To evaluate the educational effects of a lung-sound auscultation simulator, “Mr. Lung”, we compared outcomes of fifth-year medical students in 2001 and 2002. From June 2001 through March 2002, we used “Mr. Lung” for small-group teaching for 100 fifth-year medical students. The following year, we opened our laboratory so that the fifth-year students could study with “Mr. Lung” by themselves for 1 month. “Mr. Lung” was then used for objective structured clinical examinations in May 2002. From June 2002 through April 2003, we used “Mr. Lung” again for small-group teaching for 91 fifth-year students. The class consisted of 90 minutes' training for the auscultation of lung sounds. At the beginning of class, auscultation tests were performed in which the students listened through their stethoscopes to 3 examples of abnormal lung sounds on “Mr. Lung” and answered questions about the location and quality of the sounds. The percentages of correct answers in 2001 and 2002, respectively, were 36.9% and 35.4% for differences between bilateral lung sounds, 52.5% and 55.8% for coarse crackles, 34.1% and 58.3%(p<0.05) for fine crackles, 69.2% and 70.8% for wheezes, 62.1% and 90.7%(p<0.01) for rhonchi, and 22.2% and 32.6% for stridor. In conclusion, 1 month's self-study with “Mr. Lung” to prepare for the objective structured clinical examinations improves auscultation skills.

BACKGROUND: Smoking is one of the most important leading causes of morbidity and mortality. Smoking habit is recognized as nicotine dependence, which consists of physical and psychosocial dependence. To evaluate social nicotine dependence, the Kano Test for Social Nicotine Dependence (KTSND) working group developed a new questionnaire, which consists of 10 questions with a total score of 30 in Japan. We examined the social nicotine dependence among healthy adults using the new KTSND questionnaire and evaluated validity of the KTSND questionnaire in Korea. METHOD: We applied Korean KTSND questionnaire version 2 to employees of hospital, university students and people for medical examination and promotion test. Complete data obtained from the 741 responders were analyzed. RESULT: The mean age of responders was 31.8 years. Among them, males were 57.8%. Current smokers, ex-smokers, and non-smokers were 13.8%, 12.8%, and 73.4% respectively. According to smoking status, the total KTSND scores of current smokers were significantly higher than those of ex-smokers, and of non-smokers (17.1+/-5.4 versus 14.3+/-5.5, and 12.3+/-5.5, p< or =0.001). The total KTSND scores of males were higher than those of females, suggesting that males have a propensity for depending nicotine socially much more than females (14.3+/-5.7 and 11.7+/-5.4 respectively, p<0.001). Eight of ten questions produced significantly different scores among three different smoking groups. When current smokers were sub-classified by heavy smoking index (HSI) that represented physical nicotine dependence, we did not find a significant difference of KTSND score between low HSI group (<4) and high HSI group (> or =4), This finding suggested that the psychosocial dependence might play a different role from physical nicotine dependence in smoking. Most of the non-smokers (62.5%) had an experience of harmful passive smoking especially in public place. CONCLUSION: Our study suggested that the KTSND questionnaire could be a useful method to evaluate psychosocial aspects of smoking.
Adult ; Female ; Humans ; Japan ; Korea* ; Male ; Mortality ; Nicotine* ; Surveys and Questionnaires* ; Smoke ; Smoking ; Tobacco Smoke Pollution ; Tobacco Use Disorder*