PURPOSE: Ethics objective structured clinical examination (OSCE) scenarios was developed and were applied to medical students to see whether it would be suitable for assessing the students' ethical behaviors. METHODS: The data for this study were gathered from the end-of-clerkship patient-doctor-society OSCE, involving third-year medical students along the academic year of 2006. 54 students who participated in the ethics OSCE, which consisted of three stations, responded. Nine standardized patients (SPs) participated in the evaluation. The SPs were trained for 4 hours to conduct the medical interview and for 2 hours for evaluating students' performance using the checklist for each station. RESULTS: The consistency (Cronbach's alpha) of the SPs was 0.796. Mean score was 57.33. There was no difference among circuits and gender. CONCLUSION: We found that the ethics OSCE was adequate for evaluating students' performances.
Checklist ; Ethics, Medical ; Humans ; Students, Medical

Graduate medical students have been expected to have different characteristics and backgrounds. If it is true, our strategy to educate them should be differentiated. However, basic medical education for graduate entrants in Korea now is not much different from those for non-graduate entrants. Therefore, I investigated the differences between graduate entry and schoolleaver students. Herein, I reviewed their demographics, academic backgrounds, career choice motivation, moral reasoning ability, learning styles and strategy, academic achievement, quality of school life, and outcome after graduation. Also I tried to suggest the differentiated strategy for effective education according to curriculum, teaching and learning, assessment, student support system, and admission selection policy.
Achievement ; Career Choice ; Curriculum ; Demography ; Education, Medical ; Education, Medical, Graduate ; Humans ; Korea ; Learning ; Motivation ; Schools, Medical ; Students, Medical

PURPOSE: The aim of the study is to evaluate the possibility of giving student interns intern- level responsibilities and to discuss the various obstacles. METHODS: Modifications were made to the student internship program, including rotations through major departments, for 4th-year medical students and was conducted at the College of Medicine, Kangwon National University. We surveyed 49 students for the evaluation of the program, administered a checklist evaluation for their performance, and interviewed two focus groups of faculties and residents to find out the obstacles of the program. RESULTS: Most of the students answered that the program was satisfactory and necessary. Of the students, 71.4% performed as an acting intern. The mean score of the students' performance was 84.1. The students had the most difficulty with time management and making diagnostic and management decisions. Initially, at the start of the program, both students and residents were somewhat confused about the student interns' duties. They suggested that definite learning objectives, legal and institutional support to students' clinical practice, and announcements to patients and hospital staff should be put in place prior to the implementation of such a program. CONCLUSION: We discovered that it was possible for student interns to perform at the level of interns. We suggest that systemic improvements continue for the establishment of such student internship program.
Checklist ; Education, Medical ; Focus Groups ; Gangwon-do ; Humans ; Internship and Residency* ; Learning ; Students, Medical ; Time Management

PURPOSE: The aim of this study is to evaluate the students' clinical competency from the patient safety perspective. METHODS: We conducted this evaluation in 2006 at College of Medicine, Kangwon National University. We surveyed 50 fourth-year medical students after finishing all clinical clerkships. 49 Students evaluated their achievement with 5-Likert score scale. The questionnaires were composed 6 domains: communication skills, prevention & management of adverse events, using evidence and information techniques, teamwork & leadership, medical ethical behaviors, and procedural skills. The each domains were constituted several items. Total 53 items was evaluated. RESULTS: The students' preparedness was relatively low in 28 items of the total 53(difficult communication, detecting and managing medical errors, using evidence and information technique, understanding of complex systems, autonomy, and procedural skills). CONCLUSION: The items with low achievement were closely related with medical errors and patient safety. These findings suggest that the clinical education is insufficient for preventing medical errors by students. For patient safety, we should understand the importance of achievement of competency related with patient safety and establish a systematic clinical curriculum with explicit learning outcomes.
Clinical Clerkship ; Curriculum ; Education ; Gangwon-do ; Humans ; Leadership ; Learning ; Medical Errors ; Patient Safety* ; Students, Medical ; Surveys and Questionnaires

PURPOSE: The purpose of this paper was to assess if there is a relationship between Kolb learning styles and learner variables including age, gender, and grade retention among medical students. METHODS: The Kolb Learning Style Inventory(LSI) is used at many educational levels to determine the learning preferences of medical students and clinicians. The students' learning styles were analyzed for associations with learner variables. The Kolb LSI was administered to 164 Kangwon medical students. They were categorized based on learner variables. RESULTS: Kolb's 'assimilator' was the preferred learning style type of the study group(55.2%). 'Accommodator'(17.8%) and 'diverger'(16.0%) were next, followed by 'converger'(11.0%). Learning style preferences of medical students did not vary significantly according to age, gender, and grade retention. CONCLUSION: No statistically significant relationships were identified between the Kolb learning styles and learner variables. The assessment of medical students' learning styles categorized based on Kolb LSI is expected to provide educators with skills to plan teaching strategies, employ a variety of teaching methods, and facilitate academic performance.
Gangwon-do ; Humans ; Learning* ; Students, Medical ; Teaching

BACKGROUND/AIMS: There are many reports in which perioperative transfusion was closely related to the survival of cancer. The long-term survival rate of patients with hepatocellular carcinoma undergoing hepatectomy has improved, and it may be related to the reduction of intraoperative transfusion. The aim of this study is to evaluate the effect of intraoperative transfusion on the prognosis in the hepatectomized hepatocellular carcinoma patients and the relationship between the survival improvement and reduction of intraoperative transfusion. METHODS: From 1988 Jan. to 1995 Dec., 507 cases in which the amount of intraoperative transfusion was known were reviewed. Operative transfusion of whole blood or packed red cells was included in this study. The clinical, operative, and pathological factors were analyzed to identify factors that affected long-term survival and disease free survival. RESULTS: By multivariate analysis, Child classification, the extent of resection, portal vein invasion, and blood transfusion(more than 7 units) were shown to be independent factors in overall survival. Child classification, the number of tumors, portal vein invasion, and blood transfusion(more than 7 units) were shown to be independent factors in disease free survival. CONCLUSION: Operative blood transfusion affects the long-term survival and the disease free survival. Therefore, the intraoperative transfusion should be reduced if possible. Through the improvement of surgical technique and instrument, surgeon can reduce the intraoperative bleeding, and this reduction of intraoperative bleeding may contribute the improvement of survival through the reduction of intraoperative transfusion.
Blood Transfusion ; Carcinoma, Hepatocellular* ; Child ; Classification ; Disease-Free Survival ; Hemorrhage ; Hepatectomy ; Humans ; Multivariate Analysis ; Portal Vein ; Prognosis* ; Survival Rate

PURPOSE: This study was performed to evaluate the usefulness of abdominal computed tomography (CT) for patients with right lower quadrant (RLQ) pain. METHODS: Between January 2006 and July 2008, 191 consecutive patients with RLQ pain underwent abdominal CT (CT group). Forty-two patients who had undergone abdominal ultrasound (US group) and 52 patients without abdominal CT or abdominal ultrasound for RLQ pain (clinical Dx group) underwent emergent operations. Using the Alvarado scoring system, we scored all patients. The abdominal CT was performed in the abdominal and pelvic area with contrast. RESULTS: One hundred twenty-one (63.4%) of the 191 patients in the CT group were preoperatively diagnosed as having acute appendicitis and underwent surgery. There were three cases of negative appendectomy (1.6%). In the US group and the clinical Dx group, the negative appendectomy rates were 4.8% and 3.8%, respectively. The sensitivity of the abdominal CT was 96.7%. In the CT group, in addition to acute appendicitis, colitis, nonspecific enteritis, diverticulitis, urinary stone, ovary, uterine, and diseases were indentified. CONCLUSIONS: In this study, abdominal CT scans in patients with RLQ pain were useful for the diagnosis acute appendicitis and for the differential diagnosis of other diseases presenting with RLQ pain. The false positive rate was significantly lower in the CT group than in the other groups.
Appendectomy ; Appendicitis ; Colitis ; Diagnosis, Differential ; Diverticulitis ; Enteritis ; Female ; Humans ; Ovary ; Urinary Calculi

PURPOSE: Computer-aided diagnosis system was developed to improve the accuracy and the efficacy of the image interpretation. This article is to provide a possibility of computer- aided diagnosis for detection of masses in mammograms. METHODS: The craniocaudal and mediolateral images of 120 mammograms from 30 patients that were histologically proven to be malignant and 30 patients that were histologically proven to be benign were analysed using the mammography softwere. The contralateral mammograms were used as control images. Correct marks of the lesions were scored as a true positive and marks not at the location of the lesions were scored as a false negative. Any marks of the normal images were scored as a false positive and no mark of normal images were scored as a true negative. RESULTS: It took approximately 2 min to scan and 1 min to process 24 by 18-cm mammograms. There was an average of 1.4, 2.0 and 2.1 marks per image in normal, benign and malignant mammograms respectively. Mass detection rate of malignant lesion was 90.0% (27 of 30) and that of benign lesion was 63.6% (21 of 33). Mass detection rate of dense breasts was 68.8% (22 of 32) and that of fatty breasts was 83.9% (26 of 31). Mass detection rate of BI-RADS category 4, 5 and 0 was 85.7% (42 of 49) and that of category 1, 2 and 3 was 42.9% (6 of 14). The overall sensitivity was 76.2% and specificity was 28.1%. CONCLUSION: In this study, mass detection rate for malignant lesions was higher than that of benign lesions and dense breast has lower detection rate than fatty breast. According to the BI-RADS category, mass detection rate was higher in the more malignant category. Computer-aided diagnosis system for this study had limited specificity but acceptable sensitivity.
Breast* ; Diagnosis* ; Humans ; Mammography ; Sensitivity and Specificity

PURPOSE: Recent advances in the internet have enabled us to search for large amounts of medical information. In Korea there are many websites providing medical information, but the quality and quantity of these websites relating to surgery remains to be clarified. Therefore, through the analysis of the surgical websites in Korea, the characteristics and future directions are presented. METHODS: Two hundred and thirteen websites were retrieved using three search engines: Yahoo, Lycos and Naver. We reviewed these websites, and they were classified according to their administrator, subject and content. We also recorded the presence or absence of e-mail addresses, the section on medical counseling and internet reservation. RESULTS: One hundred and sixty-eight websites (78.9%) were administrated by the local clinics. In relation to the main subjects, 94.4% of websites targeted the general public. The main contents of the websites were colorectal and anal disease (83.1%). Of the 168 websites administrated by local clinics, online medical counseling was available in 142 (84.5%) and internet reservation was possible in 39 (23.2%). Most of the local clinics' websites were located in urban area. CONCLUSION: Our study showed surgical websites were led by local clinics, which specialized in colorectal and anal disease. It is emphasized that efforts to informationalization are needed by medical schools, affiliated hospitals and medical associations, and the guidelines enabling validity of medical counseling should be put in place.
Administrative Personnel ; Counseling ; Electronic Mail ; Humans ; Internet ; Korea* ; Schools, Medical ; Search Engine

BACKGROUND/AIMS: In the immunological and functional aspects, freshly isolated human hepatocytes are better than animal hepatocytes from other species such as the pig and hepatocytes from human tumor cell lines. Human liver tissue for hepatocyte isolation can be obtained either from surgical specimens of patients with liver disease, such as hepatocellular carcinoma or from donor livers that are not suitable for transplantation. In the latter case, the liver may be preserved in 4 degrees C UW solution. Therefore, studies of the limit on the preservation time to get clinically applicable hepatocytes, and proper isolation techniques improving cell viability are needed. In this study, the authors isolated hepatocytes from a few kinds of the liver with different UW preservation times and different isolation techniques. METHODS: Male Sprague-Dawley rats weighing 200g-250g were used. The hepatocytes were isolated from unpreserved livers(control), livers preserved for 24 hours in UW solution, and livers preserved for 48 hour in UW solution, with a modified Seglen's two step method. To improve cell viability, 5mM glycin was added to the EDTA solution in one group and in another, the pH of the EDTA solution was slowly changed from 6.5 to 7.25. RESULTS: The control group showed 80.0% of cell viability. 53.8% of isolated hepatocytes were viable even after 24 hours of preservation. The cell viability decreased to 36.1% and severe cellular damage was observed after 48 hours preservation. The glycin and pH change showed no protective effect on the isolation of hepatocytes from UW preserved livers. CONCLUSION: After 24 hours preservation in UW solution, many clinically useful hepatocytes were isolated with a modified Seglen's two step method. Further studies concerning the preservation of functions of hepatocytes isolated from UW preserved livers and on the technique of cell culture and cryopreservation are needed.
Animals ; Carcinoma, Hepatocellular ; Cell Culture Techniques ; Cell Line, Tumor ; Cell Survival ; Cryopreservation ; Edetic Acid ; Hepatocytes* ; Humans ; Hydrogen-Ion Concentration ; Liver Diseases ; Liver* ; Male ; Rats* ; Rats, Sprague-Dawley ; Tissue Donors