OBJECTIVES: Home-based nursing care services have increased over the past decade. However, accountability and privacy issues as well as security concerns become more challenging during care provider visits. Because of the heterogeneous combination of mobile and stationary assistive medical care devices, conventional systems lack architectural consistency, which leads to inherent time delays and inaccuracies in sharing information. The goal of our study is to develop an architecture that meets the competing goals of accountability and privacy and enhances security in distributed home-based care systems. METHODS: We realized this by using a context-aware approach to manage access to remote data. Our architecture uses a public certification service for individuals, the Japanese Public Key Infrastructure and Health Informatics-PKI to identify and validate the attributes of medical personnel. Both PKI mechanisms are provided by using separate smart cards issued by the government. RESULTS: Context-awareness enables users to have appropriate data access in home-based nursing environments. Our architecture ensures that healthcare providers perform the needed home care services by accessing patient data online and recording transactions. CONCLUSIONS: The proposed method aims to enhance healthcare data access and secure information delivery to preserve user's privacy. We implemented a prototype system and confirmed its feasibility by experimental evaluation. Our research can contribute to reducing patient neglect and wrongful treatment, and thus reduce health insurance costs by ensuring correct insurance claims. Our study can provide a baseline towards building distinctive intelligent treatment options to clinicians and serve as a model for home-based nursing care.
Asian Continental Ancestry Group ; Certification ; Computer Security ; Delivery of Health Care ; Electronic Health Records ; Health Information Exchange ; Health Personnel ; Health Smart Cards ; Home Care Services ; Home Health Nursing ; Humans ; Information Dissemination ; Insurance ; Insurance, Health ; Methods ; Nursing ; Nursing Care ; Privacy ; Social Responsibility

OBJECTIVE: This study investigated and compared the perspectives on emergency medicine (EM) professionalism competencies of medical students and EM residents. In addition, how they learned their EM professionalism was also investigated to develop the base of an educational program of professionalism in the field of EM. METHODS: Medical students in four medical colleges/schools and EM residents were recruited for the questionnaire. Regarding the importance and educational need for EM professionalism, 23 items for medical students and 59 items for EM residents were asked. The items were rated on a five point Likert scale. The perspectives of the two groups were compared. The learning methods for professionalism were investigated. RESULTS: A total of 198 medical students and 109 EM residents responded to the questionnaire. The residents responded with mean of 3.0 or more on all items, agreeing on the importance and educational need. On the other hand, the mean scale was less than 4.0 in communication and cooperation with society and social accountability. The students responded with a mean scale of 4.0 or more on all items and agreed on the importance and educational need. Of the 23 common items, there were differences between the two groups in 17 items, showing a higher mean value in the students. The most common methods of learning EM professionalism was bedside teaching during the clinical clerkship for students, and patient handover or board round for residents. CONCLUSION: EM residents tended to place more importance on medical care than social communication, cooperation, and ethical items. The most common learning method of EM professionalism was clinical practice-associated activities. The results of this study could help to develop a systematic and realistic educational program of EM professionalism in EM clerkship and resident training.
Clinical Clerkship ; Emergencies ; Emergency Medicine ; Hand ; Humans ; Learning ; Methods ; Patient Handoff ; Professionalism ; Social Responsibility ; Students, Medical

The aim of this study is to analyze the current status and performance evaluation systems of faculty in Korean medical colleges and professional graduate medical schools (called medical schools). We developed a research tool based on previous studies and distributed it to 40 medical schools from July to October 2017. The response rate was 100%. We calculated the number of faculty members and analyzed the faculty evaluation systems and awareness according to national and private medical schools. As of 2017, the number of medical faculty in Korea was 11,111 (4,973 faculty were employed by their alma mater, which is 44.76% of the total), with non-medical doctor faculty accounting for 754 of the total. The medical schools reflect research achievements as most important for re-appointment and screening to promote faculty, and the area of education is secondary excepting clinical faculty of private medical schools. However, important issues in the faculty evaluation deal with the relevance of research achievement and the need for qualitative assessment. Some medical schools revised or have been revising the faculty evaluation system in areas such as minimum standards of education for promotion and separation of promotion and tenure review. Opening non-tenure track lines for faculty show positive effects such as increasing the number of positions for hire and easing the financial burdens of medical schools. Downfalls include inconsistencies between the responsibilities and actual practices of tenure not being available and the instability of faculty's status. In conclusion, medical schools need to prepare a faculty evaluation system that fits the position of faculty members and attempt to establish a reasonable compensation system.
Compensation and Redress ; Education ; Faculty, Medical ; Health Personnel ; Humans ; Korea ; Mass Screening ; Reward ; Schools, Medical ; Social Responsibility

PURPOSE: The purpose of this study was to identify the perception and factors affecting social responsibility in nursing students. METHODS: The participants for this study were 301 nursing students in three universities and three colleges located in Seoul, Gyeonggi or Gyeongbuk in South Korea. Data were collected in Dec, 2015 using structured questionnaires and analyzed using independent t-test, one way ANOVA, Pearson correlation coefficient, multiple regression analysis with the SPSS/WIN 18.0 program. RESULTS: The mean score for social responsibility of nursing students had a significant positive correlation with satisfaction with nursing major, nursing professionalism and sociality. Sociality, nursing professionalism and nursing major satisfaction were the major predictors of social responsibility and explained 51.0%(F=142.67, p < .001) of the total variance in the study. CONCLUSION: The results suggest that it is necessary to develop strategies to promote the various nursing curricular programs that reinforce social responsibility in nursing college students.
Gyeonggi-do ; Gyeongsangbuk-do ; Humans ; Korea ; Nursing ; Professionalism ; Seoul ; Social Responsibility ; Students, Nursing

PURPOSE: This study was performed to develop the Job Satisfaction Scale for Clinical Nurses (JSS-CN) and verify its validity and reliability. METHODS: A preliminary 42-item version of the JSS-CN was developed through literature reviews and in-depth interviews. The draft scale was developed using thirty-seven items selected following content validity evaluation. Finally, thirty-three items with response options on a 5-point Likert scale were selected based on internal consistency reliability and construct validity. Subsequently, the test-retest reliability and convergent validity of the JSS-CN were verified. RESULTS: Six factors, namely, recognition from the organization and professional achievement, personal maturation through the nursing profession, interpersonal interaction with respect and recognition, accomplishment of accountability as a nurse, display of professional competency, and stability and job worth, were identified, which explained 59.7% of the total variance. The JSS-CN's Cronbach's α for the total scale was .95, and the intra-class correlation coefficient was .90. The correlation coefficient between the scores of the JSS-CN and Slavitt's scale was .75, and that between the JSS-CN and job performance was .53. CONCLUSION: Results showed that the JSS-CN has good reliability and validity. Therefore, it is concluded that the JSS-CN could be a useful tool for the measurement of the job satisfaction of clinical nurses in Korea.
Humans ; Job Satisfaction ; Korea ; Nursing ; Reproducibility of Results ; Social Responsibility ; Work Performance

OBJECTIVE: The aim of this study was to develop professionalism competency for residents and medical students in the field of emergency medicine. METHODS: Twenty emergency medicine specialists working at a university hospital were recruited for the modified Delphi method. Seventy-three items were generated and classified into five domains: 13 items in patient care, 19 in communication and cooperation, nine in social accountability, 24 in professionalism, and eight in education and research. Two-step surveys were conducted. RESULTS: Items with a low content validity ratio (< 0.42) were deleted, or combined when the meanings of the items were similar or duplicated through two-step surveys. Finally, 59 items for residents were used: 12 items in patient care, 11 in communication and cooperation, six in social accountability, 23 in professionalism, and seven in education and research. In addition, 23 items for medical students were settled: six items in patient care, five in communication and cooperation, none in social accountability, 11 in professionalism, and one in education and research. CONCLUSION: The items related to social accountability and communication and cooperation with society were considered less important by the panels. In addition, there was a tendency to clearly distinguish between resident and student levels in professionalism competency. Based on the results of this study, it is important to form a basis for developing educational programs of professionalism of emergency medicine for senior medical students and residents.
Clinical Competence ; Delphi Technique* ; Education ; Emergencies* ; Emergency Medicine* ; Humans ; Methods ; Patient Care ; Professionalism* ; Social Responsibility ; Specialization ; Students, Medical*

PURPOSE: Team-based learning (TBL) is increasingly employed in medical education because of its potential to promote active group learning. In TBL, learners are usually asked to assess the contributions of peers within their group to ensure accountability. The purpose of this study is to assess the validity and reliability of a peer evaluation instrument that was used in TBL classes in a single medical school. METHODS: A total of 141 students were divided into 18 groups in 11 TBL classes. The students were asked to evaluate their peers in the group based on evaluation criteria that were provided to them. We analyzed the comments that were written for the highest and lowest achievers to assess the validity of the peer evaluation instrument. The reliability of the instrument was assessed by examining the agreement among peer ratings within each group of students via intraclass correlation coefficient (ICC) analysis. RESULTS: Most of the students provided reasonable and understandable comments for the high and low achievers within their group, and most of those comments were compatible with the evaluation criteria. The average ICC of each group ranged from 0.390 to 0.863, and the overall average was 0.659. There was no significant difference in inter-rater reliability according to the number of members in the group or the timing of the evaluation within the course. CONCLUSION: The peer evaluation instrument that was used in the TBL classes was valid and reliable. Providing evaluation criteria and rules seemed to improve the validity and reliability of the instrument.
Education, Medical ; Humans ; Learning* ; Methods* ; Reproducibility of Results* ; Schools, Medical ; Social Responsibility

This study examined doctors' images represented in the Korean press to identify overall public perceptions of doctors and to suggest areas for improvement to enhance their image. All news reports published in the two major Korean daily newspapers between years 2011 and 2015 related to doctors and the practice of medicine were searched and collected. The news reports were categorized into the five competency domains in the Korean doctor's role (i.e., patient care, communication and cooperation, social accountability, professionalism, and education and research). Each news item was coded as being either positive or negative and was given a score regarding the extent to which positive or negative image that it represents of doctors using the Doctor Image Scale (DIS) score. A total of 314 news reports were collected, a majority of which were on patient care (36%), professionalism (33%), and social accountability (23%). Positive stories slightly outnumbered negative ones (56% vs. 44%). The largest number of positive news reports was in patient care (n=82); negative news reports most frequently appeared in professionalism (n=99) and patient care (n=32). The total DIS score was also positive (+28): the highest positive DIS score was in social accountability (+164); the highest negative DIS score was obtained in professionalism (−226). This study revealed overall positive portrayals of doctors in the Korean press, yet doctors need to better comply with regulations and ethical guidelines and enhance their medical knowledge and clinical skills and to improve their image.
Clinical Competence ; Education ; Patient Care ; Periodicals ; Physician's Role ; Professionalism ; Republic of Korea ; Social Control, Formal ; Social Responsibility

PURPOSE: This study was done to identify public attitudes toward mental illness, and to use Q methodology to build understanding of the differences among these attitude types. METHODS: Q Methodology was used to examine the public's attitude on mental illness. Thirty participants classified 33 selected Q-statements on a seven-point scale to create a normal distribution. The collected data were analyzed by using the PC QUANL program. RESULTS: Four types of attitudes toward mental illness were identified. Type I was named ‘Pursuing positive attention and patience regarding serious human rights’; type II, ‘Demanding the abolishing of prejudice through various media’, type III, ‘Emphasizing social responsibility at a distance from mental illness’, and type IV, ‘Focusing on reversible treatment of the disease’. CONCLUSION: In this study, the general public has presented a nursing intervention strategy that can provide support that allows for a positive recognition of mental disorders in accordance with the characteristics of each type.
Humans ; Mental Disorders ; Nursing ; Prejudice ; Social Responsibility

PURPOSE: Although nursing presence is a foundation for professional nursing practice and has known positive outcomes such as patient satisfaction and recovery; it is not well known. The ambiguity surrounding how to define nursing presence has challenged its evaluation and education. Therefore, in an attempt to discover attributes of this underdeveloped concept and studying it in a new context, concept development is essential. The purpose of this study was to clarify the concept of nursing presence through concept development, to produce a tentative definition of this subjective concept in clinical practice. METHODS: Concept development was carried out using Schwartz-Barcott and Kim's hybrid model including, theoretical, fieldwork and final analysis phases. First, 29 related articles available on the databases from 1990–2015 were reviewed and analyzed. Then, 22 interviews were conducted with 19 participants, followed with inductive content analysis. At last, an overall definition was performed. RESULTS: Nursing presence can be explained as co-constructed interaction identified by deliberate focus, task-oriented/patient-oriented relationship, accountability, clarification, and ubiquitous participation. Nursing presence requires clinical competence, self-actualization, reciprocating openness, and conducive working environment. Worthwhile communications, balance/recovery, and growth and transcendence are the main consequences of this concept. CONCLUSION: Co-constructed interaction underscored the value of the nursing presence as an integral component of caring with humanistic and patient-centered approaches. The findings could help clinical nurses have a better understanding of the nursing presence. Findings also can improve educators' and managers' knowledge for developing and conducting appropriate education strategies and caring activities to facilitate the promotion of nursing presence.
Clinical Competence ; Education ; Humanism ; Nurse-Patient Relations ; Nursing ; Patient Satisfaction ; Qualitative Research ; Social Responsibility