No abstract available.
Prescriptions* ; Primary Health Care*

No abstract available.

BACKGROUNG: Family medicine clerkship gives undergraduate medical students the opportunity to integrate knowledge and skills taught in class. Impression from clerkship experience and preceptor's role model allow medical students to consider family medicine as a career choice. This study investigated the effect of family medicine clerkship on the preference for family medicine as a career choice in third-year medical students. METHODS: From July through December of 1995, one hundred third-year medical students attended family medicine clerkship at Hanyang University Medical School (HUMS). They were divided into 20 groups of 4~6 students. Seven half-days of clerkship teaching were provided in a private family medicine clinic and 2 half-days, in an university hospital family medicine clinic. The score of preference for family medicine was measured using the 10 cm visual analogue scale. RESULTS:The subjects' mean age was 24.1 years. Eighty eighty percent of students were males. The mean score of preference for family medicine as a career choice were 3.2 for pre-clerkship, 6.9 for post-clerkship, and 7.0 at the end of third-year semester exam, respectively. The group preference score was different among groups. Sex, age, hometown, parents' occupation, inhabitation type, religion, and lecture exam score were not related to the preference score. Eleven percent of students hoped to specialize in family medicine in the future. The students' main conception of family medicine were 'primary care', and 'comprehensive care', in descending order. CONCLUSION: Third-year family medicine clinical clerkship improved the students' preference for family medicine as a career choice. A continuous program needs to be developed to render positive effect into the final stage of resident selection.
Career Choice* ; Clinical Clerkship ; Education ; Family Practice ; Fertilization ; Hope ; Humans ; Male ; Occupations ; Schools, Medical ; Students, Medical*

In addition to the traditional MCQ test, National Medical Licensing Examination Board (NMLEB) will introduce clinical skills assessment as an independent exam for MD qualification in 2009. The clinical skills test will evaluate six procedural skills and six clinical problems by using OSCE and CPX. The validity and reliability of the test should be established by continuing effort from experts and efficient administration. The test may change the curriculum of clinical education in many medical schools. National Health Personnel Licensing Examination Board (NHPLEB) is required to prepare this exam step by step and maintain the quality of the skills exam. There should be opportunity for medical students to participate in clinical practice during bedside teaching. Collaboration between exam institution and medical schools will be needed for a successful launching of the skills test.
Clinical Competence ; Cooperative Behavior ; Curriculum ; Health Personnel ; Humans ; Licensure ; Reproducibility of Results ; Schools, Medical ; Students, Medical

Primary care physicians who can deliver high quality primary care services are essential for strengthening the primary health care system. In Korea, primary care was regarded as substandard services practiced by any medical doctor without postgraduate education in primary care. The current and future health care systems are challenged by increasing complexity and co-morbidity and healthcare costs in medical care. The developed countries are preparing for the future by increasing support for basic, postgraduate, and continuing medical education in primary care. To strengthen the primary care in Korea, basic medical education programs should require experience in primary care clinics with a teaching and education function. Postgraduate primary care medical education must be enhanced to be qualified to practice in the community. The recognition of the importance of primary care and the need for changes in the current education and healthcare system among medical professionals and other stakeholders and support systems such as legislation and finance for primary care medical education.
Delivery of Health Care ; Developed Countries ; Education, Medical ; Education, Medical, Continuing ; Health Care Costs ; Humans ; Korea ; Physicians, Primary Care ; Primary Health Care ; Residence Characteristics

No abstract available.

If large-scale testing programs are being used, OSCE stations may be duplicated into two or more sites. There are a few studies on the reliability of OSCE with duplicated stations in Korea. The purpose of this study was to investigate the effect of duplication on the reliability of OSCE. At Hanyang university college of medicine, an OSCE is given to all senior medical students(91 per class) upon completion of all clinical clerkship rotations. The examination consisted of twenty one stations and eighteen cases that represented commonly encountered problems in primary care. Each station required seven minutes for its administration, with 6 to 6.5 minutes for the student-SP or model encounter, during which the students performs a complete focused history and/or physical examination and/or procedure and/or management, and another 0.5 to 1 minutes for the evaluator to feedback case-related comments. We analysed the reliability of duplication by comparing total OSCE scores and case scores between two exam sites. We also evaluated the reliability of duplicated stations from student's and professor's subjective response to the OSCE. All 91 fourth-year students attended the OSCE. Standardized Cronbach coefficient of the OSCE was 0.67. The station scores and OSCE total scores were different between two duplication sites. The total OSCE score of one site was slight higher than that of the other site(p=0.03). Of total 19 stations in which students were evaluated by staff evaluator, six stations are more advantageous to one part compared with counterpart stations, other six stations are vice CONCLUSIONS: OSCE reliability can be affected by duplication of examination sites and inter-rater reliability is the most important determining factor. The results demonstrate a need for caution in the interpretation of scores obtained from OSCE with duplicated stations.
Clinical Clerkship ; Humans ; Korea ; Physical Examination ; Primary Health Care

PURPOSE: Standardized patients participate in clinical performance examinations not only to simulate case scenarios but also to evaluate the performance of students using a checklist. The accuracy in checking off checklist items is one of the most important factors determining the reliability of this examination. The purposes of this study were to determine the SP' s overall accuracy in recording checklist items, and whether their accuracy was affected by certain characteristics of checklist items. METHODS: Three professors, who have been fully involved in scenario development and SP training, reviewed videotapes of the examination and evaluated the performance of the students using the same checklist. SP' s checklists were marked on this 'correct checklist'. The checklists and checklist guidelines of the items marked under the score of 50 out of 100 were analyzed. RESULTS: Results showed that the accuracy of the SP' s in recording checklist items was 86.9% and was affected by certain characteristics, such as complexity or ambiguity of checklists and checklist guidelines. CONCLUSION: In this study, the SP' s accuracy in recording checklist items was good to very good, and the result suggested that the accuracy could be improved by the elaboration of checklists and checklist guidelines.
Checklist* ; Educational Measurement ; Humans ; Observer Variation ; Videotape Recording

BACKGROUND: Establishing effective communication between doctor and patient help doctors treat their patients easily and influence patient's compliance with medical regimen and treatment outcome. The objective of this study was to evaluate common characteristic of third-year medical student's behavior in their patient interview and apply these results to medical education of communication. METHODS: Ninety-one third-year medical students in Hanyang University College of Medicine through their clerkship in family medicine had been instructed to perform medical interviews of patients who visited the Department of Family Medicine of Hanyang University Hospital. Video-taped records of the interviews using CCTV were done. The evaluation was done with a rating scale table consisting of 20 items. The rating scale was categorized in to 5 areas: beginning the interviews, collection of information, doctor-patient relationship, structure of interview and ending the interview. RESULTS: Among the 62 students who were enrolled in the study, 55 students were males(84%). In the process of collecting information 33 students(53%) applied open-ended question at least once. Eighteen students(29%) used leading question. In the doctor-patient relationship, 3 students gave empathic verbal response among 58 records which were applicable. In the structure of interview, 25 students(40%) appropriately avoided to shift abruptly the focus of discussion. When ending their interviews, 6 students(10%) clarified the interview in whole. CONCLUSIONS: We conclude that there are several deficiencies in medical students' communication skills during their process of interviews that might influence information gathering and doctor-patient relation ship.
Compliance ; Education, Medical ; Humans ; Physician-Patient Relations ; Ships ; Students, Medical* ; Treatment Outcome

BACKGROUND: Experiences on Objective Structured Clinical Examination(OSCE) for student assessment are limited in medical colleges in Korea. The purposes of this study were to develop an OSCE to fourth-year medical students after completion of all clerkships at Hanyang University Medical College. METHODS: The OSCE was a 8-station examination, with each station taking five minutes. We conducted two parallel OSCEs simultaneously by duplication. We checked each stage of the process in the development of OSCEs with recording of diary. We analysed validity and costs of the OSCE. We got feedback from all participants by questionnaires. RESULTS: Of the total 102 fourth-year students, only 74 persons(72.5%) were evaluated. The rate of pass was 63.5%. Cronbach alpha of the OSCE was 0.14. The scores were different between sites according to stations, especially in items related to attitude and physical. The total OSCE score was not significantly different either between duplication sites or among groups. OSCE scores didn't relate to those of both multiple choice tests and entrance exam for internship. Our use of only a few SP's contributed to relatively low cost of $85 per examinee. Both students and faculty were satisfied with the examination, and felt that the material tested was relevant and appropriate for primary care. The OSCE process served to identify weakness in the curriculum and/or teaching methods, and thus could serve as a mechanism to improve educational effectiveness. CONCLUSIONS: Problems of validity and reliability were detected in the developing process of the OSCE. It appeared financially feasible. Setting appropriate goal, optimum number of station, training of evaluators, development of good checklist, and enthusiastic support of the school's administartion were all needed more to success of such a program.
Checklist ; Curriculum ; Humans ; Internship and Residency ; Korea ; Primary Health Care ; Reproducibility of Results ; Students, Medical* ; Teaching ; Surveys and Questionnaires