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

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: 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

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

PURPOSE: The purpose of this study is to investigate the reliability and validity of new clinical performance examination (CPX) for assessing clinical reasoning skills and evaluating clinical reasoning ability of the students. METHODS: Third-year medical school students (n=313) in Busan-Gyeongnam consortium in 2014 were included in the study. One of 12 stations was developed to assess clinical reasoning abilities. The scenario and checklists of the station were revised by six experts. Chief complaint of the case was rhinorrhea, accompanied by fever, headache, and vomiting. Checklists focused on identifying of the main problem and systematic approach to the problem. Students interviewed the patient and recorded subjective and objective findings, assessments, plans (SOAP) note for 15 minutes. Two professors assessed students simultaneously. We performed statistical analysis on their scores and survey. RESULTS: The Cronbach α of subject station was 0.878 and Cohen κ coefficient between graders was 0.785. Students agreed on CPX as an adequate tool to evaluate students' performance, but some graders argued that the CPX failed to secure its validity due to their lack of understanding the case. One hundred eight students (34.5%) identified essential problem early and only 58 (18.5%) performed systematic history taking and physical examination. One hundred seventy-three of them (55.3%) communicated correct diagnosis with the patient. Most of them had trouble in writing SOAP notes. CONCLUSION: To gain reliability and validity, interrater agreement should be secured. Students' clinical reasoning skills were not enough. Students need to be trained on problem identification, reasoning skills and accurate record-keeping.
Checklist ; *Clinical Competence ; Communication ; Comprehension ; *Education, Medical, Undergraduate ; Educational Measurement/*standards ; Humans ; Medical History Taking ; Medical Records ; Observer Variation ; Physical Examination ; Physician-Patient Relations ; *Problem-Based Learning ; Reproducibility of Results ; Republic of Korea ; *Schools, Medical ; *Students, Medical ; Surveys and Questionnaires ; *Thinking ; Universities

BACKGROUND/AIMS: Auxiliary liver transplantation means a procedure in which part of the native liver is left in situ. In this method, it has been suggested that blocking of portal flow to the native liver (arterialized liver) could potentiate the regeneration of the graft liver. In this study, we evaluate the effect on regeneration capacity of graft liver by blocking the portal flow to the native liver in auxiliary heterotopic liver transplantation in pig. METHODS: Female pigs weighing 25 kg and 30 kg were used as the donor and the recipient for liver transplantation, respectively. After total hepatectomy in the donor pig, graft liver was placed inferior to right liver and superior to right kidney of the recipient. The donor's hepatic vein was anastomosed to infrahepatic inferior vena cava superior to renal vein. The portal vein of the recipient was divided at the hilum and anastomosed with donor's portal vein. The donor's hepatic artery was anastomosed to the aorta below the renal artery. After 1, 3, 5, 7, 15th postoperative days, the weights of native and graft liver, proliferative cell nuclear antigen (PCNA) indices of both livers, and liver function test were checked. RESULTS: During the procedure, hemodynamic status was stable without using venovenous bypass. There was no postoperative death and no severe deterioration of hepatic function. During 5th and 15th postoperative days, PCNA indices of graft liver (40~60%) were higher than those of native liver (30%). The weight of graft liver was increased more than 80% of preoperative value on day 7 and 15. CONCLUSION: By arterialization of the native liver, the regeneration of the small graft liver could be accomplished smoothly without metabolic burden. This animal model is useful for studying graft liver physiology of liver transplantation in preclinical setting. With this study, the first case of auxiliary partial orthotopic liver transplantation was performed successfully in the patients who suffered from metabolic liver disease.
Aorta ; Female ; Hemodynamics ; Hepatectomy ; Hepatic Artery ; Hepatic Veins ; Humans ; Kidney ; Liver Diseases ; Liver Function Tests ; Liver Regeneration ; Liver Transplantation* ; Liver* ; Models, Animal ; Physiology ; Portal Vein ; Proliferating Cell Nuclear Antigen ; Regeneration ; Renal Artery ; Renal Veins ; Swine ; Tissue Donors ; Transplants ; Vena Cava, Inferior ; Weights and Measures

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

PURPOSE: Despite radical lymph node dissection and combined resection, the operative results of treating advanced gastric cancer remains inadequate. The aim of this study was to determine the risk factors for recurrence of gastric cancer and the pattern of recurrence after curative resection for advanced gastric cancer. METHODS: Out of 220 patients who underwent curative resection for advanced gastric cancer from 1990 to 2000, 50 whose recurrence was confirmed by clinical, radiological, endoscopic or reoperative findings were studied retrospectively. We undertook a detailed analysis of the pattern of recurrence based on the morphologic and histopathologic characteristics of the initial tumor. RESULTS: The mean time to recurrence was 19.0 months. Early recurrence was found in 38 patients (76.0%), intermediate recurrence was found in 11 patients (22.0%), and late recurrence was found in 1 patient (2.0%). The patterns of recurrence were as follows: hepatic recurrence was found in 14 cases, peritoneal recurrence in 19 cases, local recurrence in 10 cases, extraperitoneal recurrence in 6 cases. In univariate analysis, the depth of invasion, extent of lymph node metastasis, TNM stage, and combined resection were important for recurrence. In multivariate analysis, depth of invasion and lymph node metastasis were important for recurrence. CONCLUSION: The peritoneal recurrence was the most frequently encountered pattern of recurrence. The two years following surgery was the most important period for recurrence. Depth of invasion and lymph node metastasis were related to recurrence with statistical significance. Since the results of treatment remain dismal, studies of perioperative adjuvant therapy in an attempt to reduce recurrence are warranted.
Humans ; Lymph Node Excision ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Recurrence* ; Retrospective Studies ; Risk Factors ; Stomach Neoplasms*