisfaction with clinical clerkship via the curriculum and environmental improvement is envisaged to lead to medical students' professional self-concept formation.

Do basic psychological needs affect student engagement in medical school?

PURPOSE

The purpose of this study is to verify the effect of basic psychological needs of learners on student engagement in medical school.

METHODS

A total of 91 first-year and second-year medical students participated in this study. Their basic psychological needs were determined. Student engagement scales were utilized to determine their engagement. Correlation and multiple regression analyses were conducted.

RESULTS

Basic psychological needs showed a total explanatory power of 13% for student engagement (F=5.27, p<0.01). Competence (β=0.295, p<0.01) had statistically significant effect on student engagement.

CONCLUSION

Results of the present study verified that student engagement could be determined by learner's traits. Among psychological traits of learners, student engagement was significantly affected by competence. Thus, medical school should provide various experiences to satisfy competence as a basic psychological need of learners.

Experiences of medical teachers in flipped learning for medical students: a phenomenological study

PURPOSE

The purpose of this study was to explore the experience of medical teachers in the process of adapting flipped learning method through a phenomenological approach.

METHODS

Semi-structured interviews with five medical teachers from two medical colleges and one medical school were conducted in December, 2017. Data analysis was done according to Colaizzi's descriptive phenomenological methodology.

RESULTS

A total of 160 unique significant statements were extracted. These statements generated 17 formulated meanings that were categorized into seven theme clusters and four theme categories. Main themes were: (1) teacher with high levels of passion and motivation; (2) hurdles of flipped learning: students were still passive, struggling in preparing for flipped learning; (3) positive changes from flipped learning: changes to classroom environment and teachers' reflection through experience; and (4) challenges of flipped learning: remaining tasks for teachers, expansion of flipped learning.

CONCLUSION

Through phenomenological approach, researchers were able to elucidate categories about the experience of medical teachers when attempting flipped learning. Although medical teachers did not have the exact same idea on how flipped learning was conducted and implemented, the perception of flipped learning, or difficulties in class activities, they were still wondering how they could teach students well. This study might draw more attention to flipped learning and stimulate educational and institutional supports to improve teaching and learning in medical schools.

The mediating effect of calling on the relationship between medical school students' academic burnout and empathy

PURPOSE

This study is aimed at identifying the relationships between medical school students' academic burnout, empathy, and calling, and determining whether their calling has a mediating effect on the relationship between academic burnout and empathy.

METHODS

A mixed method study was conducted. One hundred twenty-seven medical students completed a survey. Scales measuring academic burnout, medical students' empathy, and calling were utilized. For statistical analysis, correlation analysis, descriptive statistics analysis, and hierarchical multiple regression analyses were conducted. For qualitative approach, eight medical students participated in a focus group interview.

RESULTS

The study found that empathy has a statistically significant, negative correlation with academic burnout, while having a significant, positive correlation with calling. Sense of calling proved to be an effective mediator of the relationship between academic burnout and empathy.

CONCLUSION

This result demonstrates that calling is a key variable that mediates the relationship between medical students' academic burnout and empathy. As such, this study provides baseline data for an education that could improve medical students' empathy skills.

Potential bias factors that affect the course evaluation of students in preclinical courses

PURPOSE

We aim to identify what potential bias factors affected students' overall course evaluation, and to observe what factors should be considered in the curriculum evaluation system of medical schools.

METHODS

This study analyzed students' ratings of preclinical instructions at the Ajou University School of Medicine. The ratings of instructions involved 41 first-year and 45 second-year medical students.

RESULTS

There was a statistically significant difference between years of study and ratings' scoring. Learning difficulty, learning amount, student assessment, and teacher preparation from second-year students were significantly higher than first-year students (p<0.05). The analysis results revealed that student assessment was the predictor of ratings from first-year students, while teacher preparation was the predictor of ratings from second-year students.

CONCLUSION

We found significant interactions between year of study and the students' rating results. We were able to confirm that satisfaction of instructions factors perceived by medical students were different for the characteristics of courses. Our results may be an important resource for evaluating preclinical curriculums.

Can disclosure of scoring rubric for basic clinical skills improve objective structured clinical examination?

PURPOSE

To determine whether disclosure of scoring rubric for objective basic clinical skills can improve the scores on the objective structured clinical examination (OSCE) in medical students.

METHODS

Clinical performance score results of one university medical students (study group, n=345) were compared to those of another university (control group, n=1,847). Both groups took identical OSCE exam. OSCE rubric was not revealed to the study group until they were in the last 2 years of medical school.

RESULTS

There was no significant difference between before and after disclosure of rubric. However, history taking and physical examination scores of the study group were lower than those of the control group before the disclosure of rubric. After disclosure of rubric, the scores were either unchanged or slightly increased in the control group. Trend analysis of scores demonstrated that history taking and physical examination scores after the disclosure were significantly increased in the study group for 2 years.

CONCLUSION

This study revealed that disclosure of basic clinical skills rubric to medical students could enhance their clinical performance, particularly in history taking and physical examination scores.

Longitudinal analysis of the effect of academic failure tolerance on academic achievement fluctuation in medical school students

PURPOSE

Academic failure tolerance (AFT) is one of the important psychological concepts in education, but its applications in medical education are rare. Thus, the purpose of this study was to investigate the effect of academic failure tolerance on academic achievement fluctuation among medical school students using a longitudinal research design.

METHODS

The subjects were 43 medical students who responded to the AFT test. This study analyzed the longitudinal data of achievement scores up to the 2nd academic year (2012-2013) among students who were divided into academic achievement improvement and decline groups.

RESULTS

Comparing the improvement and decline groups' mean academic achievement fluctuation scores demonstrated that behavior and preferred task difficulty showed high scores whereas feeling scores were lower in the improvement group (p<0.05).

CONCLUSION

In the improvement group, despite the higher negative feeling scores during academic failure, the students favored the more difficult subjects and were more assiduous in their studies. This will form an important basis for enhancing academic achievement among medical students.

The relationship among self-efficacy, perfectionism and academic burnout in medical school students

PURPOSE

The purpose of this study was to examine the relationship among academic self-efficacy, socially-prescribed perfectionism, and academic burnout in medical school students and to determine whether academic self-efficacy had a mediating role in the relationship between perfectionism and academic burnout.

METHODS

A total of 244 first-year and second-year premed medical students and first- to fourth-year medical students were enrolled in this study. As study tools, socially-prescribed perfectionism, academic self-efficacy, and academic burnout scales were utilized. For data analysis, correlation analysis, multiple regression analysis, and hierarchical multiple regression analyses were conducted.

RESULTS

Academic burnout had correlation with socially-prescribed perfectionism. It had negative correlation with academic self-efficacy. Socially-prescribed perfectionism and academic self-efficacy had 54% explanatory power for academic burnout. When socially-prescribed perfectionism and academic self-efficacy were simultaneously used as input, academic self-efficacy partially mediated the relationship between socially-prescribed perfectionism and academic burnout.

CONCLUSION

Socially-prescribed perfectionism had a negative effect on academic self-efficacy, ultimately triggering academic burnout. This suggests that it is important to have educational and counseling interventions to improve academic self-efficacy by relieving academic burnout of medical school students.

Eutectic Bonding Utilizing Radio Frequency Induction Heating for Fabricating Vertical Light-Emitting Diodes

Vertical light-emitting diodes (VLEDs) have attracted considerable attention owing to their improved thermal, electrical, and optical performance compared to conventional LEDs. To fabricate VLEDs, a bonding technique is required following laser lift-off. Eutectic bonding techniques are preferred owing to their low-heat mechanism and production safety. However, the conventional resistance heating method for eutectic bonding process, the extremely longer process time becomes a problem such as cost rise, wapage. In this study, the thermal efficiency was measured according to the diameter of the coil in order to optimize the eutectic bonding of the RF induction heating method in order to solve this problem. We confirmed that successful eutectic bonding is possible with less than 30 min processing using Sn-Glass. In addition, Au (20 wt%)/Sn (80 wt%) alloy, a mainly used the eutectic bonding interlayer material for VLEDs, can also be used as an interlayer to provide void-free eutectic bonding in less than 30 min.

Hybrid Electrodes of Carbon Nanotube and Reduced Graphene Oxide for Energy Storage Applications

The choice of electrode materials in lithium ion batteries and supercapacitors is important for the stability, capacity, and cycle life of the device. Despite its low capacity, graphite has often been used as an electrode material due to its inherent stability. Due to an increasing demand for large-capacity energy storage systems, there is also a demand for the development of large-capacity Li ion batteries and supercapacitors. Therefore, carbonaceous materials like graphene and carbon nanotubes (CNTs), which have high stability as well as excellent electrical conductivity and mechanical strength, are receiving attention as new electrode materials. Recently, starting from simply applying graphene and CNTs as electrode materials and progressing to the development of hybrid materials, there have been increasing research efforts in enhancing the performance of Li ion batteries and supercapacitors through the use of carbonaceous materials. This paper will discuss new composite materials and electrode structures that use graphene and CNTs for applications in Li ion batteries and supercapacitors.

[Factors that influence student ratings of instruction]

PURPOSE

The purpose of this study was to examine the validity of student ratings of instruction by analyzing their relationships with several variables, including gender, academic rank, specialty, teaching time, and teaching method, at a medical school.

METHODS

This study analyzed the student ratings of 297 courses at Ajou University School of Medicine in 2013. SPSS version 12.0 was used to analyze the data and statistics by t-test, analysis of variance, and Scheffe test.

RESULTS

There were no statistically significant differences in student ratings between gender, rank, and specialty. However, student ratings were significantly influenced by teaching times and methods (p<0.05). Student ratings were high for teaching times of 10 hours or more and small-group learning, compared with lectures. There was relatively mean differences in students ratings by teaching times, specialty and rank, although the difference in ratings was not statistically significant.

CONCLUSION

Student ratings can be classified by teaching time and method for summative purposes. To apply student ratings to the evaluation of the performance of faculty, further studies are needed to analyze the variables that influence student ratings.

Association of the interferon-γ gene (CA)n repeat polymorphism with endometriosis

OBJECTIVE

To investigate whether the interferon-γ (IFN-γ) gene (CA)(n) repeat polymorphism is associated with susceptibility to endometriosis.

DESIGN

Case-control study.

SETTING

University Department of Obstetrics and Gynaecology.

POPULATION

Women with (n = 622) and without (n = 442) endometriosis.

METHODS

Genotyping was performed by fluorescent polymerase chain reaction (PCR) and gene-scan analysis.

MAIN OUTCOME MEASURES

Genotype distribution and allele frequency of the dinucleotide (CA)(n) repeat polymorphism in the IFN-γ gene.

RESULTS

Seven alleles (12-18 repeats) of the IFN-γ gene (CA)(n) repeat polymorphism were found. In both patients with endometriosis and controls the most common allele was composed of 13 repeats, followed by an allele of 15 repeats, and then by an allele of 12 repeats. Patients with endometriosis had a significantly higher incidence of genotypes with alleles composed of fewer repeats (12-13 repeats), compared with the controls (92.0 versus 84.4%, respectively, P < 001).

CONCLUSIONS

Our results suggest that the (CA)(n) repeat polymorphism in the IFN-γ gene may be associated with a risk of endometriosis in the South Korean population.

A trend study of student' consistent responses to course evaluation

PURPOSE

Most students choose the same option to questions in course evaluation surveys. Identical answers to each question render the results unreliable. The purpose of this study was to analyze the trend of medical student' consistent responses to course evaluations.

METHODS

The data of this study were the results of a course evaluation over 3 years (from 2006 to 2008) at the School of Medicine at A University.

RESULTS

The proportion of students who replied with the same answers to each question was below 20%. This result was consistent in freshmen, sophomores, and junior students. Using a 5-point Likert scale, more than 40% of the students gave 5 points consistently.

CONCLUSION

We conclude that student' responses to evaluations do not have a significant impact on the reliability of course evaluations at Medical School at A University. These results differ significantly from those of previous research. Hence, future studies are required to analyze course evaluations in medical schools using diverse aspects.

Lack of variation in alphaGal expression on lymphocytes in miniature swine of different genotypes

BACKGROUND

Gal(alpha)1-3Gal epitopes (alphaGal) have been demonstrated to be present on tissues of all pig breeds tested to-date and are the major target for human anti-(alpha)galactosyl (alphaGal) antibodies. We investigated members of an MHC-inbred miniature swine herd to assess whether there was an association between genotype and expression of alphaGal. Identification of a low expressor genotype would potentially enable selective breeding of pigs that might prove beneficial as donors in clinical xenotransplantation.

METHODS

we measured alphaGal expression on various pig cells by use of fluorescent-activated cell sorter (FACS) using (i) purified human anti-alphaGal antibody and (ii) the isolectin GS-I-B4. Initial studies were on porcine peripheral blood mononuclear cells (PBMCs) and subsequent studies on lymphocytes, platelets, and T cell subsets (CD4+ and CD8+ cells).

RESULTS

there was considerable day-to-day variation in alphaGal expression on PBMCs from the same pig. When only lymphocytes were examined, there was a high degree of reproducibility, and no significant difference in alphaGal expression was detected between representative pairs of animlas of three different genotypes. Purified anti-alphaGal antibody bound to different sites on the alphaGal epitope than did Griffonia (Bandeiraea) simplicifolia I-B4 (GS-I-B4). Lectin binding was significantly reduced in the absence of divalent cations. When CD4+ and CD8+ T cells were examined for alphaGal expression, two distinct populations of each type of cell were observed, with larger cells expressing a higher level of alphaGal.

CONCLUSIONS

although the number of pigs of different genotypes studied was small, on the basis of this limited study, pigs of a low alphaGal expressor genotype that could be selectively bred for use in clinical xenotransplantation were not identified.

Pharmacologic immunosuppressive therapy and extracorporeal immunoadsorption in the suppression of anti-alphaGal antibody in the baboon

The aim of this study was to deplete baboons of anti-(alpha)galactosyl (alphaGal] antibody and attempt to maintain depletion by pharmacologic immunosuppressive therapy (PI). In 12 experiments, involving nine baboons, repeated extracorporeal immunoadsorption (EIA) was carried out by plasma perfusion through immunoaffinity columns of synthetic alphaGal trisaccharide type 6. Five of the baboons were immunologically naive and four had undergone various procedures at least 6 months previously. All, however, had recovered lymphohematopoietic function and (with one exception) had levels of anti-alphaGal antibody within the normal range. Eleven protocols included continuous i.v. cyclosporine (to maintain whole blood levels of approximately 1,600 ng/ml). In addition, in ten protocols, the baboon received one or more of the following drugs: cyclophosphamide (1-20 mg/kg/day), mycophenolate mofetil (70-700 mg/ kg/day), brequinar sodium (1-12 mg/kg/day), prednisolone (1 mg/kg/day), melphalan (0.15-0.6 mg/kg/day), methylprednisolone (125 mg/day x3), and antilymphocyte globulin (ATG) (50 mg/kg/day x3). EIA was carried out on 1-9 occasions in each study and was temporarily successful in removing all antibody. When no PI was administered, antibody returned close to pre-EIA levels within 48 hr. Cyclosporine alone delayed the rate of antibody return only slightly. While EIA was continuing on a daily or alternate day schedule, antibody levels (both IgM and IgG) were maintained at 20-45% of pre-EIA levels. Once EIA was discontinued but PI maintained, IgM rose to 40-90% and IgG to 30-60% of pre-EIA levels. In vitro testing demonstrated significant cytotoxicity to pig cells at these antibody levels. We conclude that i) EIA utilizing columns of alphaGal trisaccharide is successful in temporarily depleting baboons of anti-alphaGal antibody, but ii) none of the PI regimens tested suppressed antibody production to levels which would be expected to prevent antibody-mediated rejection of pig xenografts. Additional strategies will therefore be required if xenotransplantation is to become a clinical reality.

A clinical consideration of systemic embolism complicated to infective endocarditis in Korea

OBJECTIVES

Infective endocarditis is still one of the important fatal diseases in Korea, especially when systemic embolisms are supervene. So, identification of patients who are in the high risk of embolism and who can be helped by early surgical intervention is very important. Considering these, we tried to elaborate the risk factors for the systemic embolism in patients with an infective endocarditis and the influence of systemic embolism on the mortality and morbidity in patients with an infective endocarditis.

METHODS

We retrospectively reviewed the clinical records of 97 patients who were admitted with the infective endocarditis between January 1983 and October 1993.

RESULTS

Among 97 patients, 80 patients met our diagnostic criteria. The mean age of patients was 38 years old. There were 43 males and 37 females. The mean duration of fever since the fever developed by history was 38 days. Valvular heart disease was the most frequent underlying heart disease. Mitral regurgitation and aortic regurgitation were the most common among valvular heart diseases. Pneumonia and acute pharyngotonsillitis were the most frequent predisposing factors of infective endocarditis. Blood cultures were positive in 51 patients (63.8%). Streptococcus viridans was the organism isolated most frequently, and Staphylococcus aureus was the second most frequently isolated one. Vegetations were detected in 58 patients (76.3%) by an echocardiography. Mitral valve and aortic valve were the most frequently involved incidence rate of embolism was 50% and the most frequent embolism site was the central nervous system and extremities were the next. Embolism occurred at the mean of 37 days after onset of fever. Overall in-hospital mortality rate was 26.3% and a cardiac-origin was the major cause of death. The only statistically significant risk factor for mortality was systemic embolism. The analysis of the relation between an incidence of embolism and the multivariables (age, presence of vegetation, location of vegetation, size of vegetation, causative organisms) showed that only the growth of Staphylococcus aureus had a significant trend toward a risk of subsequent systemic embolism.

CONCLUSION

This study suggests that systemic emboli increases the mortality rate in patients with infective endocarditis. Age of patients, presence of vegetation, size and location of vegetation are not the risk factors for embolism, while certain organism, especially Staphylococcus aureus, could be a risk factor for the systemic embolism.