Journal of Educational Evaluation for Health Professions

Research articles

Developing clinical skills assessment modules for traditional, complementary, and integrative medicine in Korea: a participatory action research study: Yoonjin Jeong, Seung Hwan Mun, Eunbyul Cho, Hye-Yoon Lee, Sang Woo Shin, Soyeon Kim, Eui-hyoung Hwang, Man-suk Hwang, Eunseok Kim, Jungyun Lee; J Educ Eval Health Prof. 2026;23:10. Published online May 26, 2026; DOI: https://doi.org/10.3352/jeehp.2026.23.10 [Epub ahead of print]

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Abstract PDF Supplementary Material: Purpose
This study aimed to develop pilot clinical skills assessment (CSA) modules for Korean medicine-specific procedures and to examine their preliminary appropriateness, perceived necessity, and feasibility as a foundation for future licensing-related assessment development.
Methods
A participatory action research framework, supplemented by qualitative interviews, was used to develop 4 CSA modules—acupuncture, Chuna manual therapy, pulse diagnosis, and constitutional diagnosis—in collaboration with expert evaluators, students, and standardized patients. The modules were implemented as formative examinations for third-year Korean medicine students, after which semi-structured interviews were conducted to obtain feedback on module content, implementation processes, and scoring procedures. Each module was also reviewed using the RUMBA checklist (Realistic, Understandable, Measurable, Behavioral, and Achievable), together with ratings of perceived necessity and feasibility for possible future use in licensing-related assessment. Interview data were analyzed inductively at the level of individual responses and then compared across modules and participant groups.
Results
Qualitative analysis yielded 3 themes: content and scoring criteria, physical environment or simulators, and education or training. Participants emphasized the need to make key aspects of performance more observable, improve authenticity through simulators or task trainers, and strengthen the capacity of scoring systems to distinguish between levels of student performance. Across all modules, mean RUMBA scores were high in the understandable, behavioral, and achievable domains, whereas measurability was more problematic, especially for pulse diagnosis.
Conclusion
These pilot findings clarify both the strengths and the limitations of Korean medicine-specific CSA modules. The modules received favorable ratings for understandability and achievability, whereas lower ratings for measurability and realism identified priorities for refinement before wider use. This study provides preliminary guidance for the continued development and broader evaluation of Korean medicine-specific performance assessments.

Personality type profiles of medical students and their differences by gender, age, and academic level in Korea: a cross-sectional study: Yera Hur, Sanghee Yeo; J Educ Eval Health Prof. 2026;23:7. Published online April 28, 2026; DOI: https://doi.org/10.3352/jeehp.2026.23.7

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Abstract PDF Supplementary Material: Purpose
Understanding the psychological characteristics of contemporary medical students is essential for effective educational design and learner support. This study aimed to identify medical students’ personality types using a geometric personality assessment tool (GEOPIA), determine whether differences exist by gender, age, or academic level, and explore the practical utility of such profiling for supporting educational practices in medical school settings.
Methods
The 40-item Korean Geometric Psychological Assessment (GEOPIA) was administered to 1,173 students across 5 Korean medical schools. GEOPIA classifies individuals into 4 primary types—Round (sociable, relationship-oriented), Triangle (task-oriented, challenging), Box (prudent, stability-seeking), and Curve (creative, sensitive). Frequency analyses and χ² tests were conducted. Of the 1,016 respondents (response rate, 86.61%), 981 were included in the final analysis.
Results
The most common primary type was Round (40.3%), followed by Box (31.7%), Triangle (15.2%), and Curve (12.8%). Across the 12 combined profiles, Round–Box (21.9%) was the most prevalent, followed by Box–Round (19.0%) and Round–Triangle (9.7%). No significant differences were observed by gender (χ²=6.360, P=0.095, Cramer’s V=0.082), age (χ²=11.454, P=0.490, Cramer’s V=0.065), or academic level (χ²=18.044, P=0.260, Cramer’s V=0.078).
Conclusion
GEOPIA may provide a practical tool for identifying learner characteristics and supporting educational decision-making in medical school settings. In instructional design, personality-type data can inform group formation, activity planning, and assignment structure. In student support, the tool offers instructors and advisors a quick way to understand learners’ characteristics, which may help guide individualized counseling and promote effective learning experiences.

Evaluation of an infectious‑disease response training program for primary care physicians in Korea using Kirkpatrick’s 4 levels and the Context, Input, Process, and Product model: a mixed‑methods study: Kyung Hee Chun, Jin Seo Lee, Seon Young Jeong, Young Soon Park; J Educ Eval Health Prof. 2025;22:40. Published online December 31, 2025; DOI: https://doi.org/10.3352/jeehp.2025.22.40

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Abstract PDF Supplementary Material: Purpose
This study systematically evaluated the effectiveness of a training program designed to enhance infectious disease response capabilities among primary care physicians. Using a mixed-methods design, the evaluation applied Kirkpatrick’s 4-level model and the Context, Input, Process, and Product (CIPP) framework to assess program outcomes and identify areas for improvement.
Methods
The study focused on a national infectious disease training program for primary care physicians conducted in 2022 (N=1,718). Quantitative pre- and post-training data were analyzed from 100 randomly selected participants, along with qualitative data obtained through in-depth interviews with 10 participants. Validated assessment tools, developed by psychometricians and content experts, were used to measure satisfaction (Kirkpatrick level 1), learning achievement (level 2), practical application (level 3), and organizational contribution (level 4).
Results
Overall training satisfaction was high (3.96±0.72). Learning achievement (level 2) demonstrated statistically significant improvement from pre-training to post-training assessments (F=12.922, P<0.001). Scores for practical application (level 3; 3.19±0.86) and organizational contribution (level 4; 3.47±0.70) indicated both strong motivation to apply newly acquired knowledge and institutional readiness to implement response strategies.
Conclusion
This study confirmed that the training program effectively enhanced both individual competencies and organizational response capacity across all 4 Kirkpatrick levels. The integrated application of the Kirkpatrick and CIPP models provided a robust framework for evaluating learning transfer and guiding program improvement. These findings highlight the importance of continued investment in diverse training initiatives, systematic evaluation processes, and the dissemination of successful practices to the broader healthcare community.

The impact of differential item functioning on ability estimation using the Korean Medical Licensing Examination with computerized adaptive testing: a post-hoc simulation study: Dogyeong Kim, Jeongwook Choi, Dong Gi Seo; J Educ Eval Health Prof. 2025;22:31. Published online October 10, 2025; DOI: https://doi.org/10.3352/jeehp.2025.22.31

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Abstract PDF Supplementary Material: Purpose
This study examined the impact of differential item functioning (DIF) on ability estimation in a computerized adaptive testing (CAT) environment using real response data from the 2017 Korean Medical Licensing Examination (KMLE). We hypothesized that excluding gender-based DIF items would improve estimation accuracy, particularly for examinees at the extremes of the ability scale.
Methods
The study was conducted in 2 steps: (1) DIF detection and (2) post-hoc simulation. The analysis used data from 3,259 examinees who completed all 360 dichotomous items. Gender-based DIF was detected with the residual-based DIF method (reference group: males; focal group: females). Two CAT conditions (all items vs. DIF-excluded) were compared against a “true θ” estimated from a fixed-form test of 264 non-DIF items. Accuracy was evaluated using bias, root mean square error (RMSE), and correlation with true θ.
Results
In the CAT condition excluding DIF items, accuracy improved, with RMSE reduced and correlation with true θ increased. However, bias was slightly larger in magnitude. Gender-specific analyses showed that DIF removal reduced the underestimation of female ability but increased the underestimation of male ability, yielding estimates that were fairer across genders. When DIF items were included, estimation errors were more pronounced at both low and high ability levels.
Conclusion
Managing DIF in CAT-based high-stakes examinations can enhance fairness and precision. Using real examinee data, this study provides practical evidence of the implications of DIF for CAT-based measurement and supports fairness-oriented test design.

Technical report

Feasibility of applying computerized adaptive testing to the Clinical Medical Science Comprehensive Examination in Korea: a psychometric study: Jeongwook Choi, Sung-Soo Jung, Eun Kwang Choi, Kyung Sik Kim, Dong Gi Seo; J Educ Eval Health Prof. 2025;22:29. Published online October 1, 2025; DOI: https://doi.org/10.3352/jeehp.2025.22.29

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Abstract PDF Supplementary Material: Purpose
This study aimed to investigate the feasibility of transitioning the Clinical Medical Science Comprehensive Examination (CMSCE) to computerized adaptive testing (CAT) in Korea, thereby providing greater opportunities for medical students to accurately compare their clinical competencies with peers nationwide and to monitor their own progress.
Methods
A medical self-assessment using CAT was conducted from March to June 2023, involving 1,541 medical students who volunteered from 40 medical colleges in Korea. An item bank consisting of 1,145 items from previously administered CMSCE examinations (2019–2021) hosted by the Medical Education Assessment Corporation was established. Items were selected through 2-stage filtering, based on classical test theory (discrimination index above 0.15) and item response theory (discrimination parameter estimates above 0.6 and difficulty parameter estimates between –5 and +5). Maximum Fisher information was employed as the item selection method, and maximum likelihood estimation was used for ability estimation.
Results
The CAT was successfully administered without significant issues. The stopping rule was set at a standard error of measurement of 0.25, with a maximum of 50 items for ability estimation. The mean ability score was 0.55, with an average of 28 items administered per student. Students at extreme ability levels reached the maximum of 50 items due to the limited availability of items at appropriate difficulty levels.
Conclusion
The medical self-assessment CAT, the first of its kind in Korea, was successfully implemented nationwide without significant problems. These results indicate strong potential for expanding the use of CAT in medical education assessments.

Research articles

Proposal for setting a passing score for the Korean Nursing Licensing Examination: Janghee Park, Mi Kyoung Yim, Sujin Shin, Rhayun Song, Jun-Ah Song, Inyoung Lee, Heejeong Kim, Minjae Lee; J Educ Eval Health Prof. 2025;22:25. Published online September 8, 2025; DOI: https://doi.org/10.3352/jeehp.2025.22.25

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Abstract PDF Supplementary Material: Purpose
The Korean Nursing Licensing Examination (KNLE) is planning to transition to a computer-based test (CBT). This study aims to propose a reasonable and efficient method for setting passing scores.
Methods
A standard-setting (passing score setting) analysis was conducted using an expert panel over the past 3 years of the national nursing examination. The standard-setting method was modified from Angoff, and the validity of the passing score was verified through the Hofstee method. The standard-setting workshop was conducted in 2 stages: first, a pilot workshop for 2 subjects, followed by a second workshop where 6 additional subjects were selected based on the pilot results. For items with an actual correct answer rate of 90% or higher, the estimated correct answer rate for minimum competency was calculated using the observed correct answer rate. A survey and discussion with the expert panel were also conducted regarding the standard-setting procedures and results.
Results
The passing score for the national nursing examination was calculated using the new method, and the score was slightly higher than the existing score. The nursing subject had similar results; however, the legal subjects varied.
Conclusion
The modified Angoff and Hofstee methods were successfully applied to the KNLE. Using the actual correct answer rate as an indicator to derive expected minimum competency was shown to be effective. This approach could streamline future standard-setting processes, particularly when converting to CBT.

Comparing generative artificial intelligence platforms and nursing student performance on a women’s health nursing examination in Korea: a Rasch model approach: Eun Jeong Ko, Tae Kyung Lee, Geum Hee Jeong; J Educ Eval Health Prof. 2025;22:23. Published online September 5, 2025; DOI: https://doi.org/10.3352/jeehp.2025.22.23

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Abstract PDF Supplementary Material

Purpose
This psychometric study aimed to compare the ability parameter estimates of generative artificial intelligence (AI) platforms with those of nursing students on a 50-item women’s health nursing examination at Hallym University, Korea, using the Rasch model. It also sought to estimate item difficulty parameters and evaluate AI performance across varying difficulty levels.
Methods
The exam, consisting of 39 multiple-choice items and 11 true/false items, was administered to 111 fourth-year nursing students in June 2023. In December 2024, 6 generative AI platforms (GPT-4o, ChatGPT free version, Claude.ai, Clova X, Mistral.ai, Google Gemini) completed the same items. The responses were analyzed using the Rasch model to estimate the ability and difficulty parameters. Unidimensionality was verified by the Dimensionality Evaluation to Enumerate Contributing Traits (DETECT), and analyses were conducted using the R packages irtQ and TAM.
Results
The items satisfied unidimensionality (DETECT=–0.16). Item difficulty parameter estimates ranged from –3.87 to 1.96 logits (mean=–0.61), with a mean difficulty index of 0.79. Examinees’ ability parameter estimates ranged from –0.71 to 3.15 logits (mean=1.17). GPT-4o, ChatGPT free version, and Claude.ai outperformed the median student ability (1.09 logits), scoring 2.68, 2.34, and 2.34, respectively, while Clova X, Mistral.ai, and Google Gemini exhibited lower scores (0.20, –0.12, 0.80). The test information curve peaked below θ=0, indicating suitability for examinees with low to average ability.
Conclusion
Advanced generative AI platforms approximated the performance of high-performing students, but outcomes varied. The Rasch model effectively evaluated AI competency, supporting its potential utility for future AI performance assessments in nursing education.

Citations

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Eroding scholarly integrity: Confronting the misuse of generative AI in nursing education
Kechi Iheduru-Anderson
Nurse Education Today.2026; 164: 107145. CrossRef

Longitudinal relationships between Korean medical students’ academic performance in medical knowledge and clinical performance examinations: a retrospective longitudinal study: Yulim Kang, Hae Won Kim; J Educ Eval Health Prof. 2025;22:18. Published online June 10, 2025; DOI: https://doi.org/10.3352/jeehp.2025.22.18

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Abstract PDF Supplementary Material: Purpose
This study investigated the longitudinal relationships between performance on 3 examinations assessing medical knowledge and clinical skills among Korean medical students in the clinical phase. This study addressed the stability of each examination score and the interrelationships among examinations over time.
Methods
A retrospective longitudinal study was conducted at Yonsei University College of Medicine in Korea with a cohort of 112 medical students over 2 years. The students were in their third year in 2022 and progressed to the fourth year in 2023. We obtained comprehensive clinical science examination (CCSE) and progress test (PT) scores 3 times (T1–T3), and clinical performance examination (CPX) scores twice (T1 and T2). Autoregressive cross-lagged models were fitted to analyze their relationships.
Results
For each of the 3 examinations, the score at 1 time point predicted the subsequent score. Regarding cross-lagged effects, the CCSE at T1 predicted PT at T2 (β=0.472, P<0.001) and CCSE at T2 predicted PT at T3 (β=0.527, P<0.001). The CPX at T1 predicted the CCSE at T2 (β=0.163, P=0.006), and the CPX at T2 predicted the CCSE at T3 (β=0.154, P=0.006). The PT at T1 predicted the CPX at T2 (β=0.273, P=0.006).
Conclusion
The study identified each examination’s stability and the complexity of the longitudinal relationships between them. These findings may help predict medical students’ performance on subsequent examinations, potentially informing the provision of necessary student support.

A nationwide survey on the curriculum and educational resources related to the Clinical Skills Test of the Korean Medical Licensing Examination: a cross-sectional descriptive study: Eun-Kyung Chung, Seok Hoon Kang, Do-Hoon Kim, MinJeong Kim, Ji-Hyun Seo, Keunmi Lee, Eui-Ryoung Han; J Educ Eval Health Prof. 2025;22:11. Published online March 13, 2025; DOI: https://doi.org/10.3352/jeehp.2025.22.11

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Abstract PDF Supplementary Material

Purpose
The revised Clinical Skills Test (CST) of the Korean Medical Licensing Exam aims to provide a better assessment of physicians’ clinical competence and ability to interact with patients. This study examined the impact of the revised CST on medical education curricula and resources nationwide, while also identifying areas for improvement within the revised CST.
Methods
This study surveyed faculty responsible for clinical clerkships at 40 medical schools throughout Korea to evaluate the status and changes in clinical skills education, assessment, and resources related to the CST. The researchers distributed the survey via email through regional consortia between December 7, 2023 and January 19, 2024.
Results
Nearly all schools implemented preliminary student–patient encounters during core clinical rotations. Schools primarily conducted clinical skills assessments in the third and fourth years, with a simplified form introduced in the first and second years. Remedial education was conducted through various methods, including one-on-one feedback from faculty after the assessment. All schools established clinical skills centers and made ongoing improvements. Faculty members did not perceive the CST revisions as significantly altering clinical clerkship or skills assessments. They suggested several improvements, including assessing patient records to improve accuracy and increasing the objectivity of standardized patient assessments to ensure fairness.
Conclusion
During the CST, students’ involvement in patient encounters and clinical skills education increased, improving the assessment and feedback processes for clinical skills within the curriculum. To enhance students’ clinical competencies and readiness, strengthening the validity and reliability of the CST is essential.

Citations

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Nationwide cross-sectional survey on the necessity of including a clinical skills assessment in the national licensure examination for Doctors of Korean Medicine
Aram Jeong, Eunbyul Cho, Chan-Young Kwon, Sanghoon Lee, Chungsik Cho, Sangwoo Shin, Min Hwangbo, Dong-Hyeon Kim, Hye-Yoon Lee
Medicine.2025; 104(45): e45366. CrossRef

Empirical effect of the Dr LEE Jong-wook Fellowship Program to empower sustainable change for the health workforce in Tanzania: a mixed-methods study: Masoud Dauda, Swabaha Aidarus Yusuph, Harouni Yasini, Issa Mmbaga, Perpetua Mwambinngu, Hansol Park, Gyeongbae Seo, Kyoung Kyun Oh; J Educ Eval Health Prof. 2025;22:6. Published online January 20, 2025; DOI: https://doi.org/10.3352/jeehp.2025.22.6

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Abstract PDF Supplementary Material: Purpose
This study evaluated the Dr LEE Jong-wook Fellowship Program’s impact on Tanzania’s health workforce, focusing on relevance, effectiveness, efficiency, impact, and sustainability in addressing healthcare gaps.
Methods
A mixed-methods research design was employed. Data were collected from 97 out of 140 alumni through an online survey, 35 in-depth interviews, and one focus group discussion. The study was conducted from November to December 2023 and included alumni from 2009 to 2022. Measurement instruments included structured questionnaires for quantitative data and semi-structured guides for qualitative data. Quantitative analysis involved descriptive and inferential statistics (Spearman’s rank correlation, non-parametric tests) using Python ver. 3.11.0 and Stata ver. 14.0. Thematic analysis was employed to analyze qualitative data using NVivo ver. 12.0.
Results
Findings indicated high relevance (mean=91.6, standard deviation [SD]=8.6), effectiveness (mean=86.1, SD=11.2), efficiency (mean=82.7, SD=10.2), and impact (mean=87.7, SD=9.9), with improved skills, confidence, and institutional service quality. However, sustainability had a lower score (mean=58.0, SD=11.1), reflecting challenges in follow-up support and resource allocation. Effectiveness strongly correlated with impact (ρ=0.746, P<0.001). The qualitative findings revealed that participants valued tailored training but highlighted barriers, such as language challenges and insufficient practical components. Alumni-led initiatives contributed to knowledge sharing, but limited resources constrained sustainability.
Conclusion
The Fellowship Program enhanced Tanzania’s health workforce capacity, but it requires localized curricula and strengthened alumni networks for sustainability. These findings provide actionable insights for improving similar programs globally, confirming the hypothesis that tailored training positively influences workforce and institutional outcomes.

Educational/Faculty development material

The role of large language models in the peer-review process: opportunities and challenges for medical journal reviewers and editors: Jisoo Lee, Jieun Lee, Jeong-Ju Yoo; J Educ Eval Health Prof. 2025;22:4. Published online January 16, 2025; DOI: https://doi.org/10.3352/jeehp.2025.22.4

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Abstract PDF Supplementary Material

The peer review process ensures the integrity of scientific research. This is particularly important in the medical field, where research findings directly impact patient care. However, the rapid growth of publications has strained reviewers, causing delays and potential declines in quality. Generative artificial intelligence, especially large language models (LLMs) such as ChatGPT, may assist researchers with efficient, high-quality reviews. This review explores the integration of LLMs into peer review, highlighting their strengths in linguistic tasks and challenges in assessing scientific validity, particularly in clinical medicine. Key points for integration include initial screening, reviewer matching, feedback support, and language review. However, implementing LLMs for these purposes will necessitate addressing biases, privacy concerns, and data confidentiality. We recommend using LLMs as complementary tools under clear guidelines to support, not replace, human expertise in maintaining rigorous peer review standards.

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Research article

Inter-rater reliability and content validity of the measurement tool for portfolio assessments used in the Introduction to Clinical Medicine course at Ewha Womans University College of Medicine: a methodological study: Dong-Mi Yoo, Jae Jin Han; J Educ Eval Health Prof. 2024;21:39. Published online December 10, 2024; DOI: https://doi.org/10.3352/jeehp.2024.21.39

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Abstract PDF Supplementary Material

Purpose
This study aimed to examine the reliability and validity of a measurement tool for portfolio assessments in medical education. Specifically, it investigated scoring consistency among raters and assessment criteria appropriateness according to an expert panel.
Methods
A cross-sectional observational study was conducted from September to December 2018 for the Introduction to Clinical Medicine course at the Ewha Womans University College of Medicine. Data were collected for 5 randomly selected portfolios scored by a gold-standard rater and 6 trained raters. An expert panel assessed the validity of 12 assessment items using the content validity index (CVI). Statistical analysis included Pearson correlation coefficients for rater alignment, the intraclass correlation coefficient (ICC) for inter-rater reliability, and the CVI for item-level validity.
Results
Rater 1 had the highest Pearson correlation (0.8916) with the gold-standard rater, while Rater 5 had the lowest (0.4203). The ICC for all raters was 0.3821, improving to 0.4415 after excluding Raters 1 and 5, indicating a 15.6% reliability increase. All assessment items met the CVI threshold of ≥0.75, with some achieving a perfect score (CVI=1.0). However, items like “sources” and “level and degree of performance” showed lower validity (CVI=0.72).
Conclusion
The present measurement tool for portfolio assessments demonstrated moderate reliability and strong validity, supporting its use as a credible tool. For a more reliable portfolio assessment, more faculty training is needed.

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History article

History of the medical licensure system in Korea from the late 1800s to 1992: Sang-Ik Hwang; J Educ Eval Health Prof. 2024;21:36. Published online December 9, 2024; DOI: https://doi.org/10.3352/jeehp.2024.21.36

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Abstract PDF Supplementary Material

The introduction of modern Western medicine in the late 19th century, notably through vaccination initiatives, marked the beginning of governmental involvement in medical licensure, with the licensing of doctors who performed vaccinations. The establishment of the national medical school “Euihakkyo” in 1899 further formalized medical education and licensure, granting graduates the privilege to practice medicine without additional examinations. The enactment of the Regulations on Doctors in 1900 by the Joseon government aimed to define doctor qualifications, including modern and traditional practitioners, comprehensively. However, resistance from the traditional medical community hindered its full implementation. During the Japanese colonial occupation of the Korean Peninsula from 1910 to 1945, the medical licensure system was controlled by colonial authorities, leading to the marginalization of traditional Korean medicine and the imposition of imperial hierarchical structures. Following liberation in 1945 from Japanese colonial rule, the Korean government undertook significant reforms, culminating in the National Medical Law, which was enacted in 1951. This law redefined doctor qualifications and reinstated the status of traditional Korean medicine. The introduction of national examinations for physicians increased state involvement in ensuring medical competence. The privatization of the Korean Medical Licensing Examination led to the establishment of the Korea Health Personnel Licensing Examination Institute in 1992, which assumed responsibility for administering licensing examinations for all healthcare workers. This shift reflected a move towards specialized management of professional standards. The evolution of the medical licensure system in Korea illustrates a dynamic process shaped by the historical context, balancing the protection of public health with the rights of medical practitioners.

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Review

The legality and appropriateness of keeping Korean Medical Licensing Examination items confidential: a comparative analysis and review of court rulings: Jae Sun Kim, Dae Un Hong, Ju Yoen Lee; J Educ Eval Health Prof. 2024;21:28. Published online October 15, 2024; DOI: https://doi.org/10.3352/jeehp.2024.21.28

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Abstract PDF Supplementary Material

This study examines the legality and appropriateness of keeping the multiple-choice question items of the Korean Medical Licensing Examination (KMLE) confidential. Through an analysis of cases from the United States, Canada, and Australia, where medical licensing exams are conducted using item banks and computer-based testing, we found that exam items are kept confidential to ensure fairness and prevent cheating. In Korea, the Korea Health Personnel Licensing Examination Institute (KHPLEI) has been disclosing KMLE questions despite concerns over exam integrity. Korean courts have consistently ruled that multiple-choice question items prepared by public institutions are non-public information under Article 9(1)(v) of the Korea Official Information Disclosure Act (KOIDA), which exempts disclosure if it significantly hinders the fairness of exams or research and development. The Constitutional Court of Korea has upheld this provision. Given the time and cost involved in developing high-quality items and the need to accurately assess examinees’ abilities, there are compelling reasons to keep KMLE items confidential. As a public institution responsible for selecting qualified medical practitioners, KHPLEI should establish its disclosure policy based on a balanced assessment of public interest, without influence from specific groups. We conclude that KMLE questions qualify as non-public information under KOIDA, and KHPLEI may choose to maintain their confidentiality to ensure exam fairness and efficiency.

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Halted medical education and medical residents’ training in Korea, journal metrics, and appreciation to reviewers and volunteers
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Journal of Educational Evaluation for Health Professions.2025; 22: 1. CrossRef

Research articles

A new performance evaluation indicator for the LEE Jong-wook Fellowship Program of Korea Foundation for International Healthcare to better assess its long-term educational impacts: a Delphi study: Minkyung Oh, Bo Young Yoon; J Educ Eval Health Prof. 2024;21:27. Published online October 2, 2024; DOI: https://doi.org/10.3352/jeehp.2024.21.27

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Abstract PDF Supplementary Material

Purpose
The Dr. LEE Jong-wook Fellowship Program, established by the Korea Foundation for International Healthcare (KOFIH), aims to strengthen healthcare capacity in partner countries. The aim of the study was to develop new performance evaluation indicators for the program to better assess long-term educational impact across various courses and professional roles.
Methods
A 3-stage process was employed. First, a literature review of established evaluation models (Kirkpatrick’s 4 levels, context/input/process/product evaluation model, Organization for Economic Cooperation and Development Assistance Committee criteria) was conducted to devise evaluation criteria. Second, these criteria were validated via a 2-round Delphi survey with 18 experts in training projects from May 2021 to June 2021. Third, the relative importance of the evaluation criteria was determined using the analytic hierarchy process (AHP), calculating weights and ensuring consistency through the consistency index and consistency ratio (CR), with CR values below 0.1 indicating acceptable consistency.
Results
The literature review led to a combined evaluation model, resulting in 4 evaluation areas, 20 items, and 92 indicators. The Delphi surveys confirmed the validity of these indicators, with content validity ratio values exceeding 0.444. The AHP analysis assigned weights to each indicator, and CR values below 0.1 indicated consistency. The final set of evaluation indicators was confirmed through a workshop with KOFIH and adopted as the new evaluation tool.
Conclusion
The developed evaluation framework provides a comprehensive tool for assessing the long-term outcomes of the Dr. LEE Jong-wook Fellowship Program. It enhances evaluation capabilities and supports improvements in the training program’s effectiveness and international healthcare collaboration.

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Long-term impact of health policy and management training for health experts from the LMICs: 2022 Dr. LEE Jong-wook fellowship program
Vasuki Rajaguru, Jun Su Park, Soo Hyeok Choi, Sunmin Kim, Jungeun Seo, Yumin Kim, Hyejin Jung, Tae Hyun Kim
International Health.2026;[Epub] CrossRef
Halted medical education and medical residents’ training in Korea, journal metrics, and appreciation to reviewers and volunteers
Sun Huh
Journal of Educational Evaluation for Health Professions.2025; 22: 1. CrossRef

Impact of a change from A–F grading to honors/pass/fail grading on academic performance at Yonsei University College of Medicine in Korea: a cross-sectional serial mediation analysis: Min-Kyeong Kim, Hae Won Kim; J Educ Eval Health Prof. 2024;21:20. Published online August 16, 2024; DOI: https://doi.org/10.3352/jeehp.2024.21.20; Correction in: J Educ Eval Health Prof 2024;21(0):35

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Abstract PDF Supplementary Material

Purpose
This study aimed to explore how the grading system affected medical students’ academic performance based on their perceptions of the learning environment and intrinsic motivation in the context of changing from norm-referenced A–F grading to criterion-referenced honors/pass/fail grading.
Methods
The study involved 238 second-year medical students from 2014 (n=127, A–F grading) and 2015 (n=111, honors/pass/fail grading) at Yonsei University College of Medicine in Korea. Scores on the Dundee Ready Education Environment Measure, the Academic Motivation Scale, and the Basic Medical Science Examination were used to measure overall learning environment perceptions, intrinsic motivation, and academic performance, respectively. Serial mediation analysis was conducted to examine the pathways between the grading system and academic performance, focusing on the mediating roles of student perceptions and intrinsic motivation.
Results
The honors/pass/fail grading class students reported more positive perceptions of the learning environment, higher intrinsic motivation, and better academic performance than the A–F grading class students. Mediation analysis demonstrated a serial mediation effect between the grading system and academic performance through learning environment perceptions and intrinsic motivation. Student perceptions and intrinsic motivation did not independently mediate the relationship between the grading system and performance.
Conclusion
Reducing the number of grades and eliminating rank-based grading might have created an affirming learning environment that fulfills basic psychological needs and reinforces the intrinsic motivation linked to academic performance. The cumulative effect of these 2 mediators suggests that a comprehensive approach should be used to understand student performance.

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Alternative grading approaches in health professions education: a scoping review protocol
Elena Wong Espiritu, Aine O’Connor, Sara Blass, Kathryn L. Dambrino, Angela Shelton Clauson
JBI Evidence Synthesis.2025; 23(11): 2301. CrossRef
Erratum: Impact of a change from A–F grading to honors/pass/fail grading on academic performance at Yonsei University College of Medicine in Korea: a cross-sectional serial mediation analysis

Journal of Educational Evaluation for Health Professions.2024; 21: 35. CrossRef

Special article on the 20th anniversary of the journal

Comparison of real data and simulated data analysis of a stopping rule based on the standard error of measurement in computerized adaptive testing for medical examinations in Korea: a psychometric study: Dong Gi Seo, Jeongwook Choi, Jinha Kim; J Educ Eval Health Prof. 2024;21:18. Published online July 9, 2024; DOI: https://doi.org/10.3352/jeehp.2024.21.18

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Abstract PDF Supplementary Material

Purpose
This study aimed to compare and evaluate the efficiency and accuracy of computerized adaptive testing (CAT) under 2 stopping rules (standard error of measurement [SEM]=0.3 and 0.25) using both real and simulated data in medical examinations in Korea.
Methods
This study employed post-hoc simulation and real data analysis to explore the optimal stopping rule for CAT in medical examinations. The real data were obtained from the responses of 3rd-year medical students during examinations in 2020 at Hallym University College of Medicine. Simulated data were generated using estimated parameters from a real item bank in R. Outcome variables included the number of examinees’ passing or failing with SEM values of 0.25 and 0.30, the number of items administered, and the correlation. The consistency of real CAT result was evaluated by examining consistency of pass or fail based on a cut score of 0.0. The efficiency of all CAT designs was assessed by comparing the average number of items administered under both stopping rules.
Results
Both SEM 0.25 and SEM 0.30 provided a good balance between accuracy and efficiency in CAT. The real data showed minimal differences in pass/fail outcomes between the 2 SEM conditions, with a high correlation (r=0.99) between ability estimates. The simulation results confirmed these findings, indicating similar average item numbers between real and simulated data.
Conclusion
The findings suggest that both SEM 0.25 and 0.30 are effective termination criteria in the context of the Rasch model, balancing accuracy and efficiency in CAT.

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AI-enhanced adaptive testing with cognitive diagnostic feedback and its association with performance in undergraduate surgical education: a pilot study
Nuno Silva Gonçalves, Carlos Collares, José Miguel Pêgo
Frontiers in Behavioral Neuroscience.2026;[Epub] CrossRef
Feasibility of applying computerized adaptive testing to the Clinical Medical Science Comprehensive Examination in Korea: a psychometric study
Jeongwook Choi, Sung-Soo Jung, Eun Kwang Choi, Kyung Sik Kim, Dong Gi Seo
Journal of Educational Evaluation for Health Professions.2025; 22: 29. CrossRef

Development of examination objectives for the Korean paramedic and emergency medical technician examination: a survey study: Tai-hwan Uhm, Heakyung Choi, Seok Hwan Hong, Hyungsub Kim, Minju Kang, Keunyoung Kim, Hyejin Seo, Eunyoung Ki, Hyeryeong Lee, Heejeong Ahn, Uk-jin Choi, Sang Woong Park; J Educ Eval Health Prof. 2024;21:13. Published online June 12, 2024; DOI: https://doi.org/10.3352/jeehp.2024.21.13

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Purpose
The duties of paramedics and emergency medical technicians (P&EMTs) are continuously changing due to developments in medical systems. This study presents evaluation goals for P&EMTs by analyzing their work, especially the tasks that new P&EMTs (with less than 3 years’ experience) find difficult, to foster the training of P&EMTs who could adapt to emergency situations after graduation.
Methods
A questionnaire was created based on prior job analyses of P&EMTs. The survey questions were reviewed through focus group interviews, from which 253 task elements were derived. A survey was conducted from July 10, 2023 to October 13, 2023 on the frequency, importance, and difficulty of the 6 occupations in which P&EMTs were employed.
Results
The P&EMTs’ most common tasks involved obtaining patients’ medical histories and measuring vital signs, whereas the most important task was cardiopulmonary resuscitation (CPR). The task elements that the P&EMTs found most difficult were newborn delivery and infant CPR. New paramedics reported that treating patients with fractures, poisoning, and childhood fever was difficult, while new EMTs reported that they had difficulty keeping diaries, managing ambulances, and controlling infection.
Conclusion
Communication was the most important item for P&EMTs, whereas CPR was the most important skill. It is important for P&EMTs to have knowledge of all tasks; however, they also need to master frequently performed tasks and those that pose difficulties in the field. By deriving goals for evaluating P&EMTs, changes could be made to their education, thereby making it possible to train more capable P&EMTs.

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Impact of Resident Doctors’ Strike on Psychological Outcomes Among Paramedics in Teaching-Hospital Emergency Departments: A Nationwide Multicenter Survey
Keun-Young Kim, Yong-Seok Kim, Seong-Ju Kim, Geon-Uk Ryu, Hyeong-Tae Kim, Chan-Young Kang, Yun-Deok Jang
Healthcare.2026; 14(4): 480. CrossRef

Revised evaluation objectives of the Korean Dentist Clinical Skill Test: a survey study and focus group interviews: Jae-Hoon Kim, Young J Kim, Deuk-Sang Ma, Se-Hee Park, Ahran Pae, June-Sung Shim, Il-Hyung Yang, Ui-Won Jung, Byung-Joon Choi, Yang-Hyun Chun; J Educ Eval Health Prof. 2024;21:11. Published online May 30, 2024; DOI: https://doi.org/10.3352/jeehp.2024.21.11

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Abstract PDF Supplementary Material

Purpose
This study aimed to propose a revision of the evaluation objectives of the Korean Dentist Clinical Skill Test by analyzing the opinions of those involved in the examination after a review of those objectives.
Methods
The clinical skill test objectives were reviewed based on the national-level dental practitioner competencies, dental school educational competencies, and the third dental practitioner job analysis. Current and former examinees were surveyed about their perceptions of the evaluation objectives. The validity of 22 evaluation objectives and overlapping perceptions based on area of specialty were surveyed on a 5-point Likert scale by professors who participated in the clinical skill test and dental school faculty members. Additionally, focus group interviews were conducted with experts on the examination.
Results
It was necessary to consider including competency assessments for “emergency rescue skills” and “planning and performing prosthetic treatment.” There were no significant differences between current and former examinees in their perceptions of the clinical skill test’s objectives. The professors who participated in the examination and dental school faculty members recognized that most of the objectives were valid. However, some responses stated that “oromaxillofacial cranial nerve examination,” “temporomandibular disorder palpation test,” and “space management for primary and mixed dentition” were unfeasible evaluation objectives and overlapped with dental specialty areas.
Conclusion
When revising the Korean Dentist Clinical Skill Test’s objectives, it is advisable to consider incorporating competency assessments related to “emergency rescue skills” and “planning and performing prosthetic treatment.”

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Establishment of a tooth preparation competency cohort at Dankook University Dental School
Hojin Moon
Journal of Korean Dental Association.2025; 63(2): 42. CrossRef

Importance, performance frequency, and predicted future importance of dietitians’ jobs by practicing dietitians in Korea: a survey study: Cheongmin Sohn, Sooyoun Kwon, Won Gyoung Kim, Kyung-Eun Lee, Sun-Young Lee, Seungmin Lee; J Educ Eval Health Prof. 2024;21:1. Published online January 2, 2024; DOI: https://doi.org/10.3352/jeehp.2024.21.1

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Abstract PDF Supplementary Material: Purpose
This study aimed to explore the perceptions held by practicing dietitians of the importance of their tasks performed in current work environments, the frequency at which those tasks are performed, and predictions about the importance of those tasks in future work environments.
Methods
This was a cross-sectional survey study. An online survey was administered to 350 practicing dietitians. They were asked to assess the importance, performance frequency, and predicted changes in the importance of 27 tasks using a 5-point scale. Descriptive statistics were calculated, and the means of the variables were compared across categorized work environments using analysis of variance.
Results
The importance scores of all surveyed tasks were higher than 3.0, except for the marketing management task. Self-development, nutrition education/counseling, menu planning, food safety management, and documentation/data management were all rated higher than 4.0. The highest performance frequency score was related to documentation/data management. The importance scores of all duties, except for professional development, differed significantly by workplace. As for predictions about the future importance of the tasks surveyed, dietitians responded that the importance of all 27 tasks would either remain at current levels or increase in the future.
Conclusion
Twenty-seven tasks were confirmed to represent dietitians’ job functions in various workplaces. These tasks can be used to improve the test specifications of the Korean Dietitian Licensing Examination and the curriculum of dietetic education programs.

Information amount, accuracy, and relevance of generative artificial intelligence platforms’ answers regarding learning objectives of medical arthropodology evaluated in English and Korean queries in December 2023: a descriptive study: Hyunju Lee, Soobin Park; J Educ Eval Health Prof. 2023;20:39. Published online December 28, 2023; DOI: https://doi.org/10.3352/jeehp.2023.20.39

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Abstract PDF Supplementary Material

Purpose
This study assessed the performance of 6 generative artificial intelligence (AI) platforms on the learning objectives of medical arthropodology in a parasitology class in Korea. We examined the AI platforms’ performance by querying in Korean and English to determine their information amount, accuracy, and relevance in prompts in both languages.
Methods
From December 15 to 17, 2023, 6 generative AI platforms—Bard, Bing, Claude, Clova X, GPT-4, and Wrtn—were tested on 7 medical arthropodology learning objectives in English and Korean. Clova X and Wrtn are platforms from Korean companies. Responses were evaluated using specific criteria for the English and Korean queries.
Results
Bard had abundant information but was fourth in accuracy and relevance. GPT-4, with high information content, ranked first in accuracy and relevance. Clova X was 4th in amount but 2nd in accuracy and relevance. Bing provided less information, with moderate accuracy and relevance. Wrtn’s answers were short, with average accuracy and relevance. Claude AI had reasonable information, but lower accuracy and relevance. The responses in English were superior in all aspects. Clova X was notably optimized for Korean, leading in relevance.
Conclusion
In a study of 6 generative AI platforms applied to medical arthropodology, GPT-4 excelled overall, while Clova X, a Korea-based AI product, achieved 100% relevance in Korean queries, the highest among its peers. Utilizing these AI platforms in classrooms improved the authors’ self-efficacy and interest in the subject, offering a positive experience of interacting with generative AI platforms to question and receive information.

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Implementation of artificial intelligence in the 2025 medical parasitology course at Hallym University
Eun Hee Ha
Journal of Educational Evaluation for Health Professions.2026; 23: 4. CrossRef
How appropriately can generative artificial intelligence platforms, including GPT-4, Gemini, Bing, and Wrtn, answer questions about colon cancer in the Korean language?
Sun Huh
Annals of Coloproctology.2025; 41(3): 190. CrossRef
How Can Clinicians Leverage Vibe Coding for Machine Learning and Deep Learning Research?
Yoonhwan Lee, Sun Huh
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Opportunities, challenges, and future directions of large language models, including ChatGPT in medical education: a systematic scoping review
Xiaojun Xu, Yixiao Chen, Jing Miao
Journal of Educational Evaluation for Health Professions.2024; 21: 6. CrossRef
The emergence of generative artificial intelligence platforms in 2023, journal metrics, appreciation to reviewers and volunteers, and obituary
Sun Huh
Journal of Educational Evaluation for Health Professions.2024; 21: 9. CrossRef
Comparison of the Performance of ChatGPT, Claude and Bard in Support of Myopia Prevention and Control
Yan Wang, Lihua Liang, Ran Li, Yihua Wang, Changfu Hao
Journal of Multidisciplinary Healthcare.2024; Volume 17: 3917. CrossRef

Effect of a transcultural nursing course on improving the cultural competency of nursing graduate students in Korea: a before-and-after study: Kyung Eui Bae, Geum Hee Jeong; J Educ Eval Health Prof. 2023;20:35. Published online December 4, 2023; DOI: https://doi.org/10.3352/jeehp.2023.20.35

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Abstract PDF Supplementary Material

Purpose
This study aimed to evaluate the impact of a transcultural nursing course on enhancing the cultural competency of graduate nursing students in Korea. We hypothesized that participants’ cultural competency would significantly improve in areas such as communication, biocultural ecology and family, dietary habits, death rituals, spirituality, equity, and empowerment and intermediation after completing the course. Furthermore, we assessed the participants’ overall satisfaction with the course.
Methods
A before-and-after study was conducted with graduate nursing students at Hallym University, Chuncheon, Korea, from March to June 2023. A transcultural nursing course was developed based on Giger & Haddad’s transcultural nursing model and Purnell’s theoretical model of cultural competence. Data was collected using a cultural competence scale for registered nurses developed by Kim and his colleagues. A total of 18 students participated, and the paired t-test was employed to compare pre-and post-intervention scores.
Results
The study revealed significant improvements in all 7 categories of cultural nursing competence (P<0.01). Specifically, the mean differences in scores (pre–post) ranged from 0.74 to 1.09 across the categories. Additionally, participants expressed high satisfaction with the course, with an average score of 4.72 out of a maximum of 5.0.
Conclusion
The transcultural nursing course effectively enhanced the cultural competency of graduate nursing students. Such courses are imperative to ensure quality care for the increasing multicultural population in Korea.

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Judy Harara, Hannah Sheridan, Adrienne McSwain-Dawson, Michael Stellefson
American Journal of Health Education.2026; 57(2): 145. CrossRef
Reflections of Cultural Differences on Nursing Care: A Systematic Review of International Quantitative Evidence
Hatice Öntürk Akyüz, Hatice Gülsoy
Holistic Nursing Practice.2026;[Epub] CrossRef
Effect of Cultural Communication Strategy in Preventing Child Marriage in a Region with Strong Cultural Resistance A Quasi-Experimental Study
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Ecem Çi̇çek Gümüş, İlknur Dolu
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Technical report

Item difficulty index, discrimination index, and reliability of the 26 health professions licensing examinations in 2022, Korea: a psychometric study: Yoon Hee Kim, Bo Hyun Kim, Joonki Kim, Bokyoung Jung, Sangyoung Bae; J Educ Eval Health Prof. 2023;20:31. Published online November 22, 2023; DOI: https://doi.org/10.3352/jeehp.2023.20.31

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Abstract PDF Supplementary Material

Purpose
This study presents item analysis results of the 26 health personnel licensing examinations managed by the Korea Health Personnel Licensing Examination Institute (KHPLEI) in 2022.
Methods
The item difficulty index, item discrimination index, and reliability were calculated. The item discrimination index was calculated using a discrimination index based on the upper and lower 27% rule and the item-total correlation.
Results
Out of 468,352 total examinees, 418,887 (89.4%) passed. The pass rates ranged from 27.3% for health educators level 1 to 97.1% for oriental medical doctors. Most examinations had a high average difficulty index, albeit to varying degrees, ranging from 61.3% for prosthetists and orthotists to 83.9% for care workers. The average discrimination index based on the upper and lower 27% rule ranged from 0.17 for oriental medical doctors to 0.38 for radiological technologists. The average item-total correlation ranged from 0.20 for oriental medical doctors to 0.38 for radiological technologists. The Cronbach α, as a measure of reliability, ranged from 0.872 for health educators-level 3 to 0.978 for medical technologists. The correlation coefficient between the average difficulty index and average discrimination index was -0.2452 (P=0.1557), that between the average difficulty index and the average item-total correlation was 0.3502 (P=0.0392), and that between the average discrimination index and the average item-total correlation was 0.7944 (P<0.0001).
Conclusion
This technical report presents the item analysis results and reliability of the recent examinations by the KHPLEI, demonstrating an acceptable range of difficulty index and discrimination index values, as well as good reliability.

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ItemSight: Development of a Shiny Application for Simplified Item Analysis of Type A Multiple-Choice Questions
Himel Mondal, Pradosh Kumar Sarangi, Shaikat Mondal, Anupkumar D Dhanvijay, Rintu K Gayen, Aritra Mukhopadhyay, Raunak Mishra
Cureus.2026;[Epub] CrossRef
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Shanna Williams, Helen Kaiser, Sarah Feingold
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Research articles

Medical students’ patterns of using ChatGPT as a feedback tool and perceptions of ChatGPT in a Leadership and Communication course in Korea: a cross-sectional study: Janghee Park; J Educ Eval Health Prof. 2023;20:29. Published online November 10, 2023; DOI: https://doi.org/10.3352/jeehp.2023.20.29

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Abstract PDF Supplementary Material

Purpose
This study aimed to analyze patterns of using ChatGPT before and after group activities and to explore medical students’ perceptions of ChatGPT as a feedback tool in the classroom.
Methods
The study included 99 2nd-year pre-medical students who participated in a “Leadership and Communication” course from March to June 2023. Students engaged in both individual and group activities related to negotiation strategies. ChatGPT was used to provide feedback on their solutions. A survey was administered to assess students’ perceptions of ChatGPT’s feedback, its use in the classroom, and the strengths and challenges of ChatGPT from May 17 to 19, 2023.
Results
The students responded by indicating that ChatGPT’s feedback was helpful, and revised and resubmitted their group answers in various ways after receiving feedback. The majority of respondents expressed agreement with the use of ChatGPT during class. The most common response concerning the appropriate context of using ChatGPT’s feedback was “after the first round of discussion, for revisions.” There was a significant difference in satisfaction with ChatGPT’s feedback, including correctness, usefulness, and ethics, depending on whether or not ChatGPT was used during class, but there was no significant difference according to gender or whether students had previous experience with ChatGPT. The strongest advantages were “providing answers to questions” and “summarizing information,” and the worst disadvantage was “producing information without supporting evidence.”
Conclusion
The students were aware of the advantages and disadvantages of ChatGPT, and they had a positive attitude toward using ChatGPT in the classroom.

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Wen Luo, Tao Feng, Ting Zhang, Xinyu Chen, Xianying Lu, Yuhang Li, Chaoming Hou, Jing Gao
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Nora Arvai, Bertalan Meskó, Gellért Katonai
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Higher education students’ perceptions of ChatGPT: A global study of early reactions
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Jacob G. J. Wihlidal, Nikolaus E. Wolter, Evan J. Propst, Vincent Lin, Michael Au, Shaunak Amin, Jennifer M. Siu
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Information amount, accuracy, and relevance of generative artificial intelligence platforms’ answers regarding learning objectives of medical arthropodology evaluated in English and Korean queries in December 2023: a descriptive study
Hyunju Lee, Soobin Park
Journal of Educational Evaluation for Health Professions.2023; 20: 39. CrossRef

Suggestion for item allocation to 8 nursing activity categories of the Korean Nursing Licensing Examination: a survey-based descriptive study: Kyunghee Kim, So Young Kang, Younhee Kang, Youngran Kweon, Hyunjung Kim, Youngshin Song, Juyeon Cho, Mi-Young Choi, Hyun Su Lee; J Educ Eval Health Prof. 2023;20:18. Published online June 12, 2023; DOI: https://doi.org/10.3352/jeehp.2023.20.18

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Abstract PDF Supplementary Material

Purpose
This study aims to suggest the number of test items in each of 8 nursing activity categories of the Korean Nursing Licensing Examination, which comprises 134 activity statements including 275 items. The examination will be able to evaluate the minimum ability that nursing graduates must have to perform their duties. Methods: Two opinion surveys involving the members of 7 academic societies were conducted from March 19 to May 14, 2021. The survey results were reviewed by members of 4 expert associations from May 21 to June 4, 2021. The results for revised numbers of items in each category were compared with those reported by Tak and his colleagues and the National Council License Examination for Registered Nurses of the United States. Results: Based on 2 opinion surveys and previous studies, the suggestions for item allocation to 8 nursing activity categories of the Korean Nursing Licensing Examination in this study are as follows: 50 items for management of care and improvement of professionalism, 33 items for safety and infection control, 40 items for management of potential risk, 28 items for basic care, 47 items for physiological integrity and maintenance, 33 items for pharmacological and parenteral therapies, 24 items for psychosocial integrity and maintenance, and 20 items for health promotion and maintenance. Twenty other items related to health and medical laws were not included due to their mandatory status. Conclusion: These suggestions for the number of test items for each activity category will be helpful in developing new items for the Korean Nursing Licensing Examination.

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An integrated behavioral neuroscience and educational psychology curriculum enhances medical interns’ engagement, resilience, and clinical performance in Saudi Arabia
Marwa M. Fawzi, Khaled A. Shahat, Nevein M. Abdelhady, Ayman A. Refai, Shaimaa M. Hassan, Zeinab A. Awadallah, Rana Hesham, Nour M. Laissy, Hanya Gaber, Rana A. Alduraywish, Tayseer Mansour
Frontiers in Medicine.2026;[Epub] CrossRef

Adequacy of the examination-based licensing system and a training-based licensing system for midwifery license according to changes in childbirth medical infrastructure in Korea: a survey-based descriptive study: Yun Mi Kim, Sun Hee Lee, Sun Ok Lee, Mi Young An, Bu Youn Kim, Jum Mi Park; J Educ Eval Health Prof. 2023;20:15. Published online May 22, 2023; DOI: https://doi.org/10.3352/jeehp.2023.20.15

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Abstract PDF Supplementary Material: Purpose
The number of Korean midwifery licensing examination applicants has steadily decreased due to the low birth rate and lack of training institutions for midwives. This study aimed to evaluate the adequacy of the examination-based licensing system and the possibility of a training-based licensing system.
Methods
A survey questionnaire was developed and dispatched to 230 professionals from December 28, 2022 to January 13, 2023, through an online form using Google Surveys. Descriptive statistics were used to analyze the results.
Results
Responses from 217 persons (94.3%) were analyzed after excluding incomplete responses. Out of the 217 participants, 198 (91.2%) agreed with maintaining the current examination-based licensing system; 94 (43.3%) agreed with implementing a training-based licensing system to cover the examination costs due to the decreasing number of applicants; 132 (60.8%) agreed with establishing a midwifery education evaluation center for a training-based licensing system; 163 (75.1%) said that the quality of midwifery might be lowered if midwives were produced only by a training-based licensing system, and 197 (90.8%) said that the training of midwives as birth support personnel should be promoted in Korea.
Conclusion
Favorable results were reported for the examination-based licensing system; however, if a training-based licensing system is implemented, it will be necessary to establish a midwifery education evaluation center to manage the quality of midwives. As the annual number of candidates for the Korean midwifery licensing examination has been approximately 10 in recent years, it is necessary to consider more actively granting midwifery licenses through a training-based licensing system.

Factors influencing the learning transfer of nursing students in a non-face-to-face educational environment during the COVID-19 pandemic in Korea: a cross-sectional study using structural equation modeling: Geun Myun Kim, Yunsoo Kim, Seong Kwang Kim; J Educ Eval Health Prof. 2023;20:14. Published online April 27, 2023; DOI: https://doi.org/10.3352/jeehp.2023.20.14

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203 Download
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Abstract PDF Supplementary Material

Purpose
The aim of this study was to identify factors influencing the learning transfer of nursing students in a non-face-to-face educational environment through structural equation modeling and suggest ways to improve the transfer of learning.
Methods
In this cross-sectional study, data were collected via online surveys from February 9 to March 1, 2022, from 218 nursing students in Korea. Learning transfer, learning immersion, learning satisfaction, learning efficacy, self-directed learning ability and information technology utilization ability were analyzed using IBM SPSS for Windows ver. 22.0 and AMOS ver. 22.0.
Results
The assessment of structural equation modeling showed adequate model fit, with normed χ2=1.74 (P<0.024), goodness-of-fit index=0.97, adjusted goodness-of-fit index=0.93, comparative fit index=0.98, root mean square residual=0.02, Tucker-Lewis index=0.97, normed fit index=0.96, and root mean square error of approximation=0.06. In a hypothetical model analysis, 9 out of 11 pathways of the hypothetical structural model for learning transfer in nursing students were statistically significant. Learning self-efficacy and learning immersion of nursing students directly affected learning transfer, and subjective information technology utilization ability, self-directed learning ability, and learning satisfaction were variables with indirect effects. The explanatory power of immersion, satisfaction, and self-efficacy for learning transfer was 44.4%.
Conclusion
The assessment of structural equation modeling indicated an acceptable fit. It is necessary to improve the transfer of learning through the development of a self-directed program for learning ability improvement, including the use of information technology in nursing students’ learning environment in non-face-to-face conditions.

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Flow in Relation to Academic Achievement in Online-Learning: A Meta-Analysis Study
Da Xing, Yunjung Lee, Gyun Heo
Measurement: Interdisciplinary Research and Perspectives.2025; 23(1): 1. CrossRef
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Yilin Ren, Jienan Wu
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The Impact of the COVID-19 Pandemic on Clinical Practice Education in South Korea: A Cross-Sectional Study
Kuemju Park
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Evaluation of medical school faculty members’ educational performance in Korea in 2022 through analysis of the promotion regulations: a mixed methods study: Hye Won Jang, Janghee Park; J Educ Eval Health Prof. 2023;20:7. Published online February 28, 2023; DOI: https://doi.org/10.3352/jeehp.2023.20.7

6,301 View
164 Download
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Abstract PDF Supplementary Material

Purpose
To ensure faculty members’ active participation in education in response to growing demand, medical schools should clearly describe educational activities in their promotion regulations. This study analyzed the status of how medical education activities are evaluated in promotion regulations in 2022, in Korea.
Methods
Data were collected from promotion regulations retrieved by searching the websites of 22 medical schools/universities in August 2022. To categorize educational activities and evaluation methods, the Association of American Medical Colleges framework for educational activities was utilized. Correlations between medical schools’ characteristics and the evaluation of medical educational activities were analyzed.
Results
We defined 6 categories, including teaching, development of education products, education administration and service, scholarship in education, student affairs, and others, and 20 activities with 57 sub-activities. The average number of included activities was highest in the development of education products category and lowest in the scholarship in education category. The weight adjustment factors of medical educational activities were the characteristics of the target subjects and faculty members, the number of involved faculty members, and the difficulty of activities. Private medical schools tended to have more educational activities in the regulations than public medical schools. The greater the number of faculty members, the greater the number of educational activities in the education administration and service categories.
Conclusion
Medical schools included various medical education activities and their evaluation methods in promotion regulations in Korea. This study provides basic data for improving the rewarding system for efforts of medical faculty members in education.

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A proposal to address faculty recruitment challenges in regional medical schools: incorporating clinical performance into scholarly evaluation
Ji Young Lee, Heesung Song
Journal of Medicine and Life Science.2025;[Epub] CrossRef

Identifying the nutrition support nurses’ tasks using importance–performance analysis in Korea: a descriptive study: Jeong Yun Park; J Educ Eval Health Prof. 2023;20:3. Published online January 18, 2023; DOI: https://doi.org/10.3352/jeehp.2023.20.3

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186 Download

Abstract PDF Supplementary Material: Purpose
Nutrition support nurse is a member of a nutrition support team and is a health care professional who takes a significant part in all aspects of nutritional care. This study aims to investigate ways to improve the quality of tasks performed by nutrition support nurses through survey questionnaires in Korea.
Methods
An online survey was conducted between October 12 and November 31, 2018. The questionnaire consists of 36 items categorized into 5 subscales: nutrition-focused support care, education and counseling, consultation and coordination, research and quality improvement, and leadership. The importance–performance analysis method was used to confirm the relationship between the importance and performance of nutrition support nurses’ tasks.
Results
A total of 101 nutrition support nurses participated in this survey. The importance (5.56±0.78) and performance (4.50±1.06) of nutrition support nurses’ tasks showed a significant difference (t=11.27, P<0.001). Education, counseling/consultation, and participation in developing their processes and guidelines were identified as low-performance activities compared with their importance.
Conclusion
To intervene nutrition support effectively, nutrition support nurses should have the qualification or competency through the education program based on their practice. Improved awareness of nutrition support nurses participating in research and quality improvement activity for role development is required.

Brief report

Are ChatGPT’s knowledge and interpretation ability comparable to those of medical students in Korea for taking a parasitology examination?: a descriptive study: Sun Huh; J Educ Eval Health Prof. 2023;20:1. Published online January 11, 2023; DOI: https://doi.org/10.3352/jeehp.2023.20.1

23,601 View
1,251 Download
261 Web of Science
128 Crossref

Abstract PDF Supplementary Material

This study aimed to compare the knowledge and interpretation ability of ChatGPT, a language model of artificial general intelligence, with those of medical students in Korea by administering a parasitology examination to both ChatGPT and medical students. The examination consisted of 79 items and was administered to ChatGPT on January 1, 2023. The examination results were analyzed in terms of ChatGPT’s overall performance score, its correct answer rate by the items’ knowledge level, and the acceptability of its explanations of the items. ChatGPT’s performance was lower than that of the medical students, and ChatGPT’s correct answer rate was not related to the items’ knowledge level. However, there was a relationship between acceptable explanations and correct answers. In conclusion, ChatGPT’s knowledge and interpretation ability for this parasitology examination were not yet comparable to those of medical students in Korea.

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Research article

Possibility of independent use of the yes/no Angoff and Hofstee methods for the standard setting of the Korean Medical Licensing Examination written test: a descriptive study: Do-Hwan Kim, Ye Ji Kang, Hoon-Ki Park; J Educ Eval Health Prof. 2022;19:33. Published online December 12, 2022; DOI: https://doi.org/10.3352/jeehp.2022.19.33

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Abstract PDF Supplementary Material

Purpose
This study aims to apply the yes/no Angoff and Hofstee methods to actual Korean Medical Licensing Examination (KMLE) 2022 written examination data to estimate cut scores for the written KMLE.
Methods
Fourteen panelists gathered to derive the cut score of the 86th KMLE written examination data using the yes/no Angoff method. The panel reviewed the items individually before the meeting and shared their respective understanding of the minimum-competency physician. The standard setting process was conducted in 5 rounds over a total of 800 minutes. In addition, 2 rounds of the Hofstee method were conducted before starting the standard setting process and after the second round of yes/no Angoff.
Results
For yes/no Angoff, as each round progressed, the panel’s opinion gradually converged to a cut score of 198 points, and the final passing rate was 95.1%. The Hofstee cut score was 208 points out of a maximum 320 with a passing rate of 92.1% at the first round. It scored 204 points with a passing rate of 93.3% in the second round.
Conclusion
The difference between the cut scores obtained through yes/no Angoff and Hofstee methods did not exceed 2% points, and they were within the range of cut scores from previous studies. In both methods, the difference between the panelists decreased as rounds were repeated. Overall, our findings suggest the acceptability of cut scores and the possibility of independent use of both methods.

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Integrating Complementary Practices into Caregiver Training for Community Stroke Rehabilitation: A Pre–Post Study in Thailand
Naphatsaran Roekruangrit, Sirinun Treemongkolthip, Watchara Damjuti
Journal of Health Research.2026;[Epub] CrossRef
Angoff methods in standard setting in health professional education: a systematic review and meta-analysis
Kannan Sridharan, Gowri Sivaramakrishnan
BMC Medical Education.2025;[Epub] CrossRef
Standard setting methods in objective structured clinical examination (OSCE): A comparative study of five methods
Reshma Ansari, Norhafizah Ab Manan, Nur Ain Mahat, Norfaizatul Shalida Omar, Atikah Abdul Latiff, Sara Idris, Azli Shahril Othman
Journal of Medical Education Development.2024; 17(56): 87. CrossRef
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Presidential address: improving item validity and adopting computer-based testing, clinical skills assessments, artificial intelligence, and virtual reality in health professions licensing examinations in Korea
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Brief report

Self-directed learning quotient and common learning types of pre-medical students in Korea by the Multi-Dimensional Learning Strategy Test 2nd edition: a descriptive study: Sun Kim, A Ra Cho, Chul Woon Chung; J Educ Eval Health Prof. 2022;19:32. Published online November 28, 2022; DOI: https://doi.org/10.3352/jeehp.2022.19.32

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Abstract PDF Supplementary Material: This study aimed to find the self-directed learning quotient and common learning types of pre-medical students through the confirmation of 4 characteristics of learning strategies, including personality, motivation, emotion, and behavior. The response data were collected from 277 out of 294 target first-year pre-medical students from 2019 to 2021, using the Multi-Dimensional Learning Strategy Test 2nd edition. The most common learning type was a self-directed type (44.0%), stagnant type (33.9%), latent type (14.4%), and conscientiousness type (7.6%). The self-directed learning index was high (29.2%), moderate (24.6%), somewhat high (21.7%), somewhat low (14.4%), and low (10.1%). This study confirmed that many students lacked self-directed learning capabilities for learning strategies. In addition, it was found that the difficulties experienced by each student were different, and the variables resulting in difficulties were also diverse. It may provide insights into how to develop programs that can help students increase their self-directed learning capability.

Research articles

Acceptability of the 8-case objective structured clinical examination of medical students in Korea using generalizability theory: a reliability study: Song Yi Park, Sang-Hwa Lee, Min-Jeong Kim, Ki-Hwan Ji, Ji Ho Ryu; J Educ Eval Health Prof. 2022;19:26. Published online September 8, 2022; DOI: https://doi.org/10.3352/jeehp.2022.19.26

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Abstract PDF Supplementary Material

Purpose
This study investigated whether the reliability was acceptable when the number of cases in the objective structured clinical examination (OSCE) decreased from 12 to 8 using generalizability theory (GT).
Methods
This psychometric study analyzed the OSCE data of 439 fourth-year medical students conducted in the Busan and Gyeongnam areas of South Korea from July 12 to 15, 2021. The generalizability study (G-study) considered 3 facets—students (p), cases (c), and items (i)—and designed the analysis as p×(i:c) due to items being nested in a case. The acceptable generalizability (G) coefficient was set to 0.70. The G-study and decision study (D-study) were performed using G String IV ver. 6.3.8 (Papawork, Hamilton, ON, Canada).
Results
All G coefficients except for July 14 (0.69) were above 0.70. The major sources of variance components (VCs) were items nested in cases (i:c), from 51.34% to 57.70%, and residual error (pi:c), from 39.55% to 43.26%. The proportion of VCs in cases was negligible, ranging from 0% to 2.03%.
Conclusion
The case numbers decreased in the 2021 Busan and Gyeongnam OSCE. However, the reliability was acceptable. In the D-study, reliability was maintained at 0.70 or higher if there were more than 21 items/case in 8 cases and more than 18 items/case in 9 cases. However, according to the G-study, increasing the number of items nested in cases rather than the number of cases could further improve reliability. The consortium needs to maintain a case bank with various items to implement a reliable blueprinting combination for the OSCE.

Citations

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From Agents to Governance: Essential AI Skills for Clinicians in the Large Language Model Era
Weiping Cao, Qing Zhang, Jialin Liu, Siru Liu
Journal of Medical Internet Research.2026; 28: e86550. CrossRef
Applying borderline methods for setting standards in objective structured clinical examination: the first case in undergraduate medical program in Vietnam
Hoa Thi Thu Doan, Hanh Thi My Nguyen, Anh Tuan Pham
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Flávia Del Castanhel, Fernanda R. Fonseca, Luciana Bonnassis Burg, Leonardo Maia Nogueira, Getúlio Rodrigues de Oliveira Filho, Suely Grosseman
American Journal of Hospice and Palliative Medicine®.2024; 41(7): 792. CrossRef

Possibility of using the yes/no Angoff method as a substitute for the percent Angoff method for estimating the cutoff score of the Korean Medical Licensing Examination: a simulation study: Janghee Park; J Educ Eval Health Prof. 2022;19:23. Published online August 31, 2022; DOI: https://doi.org/10.3352/jeehp.2022.19.23

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Abstract PDF Supplementary Material

Purpose
The percent Angoff (PA) method has been recommended as a reliable method to set the cutoff score instead of a fixed cut point of 60% in the Korean Medical Licensing Examination (KMLE). The yes/no Angoff (YNA) method, which is easy for panelists to judge, can be considered as an alternative because the KMLE has many items to evaluate. This study aimed to compare the cutoff score and the reliability depending on whether the PA or the YNA standard-setting method was used in the KMLE.
Methods
The materials were the open-access PA data of the KMLE. The PA data were converted to YNA data in 5 categories, in which the probabilities for a “yes” decision by panelists were 50%, 60%, 70%, 80%, and 90%. SPSS for descriptive analysis and G-string for generalizability theory were used to present the results.
Results
The PA method and the YNA method counting 60% as “yes,” estimated similar cutoff scores. Those cutoff scores were deemed acceptable based on the results of the Hofstee method. The highest reliability coefficients estimated by the generalizability test were from the PA method and the YNA method, with probabilities of 70%, 80%, 60%, and 50% for deciding “yes,” in descending order. The panelist’s specialty was the main cause of the error variance. The error size was similar regardless of the standard-setting method.
Conclusion
The above results showed that the PA method was more reliable than the YNA method in estimating the cutoff score of the KMLE. However, the YNA method with a 60% probability for deciding “yes” also can be used as a substitute for the PA method in estimating the cutoff score of the KMLE.

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Refining competency benchmarks: a scoping review of Angoff standard-setting in dental education
Galvin Sim Siang Lin, Abdul Rauf Badrul Hisham, Muhammad Nazmi Abdul Majid, Chan Choong Foong, Ting Khee Ho, Lara T. Friedlander
BMC Oral Health.2026;[Epub] CrossRef
Standard setting for dental knowledge tests: reproducibility of the modified Angoff and Ebel method across judges
Ting Khee Ho, Noor Lide Abu Kassim, Lucy O’Malley, Reza Vahid Roudsari
BMC Medical Education.2025;[Epub] CrossRef
Angoff methods in standard setting in health professional education: a systematic review and meta-analysis
Kannan Sridharan, Gowri Sivaramakrishnan
BMC Medical Education.2025;[Epub] CrossRef
Comparing the passing rates of nursing students participating in the objective structured clinical examination using fixed score, Angoff, yes/no Angoff, and 3-level Angoff methods†
Fatemeh Maghsoodi, Mohammadreza Yazdankhahfard, Shahnaz Pouladi, Kamran Mirzaei, Amin Beigzadeh
Frontiers of Nursing.2025; 12(4): 511. CrossRef
Issues in the 3rd year of the COVID-19 pandemic, including computer-based testing, study design, ChatGPT, journal metrics, and appreciation to reviewers
Sun Huh
Journal of Educational Evaluation for Health Professions.2023; 20: 5. CrossRef
Possibility of independent use of the yes/no Angoff and Hofstee methods for the standard setting of the Korean Medical Licensing Examination written test: a descriptive study
Do-Hwan Kim, Ye Ji Kang, Hoon-Ki Park
Journal of Educational Evaluation for Health Professions.2022; 19: 33. CrossRef

Technical report

Development of examination objectives based on nursing competency for the Korean Nursing Licensing Examination: a validity study: Sujin Shin, Gwang Suk Kim, Jun-Ah Song, Inyoung Lee; J Educ Eval Health Prof. 2022;19:19. Published online August 22, 2022; DOI: https://doi.org/10.3352/jeehp.2022.19.19

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Abstract PDF Supplementary Material

Purpose
This study aimed to develop the examination objectives based on nursing competency of the Korean Nursing Licensing Examination.
Methods
This is a validity study to develop the examination objectives based on nursing competency. Data were collected in December 2021. We reviewed the literature related to changing nurse roles and on the learning objectives for the Korea Medical Licensing Examination and other health personnel licensing examinations. Thereafter, we created a draft of the nursing problems list for examination objectives based on the literature review, and the content validity was evaluated by experts. A final draft of the examination objectives is presented and discussed.
Results
A total of 4 domains, 12 classes, and 85 nursing problems for the Korean Nursing Liscensing Examination were developed. They included the essentials of objectives, related factors, evaluation goals, related activity statements, related clients, related settings, and specific outcomes.
Conclusion
This study developed a draft of the examination objectives based on clinical competency that were related to the clinical situations of nurses and comprised appropriate test items for the licensing examination. Above results may be able to provide fundamental data for item development that reflects future nursing practices.

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Xia Mao, John R. Boulet, Jeanne M. Sandella, Michael F. Oliverio, Larissa Smith
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Suggestion for item allocation to 8 nursing activity categories of the Korean Nursing Licensing Examination: a survey-based descriptive study
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Research article

Is it possible to introduce an interview to the Korean Medical Licensing Examination to assess professional attributes?: a survey-based observational study: Seung-Joo Na, HyeRin Roh, Kyung Hee Chun, Kyung Hye Park, Do-Hwan Kim; J Educ Eval Health Prof. 2022;19:10. Published online May 10, 2022; DOI: https://doi.org/10.3352/jeehp.2022.19.10

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Abstract PDF Supplementary Material: Purpose
This study aimsed to gather opinions from medical educators on the possibility of introducing an interview to the Korean Medical Licensing Examination (KMLE) to assess professional attributes. Specifically following topics were dealt with: the appropriate timing and tool to assess unprofessional conduct; ; the possiblity of prevention of unprofessional conduct by introducing an interview to the KMLE; and the possibility of implementation of an interview to the KMLE.
Methods
A cross-sectional study approach based on a survey questionnaire was adopted. We analyzed 104 pieces of news about doctors’ unprofessional conduct to determine the deficient professional attributes. We derived 24 items of unprofessional conduct and developed the questionnaire and surveyed 250 members of the Korean Society of Medical Education 2 times. Descriptive statistics, cross-tabulation analysis, and Fisher’s exact test were applied to the responses. The answers to the open-ended questions were analyzed using conventional content analysis.
Results
In the survey, 49 members (19.6%) responded. Out of 49, 24 (49.5%) responded in the 2nd survey. To assess unprofessional conduct, there was no dominant timing among basic medical education (BME), KMLE, and continuing professional development (CPD). There was no overwhelming assessment tool among written examination, objective structured clinical examination, practice observation, and interview. Response rates of “impossible” (49.0%) and “possible” (42.9%) suggested an interview of the KMLE prevented unprofessional conduct. In terms of implementation, “impossible” (50.0%) was selected more often than “possible” (33.3%).
Conclusion
Professional attributes should be assessed by various tools over the period from BME to CPD. Hence, it may be impossible to introduce an interview to assess professional attributes to the KMLE, and a system is needed such as self-regulation by the professional body rather than licensing examination.

Brief report

Newly appointed medical faculty members’ self-evaluation of their educational roles at the Catholic University of Korea College of Medicine in 2020 and 2021: a cross-sectional survey-based study: Sun Kim, A Ra Cho, Chul Woon Chung; J Educ Eval Health Prof. 2021;18:28. Published online November 5, 2021; DOI: https://doi.org/10.3352/jeehp.2021.18.28

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Abstract PDF Supplementary Material

This study aimed to investigate the degree to which newly appointed medical faculty members at the Catholic University of Korea are aware of Harden and Crosby’s 12 educational roles and to identify their preferred educational roles. A 12-item survey questionnaire was distributed to 110 participants, and 100 responses were included in the analysis. The respondents gave the highest score to “clinical or practical teacher” and the lowest score to “curriculum planner” for their current personal competencies. For their preferred personal future competencies, they assigned the highest score to “on the job role model” and the lowest score to “student assessor.” They gave almost equally high values to all 12 roles. However, individual faculty members had different preferences for educational roles. Accordingly, medical schools need to plan and implement customized faculty development programs, and efforts to provide appropriate educational roles according to individual faculty members’ preferences are needed.

Citations

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Self-directed learning quotient and common learning types of pre-medical students in Korea by the Multi-Dimensional Learning Strategy Test 2nd edition: a descriptive study
Sun Kim, A Ra Cho, Chul Woon Chung
Journal of Educational Evaluation for Health Professions.2022; 19: 32. CrossRef

Research articles

Changes in academic performance in the online, integrated system-based curriculum implemented due to the COVID-19 pandemic in a medical school in Korea: Do-Hwan Kim, Hyo Jeong Lee, Yanyan Lin, Ye Ji Kang; J Educ Eval Health Prof. 2021;18:24. Published online September 23, 2021; DOI: https://doi.org/10.3352/jeehp.2021.18.24

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Purpose
This study examined how students’ academic performance changed after undergoing a transition to online learning during the coronavirus disease 2019 (COVID-19) pandemic, based on the test results of 16 integrated courses conducted in 3 semesters at Hanyang University College of Medicine in Korea.
Methods
For the 16 required courses that formed an integrated system-based curriculum running for 3 semesters, the major examinations’ raw scores were collected for each student. Percent-correct scores were used in the subsequent analysis. We used the t-test to compare grades between 2019 and 2020, and the Cohen D was calculated as a measure of effect size. The correlation of scores between courses was calculated using Pearson correlation coefficients.
Results
There was a significant decrease in scores in 2020 for 10 courses (62.5%). While most of the integrated system-based curriculum test scores showed strong correlations, with coefficients of 0.6 or higher in both 2019 and 2020, the correlation coefficients were generally higher in 2020. When students were divided into low, middle, and high achievement groups, low-achieving students consistently showed declining test scores in all 3 semesters.
Conclusion
Our findings suggest that the transition to online classes due to COVID-19 has led to an overall decline in academic performance. This overall decline, which may occur when the curriculum is centered on recorded lectures, needs to be addressed. Further, medical schools need to consider establishing a support system for the academic development of low-achieving students.

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Birte Barbian, Thomas Shiozawa, Morris Gellisch, Irene Brunk, Katharina Langer‐Fischer, Nicole Wagner, Sina Benker, Michelle Bellstedt, Nils Otto, Dogus Darici
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Coronavirus Disease 2019 Cases at Universities and Colleges in Seoul Metropolitan Area
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The accuracy and consistency of mastery for each content domain using the Rasch and deterministic inputs, noisy “and” gate diagnostic classification models: a simulation study and a real-world analysis using data from the Korean Medical Licensing Examination: Dong Gi Seo, Jae Kum Kim; J Educ Eval Health Prof. 2021;18:15. Published online July 5, 2021; DOI: https://doi.org/10.3352/jeehp.2021.18.15

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Purpose
Diagnostic classification models (DCMs) were developed to identify the mastery or non-mastery of the attributes required for solving test items, but their application has been limited to very low-level attributes, and the accuracy and consistency of high-level attributes using DCMs have rarely been reported compared with classical test theory (CTT) and item response theory models. This paper compared the accuracy of high-level attribute mastery between deterministic inputs, noisy “and” gate (DINA) and Rasch models, along with sub-scores based on CTT.
Methods
First, a simulation study explored the effects of attribute length (number of items per attribute) and the correlations among attributes with respect to the accuracy of mastery. Second, a real-data study examined model and item fit and investigated the consistency of mastery for each attribute among the 3 models using the 2017 Korean Medical Licensing Examination with 360 items.
Results
Accuracy of mastery increased with a higher number of items measuring each attribute across all conditions. The DINA model was more accurate than the CTT and Rasch models for attributes with high correlations (>0.5) and few items. In the real-data analysis, the DINA and Rasch models generally showed better item fits and appropriate model fit. The consistency of mastery between the Rasch and DINA models ranged from 0.541 to 0.633 and the correlations of person attribute scores between the Rasch and DINA models ranged from 0.579 to 0.786.
Conclusion
Although all 3 models provide a mastery decision for each examinee, the individual mastery profile using the DINA model provides more accurate decisions for attributes with high correlations than the CTT and Rasch models. The DINA model can also be directly applied to tests with complex structures, unlike the CTT and Rasch models, and it provides different diagnostic information from the CTT and Rasch models.

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Stable Knowledge Tracing Using Causal Inference
Jia Zhu, Xiaodong Ma, Changqin Huang
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Development of a character qualities test for medical students in Korea using polytomous item response theory and factor analysis: a preliminary scale development study
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Journal of Educational Evaluation for Health Professions.2023; 20: 20. CrossRef

Changes in the working conditions and learning environment of medical residents after the enactment of the Medical Resident Act in Korea in 2015: a national 4-year longitudinal study: Sangho Sohn, Yeonjoo Seo, Yunsik Jeong, Seungwoo Lee, Jeesun Lee, Kyung Ju Lee; J Educ Eval Health Prof. 2021;18:7. Published online April 20, 2021; DOI: https://doi.org/10.3352/jeehp.2021.18.7

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Purpose
In 2015, the South Korean government legislated the Act for the Improvement of Training Conditions and Status of Medical Residents (Medical Resident Act). This study investigated changes in the working and learning environment pre- and post-implementation of the Medical Resident Act in 2017, as well as changes in training conditions by year post-implementation.
Methods
An annual cross-sectional voluntary survey was conducted by the Korean Intern Resident Association (KIRA) between 2016 and 2019. The learning and working environment, including extended shift length, rest time, learning goals, and job satisfaction, were compared by institution type, training year, and specialty.
Results
Of the 55,727 enrollees in the KIRA, 15,029 trainees took the survey, and the number of survey participants increased year by year (from 2,984 in 2016 to 4,700 in 2019). Overall working hours tended to decrease; however, interns worked the most (114 hours in 2016, 88 hours in 2019; P<0.001). Having 10 hours or more of break time has gradually become more common (P<0.001). Lunch breaks per week decreased from 5 in 2017 to 4 in 2019 (P<0.001). Trainees’ sense of educational deprivation due to physician assistants increased from 17.5% in 2016 to 25.6% in 2018 (P<0.001). Awareness of tasks and program/work achievement goals increased from 29.2% in 2016 to 58.3% in 2018 (P<0.001). Satisfaction with the learning environment increased over time, whereas satisfaction with working conditions varied.
Conclusion
The Medical Resident Act has brought promising changes to the training of medical residents in Korea, as well as their satisfaction with the training environment.

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Brief report

Core elements of character education essential for doctors suggested by medical students in Korea: a preliminary study: Yera Hur, Keumho Lee; J Educ Eval Health Prof. 2020;17:43. Published online December 21, 2020; DOI: https://doi.org/10.3352/jeehp.2020.17.43

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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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Character education empirical research: A thematic review and comparative content analysis
Peter Oldham, Shane McLoughlin
Journal of Moral Education.2026; 55(2): 313. CrossRef
Medical students’ self-evaluation of character, and method of character education
Yera Hur, Sanghee Yeo, Keumho Lee
BMC Medical Education.2022;[Epub] CrossRef
Ethical and Moral Issues in Undergraduate Medical Education: An Exploratory Study
Noor-i-Kiran Naeem, Zil-e-Fatima Naeem, Asfandyar Anwer
Journal of Shalamar Medical & Dental College - JSHMDC.2022; 3(2): 48. CrossRef
Definition of character for medical education based on expert opinions in Korea
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Brief Report

Clinical performance of medical students in Korea in a whole-task emergency station in the objective structured clinical examination with a standardized patient complaining of palpitations: Song Yi Park, Hyun-Hee Kong, Min-Jeong Kim, Yoo Sang Yoon, Sang-Hwa Lee, Sunju Im, Ji-Hyun Seo; J Educ Eval Health Prof. 2020;17:42. Published online December 16, 2020; DOI: https://doi.org/10.3352/jeehp.2020.17.42

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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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Newly appointed medical faculty members’ self-evaluation of their educational roles at the Catholic University of Korea College of Medicine in 2020 and 2021: a cross-sectional survey-based study
Sun Kim, A Ra Cho, Chul Woon Chung
Journal of Educational Evaluation for Health Professions.2021; 18: 28. CrossRef
Comparing the cut score for the borderline group method and borderline regression method with norm-referenced standard setting in an objective structured clinical examination in medical school in Korea
Song Yi Park, Sang-Hwa Lee, Min-Jeong Kim, Ki-Hwan Ji, Ji Ho Ryu
Journal of Educational Evaluation for Health Professions.2021; 18: 25. CrossRef

Research articles

Development and validation of a portfolio assessment system for medical schools in Korea: Dong Mi Yoo, A Ra Cho, Sun Kim; J Educ Eval Health Prof. 2020;17:39. Published online December 9, 2020; DOI: https://doi.org/10.3352/jeehp.2020.17.39

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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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Design Logic and Evaluative Implications of Portfolio-Based Learning in Korean Medicine Education : A Conceptual Analysis Based on Competency-Based Education and Programmatic Assessment
Myung-ho Jin, Seon Kyoung Kim
Journal of Korean Medicine.2026; 47(1): 167. CrossRef
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Health Science Reports.2026;[Epub] CrossRef
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Inter-rater reliability and content validity of the measurement tool for portfolio assessments used in the Introduction to Clinical Medicine course at Ewha Womans University College of Medicine: a methodological study
Dong-Mi Yoo, Jae Jin Han
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Hollis Lai, Nazila Ameli, Steven Patterson, Anthea Senior, Doris Lunardon
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Medical Student Portfolios: A Systematic Scoping Review
Rei Tan, Jacquelin Jia Qi Ting, Daniel Zhihao Hong, Annabelle Jia Sing Lim, Yun Ting Ong, Anushka Pisupati, Eleanor Jia Xin Chong, Min Chiam, Alexia Sze Inn Lee, Laura Hui Shuen Tan, Annelissa Mien Chew Chin, Limin Wijaya, Warren Fong, Lalit Kumar Radha K
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Differences in nurses’ perceptions of self-reported pain and the administered morphine dose according to the patient’s facial expression in Korea: Jeong Yun Park, Da In Lee; J Educ Eval Health Prof. 2020;17:38. Published online December 1, 2020; DOI: https://doi.org/10.3352/jeehp.2020.17.38

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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.

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Key competencies for Korean nurses in prenatal genetic nursing: experiential genetic nursing knowledge, and ethics and law: Gyeyoung Shin, Myunghee Jun, Hye-Kyung Kim, Michael Wreen, Sylvia Mimi Kubsch; J Educ Eval Health Prof. 2020;17:36. Published online November 26, 2020; DOI: https://doi.org/10.3352/jeehp.2020.17.36

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Abstract PDF Supplementary Material

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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Empowering midwives with genetic knowledge: A systematic review of educational needs in genomics
Talia Gusen, Lucinda Freeman, Loretta Musgrave
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Konstantinos Mintzaridis, Evangelos Dousis, Eleni Evangelou, Maria Polikandrioti, Ioannis Koutelekos
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Level of professional ethics awareness and medical ethics competency of dental hygienists and dental hygiene students: the need to add ethics items to the Korean Dental Hygienist Licensing Examination: Yoon-Sook Hwang, Jong-Hwa Jang, Kyung-Hee Kang, Minji Kim, Jeong-Ran Park, Sohyun Son, Sun-Mi Lee, Da-Yee Jeung, Jung-Eun Ha, Su-Min Hong, Young-Eun Jang; J Educ Eval Health Prof. 2020;17:34. Published online November 17, 2020; DOI: https://doi.org/10.3352/jeehp.2020.17.34

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Abstract PDF Supplementary Material: 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.

Reviews

A proposal for the future of medical education accreditation in Korea: Ki-Young Lim; J Educ Eval Health Prof. 2020;17:32. Published online October 21, 2020; DOI: https://doi.org/10.3352/jeehp.2020.17.32

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Abstract PDF Supplementary Material

For the past 20 years, the medical education accreditation program of the Korean Institute of Medical Education and Evaluation (KIMEE) has contributed significantly to the standardization and improvement of the quality of basic medical education in Korea. It should now contribute to establishing and promoting the future of medical education. The Accreditation Standards of KIMEE 2019 (ASK2019) have been adopted since 2019, with the goal of achieving world-class medical education by applying a learner-centered curriculum using a continuum framework for the 3 phases of formal medical education: basic medical education, postgraduate medical education, and continuing professional development. ASK2019 will also be able to promote medical education that meets community needs and employs systematic assessments throughout the education process. These are important changes that can be used to gauge the future of the medical education accreditation system. Furthermore, globalization, inter-professional education, health systems science, and regular self-assessment systems are emerging as essential topics for the future of medical education. It is time for the medical education accreditation system in Korea to observe and adopt new trends in global medical education.

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Is accreditation in medical education in Korea an opportunity or a burden?: Hanna Jung, Woo Taek Jeon, Shinki An; J Educ Eval Health Prof. 2020;17:31. Published online October 21, 2020; DOI: https://doi.org/10.3352/jeehp.2020.17.31

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The accreditation process is both an opportunity and a burden for medical schools in Korea. The line that separates the two is based on how medical schools recognize and utilize the accreditation process. In other words, accreditation is a burden for medical schools if they view the accreditation process as merely a formal procedure or a means to maintain accreditation status for medical education. However, if medical schools acknowledge the positive value of the accreditation process, accreditation can be both an opportunity and a tool for developing medical education. The accreditation process has educational value by catalyzing improvements in the quality, equity, and efficiency of medical education and by increasing the available options. For the accreditation process to contribute to medical education development, accrediting agencies and medical schools must first be recognized as partners of an educational alliance working together towards common goals. Secondly, clear guidelines on accreditation standards should be periodically reviewed and shared. Finally, a formative self-evaluation process must be introduced for institutions to utilize the accreditation process as an opportunity to develop medical education. This evaluation system could be developed through collaboration among medical schools, academic societies for medical education, and the accrediting authority.

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History of the medical education accreditation system in Korea: implementation and activities in the early stages: Kwang-ho Meng; J Educ Eval Health Prof. 2020;17:29. Published online October 21, 2020; DOI: https://doi.org/10.3352/jeehp.2020.17.29

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Following the opening of 12 new medical schools in Korea in the 1980s, standardization and accreditation of medical schools came to the forefront in the early 1990s. To address the medical community’s concerns about the quality of medical education, the Korean Council for University Education and Ministry of Education conducted a compulsory medical school evaluation in 1996 to see whether medical schools were meeting academic standards or not. This evaluation was, however, a norm-referenced assessment, rather than a criterion-referenced assessment. As a result, the Accreditation Board for Medical Education in Korea (ABMEK) was founded in 1998 as a voluntary organization by the medical community. With full support of the Korean medical community, ABMEK completed its 1st cycle of evaluations of all 41 medical schools from 2000 to 2004. In 2004, ABMEK changed its name to the Korean Institute of Medical Education and Evaluation (KIMEE) as a corporate body. After that, the Korean government paid closer attention to its voluntary accreditation activities. In 2014, the Ministry of Education officially recognized the KIMEE as the 1st professional institute for higher education evaluation accreditation. The most important lesson learned from ABMEK/KIMEE is the importance of collaboration among all medical education-related organizations, including the Korean Medical Association.

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Rules and guidelines for distancing in daily life to control coronavirus disease 2019 in Korea: 3rd version, announced on July 3, 2020: J Educ Eval Health Prof. 2020;17:20. Published online July 13, 2020; DOI: https://doi.org/10.3352/jeehp.2020.17.20

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In Korea, the first case of coronavirus disease 2019 (COVID-19) was reported on January 21, 2020, after which the number of infected people began to increase. Intensive control measures stabilized the spread of COVID-19 in Korea. Therefore, the Korean government introduced the policy of “distancing in daily life” to support the maintenance of normal life starting on March 22, 2020. This policy provides rules and guidelines on distancing in daily life to facilitate the control of COVID-19 in Korea. “Distancing in daily life” refers to a new, sustainable way of life and social interactions that prepares society to face the possibility of long-term prevalence of COVID-19. These guidelines aim to achieve the goal of infection prevention and containment, while sustaining people’s everyday life, economic, and social activities. All members of society and communities are called upon to fulfill their respective responsibilities to combat the COVID-19 pandemic and to safeguard everyone’s health and well-being. Five key rules govern personal distancing in daily life: stay home for 3–4 days if you feel unwell; keep a distance of 2 arms’ length from others; wash your hands for 30 seconds and cough or sneeze into your sleeve; ventilate spaces at least twice a day and disinfect regularly; and stay connected while physically distancing. Collective distancing in daily life for communities and organizations is supported by these 5 key rules, and detailed guidelines are set out for different types of facilities. All individuals and communities are obliged to abide by these rules and guidelines for distancing as part of daily life.

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