Medical schools have been slowly adopting online learning into pedagogical methods for more than a decade. While some medical educators are reluctant to accept these changes, the ongoing coronavirus disease 2019 (COVID-19) pandemic poses a threat to the delivery of traditional medical education, which has accelerated the inevitable implementation of online learning. This sudden change may be a new challenge to medical educators who are new to this territory. Therefore, this review aims to provide foundational concepts of online learning and practical guidelines in the context of medical education. The authors first identify three foundational concepts, which are transactional distance, presence, and independent learners. In online learning, transactional distance, determined by dialogue and structure, becomes more important than physical distance. Furthermore, effective and successful online learning requires the achievement and accommodation of cognitive, social, and teaching presences. It is also crucial to recognize learners not as passive recipients of information predefined by a teacher, but as active, capable, and independent individuals. The authors, then, discuss the practical guidelines for designing an effective online curriculum. Five online pedagogical guidelines are laid out in this review: design structures and flows to embrace experiential learning, accommodate both synchronous and asynchronous learning, design/facilitate interactions, promote practice opportunities, and promote a learning community. By understanding the foundational concepts and applying these guidelines, the adoption of online learning in the medical school may supplement the traditional medical education or even provide additional benefits in the new normal after the COVID-19 pandemic.

Creation of guidelines and education on digital professionalism have been sluggish despite the ever-increasing use of social media by digitally native medical students, who are at risk of blurring the line between their professional and personal lives online. A qualitative thematic analysis was applied on 79 videos extracted from 70,154 YouTube videos uploaded by Korean medical students between March and April 2020. We found 20% contained at least one concerning behavior themed under ‘failure to engage,’ ‘disrespectful behaviors,’ or ‘poor selfawareness.’ Professional lapses identified were classified into seriousness levels. Mostly were “controversial’ or ‘concerning’ but some ‘highly concerning’ contents were also found. This is the first study on digital professionalism behavior on medical students' YouTube videos. The potential negative impact on the medical profession of the easily accessible public online videos cannot be ignored and thus we suggest the need for them to be taken more seriously.

Purpose: Clinical rotations of medical students across the world have inevitably been affected due to the coronavirus disease 2019 (COVID-19) pandemic. The aims of this study were to explore medical students’ perception on the school’s response and management of clinical rotation during the COVID-19 pandemic and on how it had affected the quality of their education. Methods: An online questionnaire was distributed to third year medical students at one institution whose clinical rotations re-started during the pandemic. The questions asked about the students’ satisfaction with the school’s policy and feelings of safety, and the impact of COVID-19 on clinical learning. Results: The students’ perception on the school’s response to the pandemic was mixed. Re-commencement of the clinical rotations and procurement of personal protective equipment was positive but a third of students still felt unsafe. The decreased number of hospital patients did not seem to have impacted their overall clinical education with praise on the role of the supervising physicians. Seventy-six-point seven percent of students conferred the positive educational opportunities on medical professionalism presented to them only as the clinical rotation during the ongoing pandemic. Conclusion Our observations on the re-commencement of clerkship during this pandemic may help equip medical institutions on future public health crisis.

PURPOSE: We are going to establish the efficacy of endoscopic examinations in diagnosing and treating upper GI bleeding in full term neonates. METHODS: We retrospectively reviewed newborns who underwent endoscopic examination because of hematemesis from July 1998 to April 2001. RESULTS: Gestational ages were between 38 and 41weeks, and birth weights were between 2,730 and 3,400 gm. Total of 9 patients were reviewed. Endoscopic examination revealed gastric ulcer in 6 cases, multiple erosions in 2 cases and negative finding in 1 case. All 6 gastric ulcers were multiple and among them 2 patients endoscopic hemostatic therapy. No complication due to the procedure was noticed. Five patients recieved transfusions. All 9 cases were cured through conservative and endoscopic therapy without recurrence. CONCLUSION: The common cause of upper GI hemorrhage in newborns with no preceding disease turns out to be multiple gastric ulcers and the prognosis is good. The endoscopic approach is useful in diagnosing and treating upper GI bleeding in newborns.
Birth Weight ; Gestational Age ; Hematemesis ; Hemorrhage ; Humans ; Infant, Newborn* ; Prognosis ; Recurrence ; Retrospective Studies ; Stomach Ulcer

To investigate the clinical usefulness of the intravenous anesthesia of the facial chemical peeling with midazolam(0.1 mg/kg)-fentanyl(3 ug/kg) - esmolol(initial 500 ug/kg,maintenance 200 ug/kg/min), the authors took 133 cases into consideration. The results of the statistical evaluation were as follows: 1) Most of the cases were small pox scar(70.7%). 2) One point five percent of the cases dreamed during anesthesia. 3) Ninety-four point seven percents of the cases were in the emotion of "Peaceful and relaxed" and 60.1% of them were in the mood of Pleased or very pleased and the others were "So and so". 4) Ninety-one point seven percents of the cases were willing to choose the same anesthetic method next time. 5) Fifty-two point six percents of the cases showed hypertensive episodes during anesthesia. 6) The incidence of the cases with SaO lower than 85% was 36.8%. The anesthetic technique with intravenous midazolam-fentanyl-esmolol for the facial chemical peeling with trichloroacetic acid(TCA) gives the patient comfortness and preference for this anesthetic technique. Close monitoring of the respiration is needed, because it can depress respiratory function. And control of the high blood pressure during anesthesia seems to be needed.
Anesthesia* ; Anesthesia, Intravenous ; Deep Sedation* ; Dreams ; Fentanyl* ; Humans ; Hypertension ; Incidence ; Midazolam* ; Respiration

Objective: To investigate the anatomical characteristics of the biceps femoris short head (BS) and determine the optimal needle placement for BS examination. Methods: Twenty-one lower limbs were dissected. The distances from the medial and lateral margins of the biceps femoris long head (BL) tendon to the common fibular nerve (CFN) (M_CFN_VD and L_CFN_VD, respectively) and the distance from the lateral margin of the BL tendon to the lateral margin of the BS (L_BS_HD) were measured 5 cm proximal to the tip of the fibular head (P1), four fingerbreadths proximal to the tip of the fibular head (P2), and at the upper apex of the popliteal fossa (P3). Results: The BS was located lateral to the BL tendon. The CFN was located along the medial margin of the BL tendon. The median values were 2.0 (P1), 3.0 (P2), and 0 mm (P3) for M_CFN_VD; and 17.4 (P1), 20.2 (P2), and 21.8 mm (P3) for L_CFN_VD; and 8.1 (P1), 8.8 (P2), and 13.0 mm (P3) for L_BS_VD. Conclusion The lateral approach to the BL tendon was safer than the medial approach for examining the BS. Amore proximal insertion site around the upper apex of the popliteal fossa was more accurate than the distal insertion site. In this study, we propose a safer and more accurate approach for electromyography of the BS.