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This preliminary study aimed to determine how medical students perceive character education in Korea. A structured survey questionnaire was distributed to 10 medical students between September and December 2018, of whom 6 students replied. Students’ responses were classified into elements, which were also categorized. Twenty-nine core elements of characters in 8 categories were verified as essential for doctors and as needs for character education. The most frequently suggested categories were “care and respect,” “empathy and communication,” and “responsibility and calling.” Participants also stated that various forms of character education are necessary and that they were not satisfied with the teaching methods of the character education that they had received. These results verified the most essential character traits for doctors and identified problems related to current character education. The results of this study will be helpful for preparing the character education curriculum in medical schools.
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This study assessed the clinical performance of 150 third-year medicalstudents in Busan, Korea in a whole-task emergency objective structured clinical examination station that simulated a patient with palpitations visiting the emergency department. The examination was conducted from November 25 to 27, 2019. Clinical performance was assessed as the number and percentage of students who performed history-taking (HT), a physical examination (PE), an electrocardiography (ECG) study, patient education (Ed), and clinical reasoning (CR), which were items on the checklist. It was found that 18.0% of students checked the patient’s pulse, 51.3% completed an ECG study, and 57.9% explained the results to the patient. A sizable proportion (38.0%) of students did not even attempt an ECG study. In a whole-task emergency station, students showed good performance on HT and CR, but unsatisfactory results for PE, ECG study, and Ed. Clinical skills educational programs for subjected student should focus more on PE, timely diagnostic tests, and sufficient Ed.
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Purpose The aim of this study was to develop and validate a scale to measure nursing students’ readiness for the flipped classroom in Sri Lanka.
Methods A literature review provided the theoretical framework for developing the Nursing Students’ Readiness for Flipped Classroom (NSR-FC) questionnaire. Five content experts evaluated the NSR-FC, and content validity indices (CVI) were calculated. Cross-sectional surveys among 355 undergraduate nursing students from 3 state universities in Sri Lanka were carried out to assess the psychometric properties of the NSR-FC. Principal component analysis (PCA, n=265), internal consistency (using the Cronbach α coefficient, n=265), and confirmatory factor analysis (CFA, n=90) were done to test construct validity and reliability.
Results Thirty-seven items were included in the NSR-FC for content validation, resulting in an average scale CVI of 0.94. Two items received item level CVI of less than 0.78. The factor structures of the 35 items were explored through PCA with orthogonal factor rotation, culminating in the identification of 5 factors. These factors were classified as technological readiness, environmental readiness, personal readiness, pedagogical readiness, and interpersonal readiness. The NSR-FC also showed an overall acceptable level of internal consistency (Cronbach α=0.9). CFA verified a 4-factor model (excluding the interpersonal readiness factor) and 20 items that achieved acceptable fit (standardized root mean square residual=0.08, root mean square error of approximation=0.08, comparative fit index=0.87, and χ2/degrees of freedom=1.57).
Conclusion The NSR-FC, as a 4-factor model, is an acceptable measurement scale for assessing nursing students’ readiness for the flipped classroom in terms of its construct validity and reliability.
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Purpose This study aimed to translate simulation-based dietitian nutritionist education to clinical competency attainment in a group of practicing registered dietitian nutritionists (RDNs). Using a standardized instrument to measure performance on a newly-required clinical skill, the nutrition-focused physical exam (NFPE), competence was measured both before and after a simulation-based education (SBE) session.
Methods Eighteen practicing RDNs were recruited by their employer, Spectrum Health. Following a pre-briefing session, participants completed an initial 10-minute encounter, performing NFPE on a standardized patient (SP). Next, participants completed a 90-minute SBE training session on skills within the NFPE, including hands-on practice and role play, followed by a post-training SP encounter. Video recordings of the SP encounters were scored to assess competence in 7 skill areas within the NFPE. Scores were analyzed for participants’ initial competence and change in competence.
Results The proportions of participants with initial competence ranged from 0% to 44% across the 7 skill areas assessed. The only competency where participants initially scored in the “meets expectations” range was “approach to the patient.” When raw competence scores were assessed for changes from pre- to post-SBE training, the paired t-test indicated significant increases in all 7 competency areas following the simulation-based training (P<0.001).
Conclusion This study showed the effectiveness of a SBE training program for increasing competence scores of practicing RDNs on a defined clinical skill.
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Purpose Consistent evaluation procedures based on objective and rational standards are essential for the sustainability of portfolio-based education, which has been widely introduced in medical education. We aimed to develop and implement a portfolio assessment system, and to assess its validity and reliability.
Methods We developed a portfolio assessment system from March 2019 to August 2019 and confirmed its content validity through expert assessment by an expert group comprising 2 medical education specialists, 2 professors involved in education at medical school, and a professor of basic medical science. Six trained assessors conducted 2 rounds of evaluation of 7 randomly selected portfolios for the “Self-Development and Portfolio II” course from January 2020 to July 2020. These data are used inter-rater reliability was evaluated using intra-class correlation coefficients (ICCs) in September 2020.
Results The portfolio assessment system is based on the following process; assessor selection, training, analytical/comprehensive evaluation, and consensus. Appropriately trained assessors evaluated portfolios based on specific assessment criteria and a rubric for assigning points. In the analysis of inter-rater reliability, the first round of evaluation grades was submitted, and all assessment areas except “goal-setting” showed a high ICC of 0.81 or higher. After the first round of assessment, we attempted to standardize objective assessment procedures. As a result, all components of the assessments showed close correlations, with ICCs of 0.81 or higher.
Conclusion We confirmed that when assessors with an appropriate training conduct portfolio assessment based on specified standards through a systematic procedure, the results are reliable.
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Purpose This study aimed to compare nurses’ perceptions of self-reported pain, the recorded pain score, and pain treatment according to the patient’s facial expression.
Methods In this descriptive cross-sectional survey, the participants were 472 nurses working at a tertiary hospital in Seoul, Korea. A self-report questionnaire presented nurses with a smiling patient complaining of acute post-surgical pain and a grimacing patient with cancer pain, both of whom reported a pain level of 8 out of 10, and asked nurses to indicate their perception of the pain intensity, the pain score that they would record, and the medication that they would provide for each patient.
Results The pain intensity perceived by nurses for the grimacing patient was significantly higher than that for the smiling patient (P<0.001). The recorded pain score was likewise significantly higher for the grimacing patient than for the smiling patient (P<0.001). There was a significant difference in the amount of morphine chosen by the nurses for pain interventions between the smiling and grimacing patients (P=0.040). Higher perceived pain intensity and score were associated with higher administered doses of morphine.
Conclusion These findings suggest that nurses might be affected by patients’ facial expressions when treating pain. A pain management program should be developed that trains nurses to accurately recognize pain hidden in patients’ faces and provides them with the knowledge of how to appropriately assess and manage patients’ pain.
Purpose Breast cancer is one of the most common cancers in women worldwide. Educational and awareness programs impact early practices of breast self-examination, resulting in the early detection of cancer and thereby decreasing mortality. The study aimed to assess the levels of knowledge and awareness of breast cancer and breast self-examination among medical and nursing students in Oman and to compare their knowledge, attitudes, and skills after a training program.
Methods This quasi-experimental study was carried out for female 90 medical and 80 nursing students in Oman in November 2019. A pre-test questionnaire was given before the training program and a post-test questionnaire was administered after the training program. Students’ knowledge, attitude, and skills regarding breast cancer and breast self-examination were compared. Scores for skills of practicing breast self-examination were compared between lecture and activity group and lecture-only group.
Results Pre-test and post-test data were collected from 170 female students. Significant improvements were observed in the post-test scores for students’ knowledge, attitude, and skills after the intervention (P<0.001). The mean scores for skills of practicing breast self-examination after the lecture and the activity were higher than those obtained after the lecture only (P=0.014 for medical students and P=0.016 for nursing students).
Conclusion An educational training program on breast cancer and breast examination with an emphasis on skills can motivate participants to perform breast self-examination regularly, and may therefore help students to train other women to perform breast self-examination for the early detection of breast cancer.
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Purpose This study aims at determining the competencies of Korean nurses in prenatal genetic nursing.
Methods First, a 3-round Delphi survey was conducted to establish prenatal genetic nursing competencies. Second, a prenatal genetic nursing education program (PGNEP), incorporating the findings from the Delphi survey, was designed. Third, a single group pre- and post-quasi-experimental study at a PGNEP workshop was conducted to assess the effectiveness of the integration of the competencies into the PGNEP with the measurements of knowledge about prenatal genetic testing and nursing (K-PGTN) and information needs about prenatal genetic testing and nursing (I-PGTN). Finally, the identified competencies were reexamined for their clarity.
Results Based on the Delphi survey 78 competency components were identified. The components were then classified under 10 categories, which were organized under 4 domains. The domain of “experiential genetic nursing knowledge” and the domain of “ethics and law” were ranked as the first and the second in significance. The quasi-experimental study showed that the mean scores in K-PGTN were significantly increased from 8.19±2.67 to 11.25±2.51 (P<0.001). The mean scores of “ethics and law” in I-PGTN decreased significantly (P=0.023). The headings of 4 categories and 2 domains were revised.
Conclusion This study identified competencies for prenatal genetic nursing and nursing education in Korea. There is a need for nursing instructors and researchers to improve the competencies of nurses in the identified areas. Particular emphasis should be placed on experiential nursing knowledge and on ethics and law related to prenatal genetic nursing.
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Purpose The deterministic inputs, noisy “and” gate (DINA) model is a promising statistical method for providing useful diagnostic information about students’ level of achievement, as educators often want to receive diagnostic information on how examinees did on each content strand, which is referred to as a diagnostic profile. The purpose of this paper was to classify examinees of the Korean Medical Licensing Examination (KMLE) in different content domains using the DINA model.
Methods This paper analyzed data from the KMLE, with 360 items and 3,259 examinees. An application study was conducted to estimate examinees’ parameters and item characteristics. The guessing and slipping parameters of each item were estimated, and statistical analysis was conducted using the DINA model.
Results The output table shows examples of some items that can be used to check item quality. The probabilities of mastery of each content domain were also estimated, indicating the mastery profile of each examinee. The classification accuracy and consistency for 8 content domains ranged from 0.849 to 0.972 and from 0.839 to 0.994, respectively. As a result, the classification reliability of the cognitive diagnosis model was very high for the 8 content domains of the KMLE.
Conclusion This mastery profile can provide useful diagnostic information for each examinee in terms of each content domain of the KMLE. Individual mastery profiles allow educators and examinees to understand which domain(s) should be improved in order to master all domains in the KMLE. In addition, all items showed reasonable results in terms of item parameters.
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Purpose This study aimed to evaluate the level of professional ethics awareness and medical ethics competency in order to assess the potential need for ethics items to be included on the Korean Dental Hygienist Licensing Examination.
Methods In total, 358 clinical dental hygienists and dental hygiene students completed a structured questionnaire to evaluate their level of ethical awareness and medical ethics competency. The sub-factors of medical ethics were classified into relationships with patients, medical and social relations, and individual specialized fields.
Results Only 32.1% of participants indicated that they had taken a course on professional ethics in the university curriculum, but 95.2% of respondents considered professional ethics to be important. The overall score for medical ethics competency was average (3.37 out of 5). The score for relationships with patients was 3.75 points, followed by medical and social relations (3.19 points) and individual specialized fields (3.16 points). The level of professional ethics awareness was higher among participants who had taken a course on professional ethics than among those who had not done so or who did not remember whether they had done so.
Conclusion Dental hygienists were aware of the importance of professional ethics, but their medical ethics competency was moderate. Therefore, medical ethics should be treated as a required subject in the university curriculum, and medical ethics competency evaluations should be strengthened by adding ethics items to the Korean Dental Hygienist Licensing Examination.
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